中华眼科杂志
中華眼科雜誌
중화안과잡지
Chinese Journal of Ophthalmology
2012年
5期
390-393
,共4页
买志彬%刘苏冰%聂晓丽%孙宏霞%辛宝莉%唐秀侠
買誌彬%劉囌冰%聶曉麗%孫宏霞%辛寶莉%唐秀俠
매지빈%류소빙%섭효려%손굉하%신보리%당수협
激光%外科皮瓣%角膜磨镶术,激光原位
激光%外科皮瓣%角膜磨鑲術,激光原位
격광%외과피판%각막마양술,격광원위
Lasers%Surgical flaps%Keratomileusis,laser in situ
目的 探讨准分子激光原位角膜磨镶术(LASIK)中应用FEMTO LDV型飞秒激光仪制作角膜瓣的可预测性及影响角膜瓣厚度及横径的相关因素.方法 系列病例研究.将260例近视眼按预设角膜瓣厚度分为110μm组(208只眼)和90μm组(52只眼),角膜瓣横径8.5～9.5 mm.对角膜瓣实际横径与预设角膜瓣横径及角膜瓣实际厚度与预设角膜瓣厚度分别进行差异性分析,对相关影响因素进行多元逐步同归分析.结果 110 μm组与90μm组的角膜瓣厚度测量值分别为(104.81±3.09)、(95.12±7.65) μm,与目标值比较,差异均无统计学意义(t=- 1.743,-1.892;P＞0.05).110μm组及90μm组患者的角膜厚度分别为(550.81±32.88)、(509.13±23.25) μm,年龄分别为(24.80±5.08)、(25.20±6.11)岁,角膜中央最大K值分别为(45.01±1.55)、(45.20±1.59)D,角膜瓣横径分别为(9.04±0.19)、(8.98±0.23)mm,眼压分别为(15.73±2.44)、( 14.65±1.50)mm Hg(1mmHg=0.133 kPa).相关性分析显示,两组角膜瓣厚度与角膜瓣横径呈负相关(r=-0.143,-0.315;P ＜0.05),与患者术前年龄(r=-0.160,0.024)、角膜厚度(r=0.054,0.074)、角膜中央最大K值(r=-0.011,-0.212)及眼压(r=-0.008,0.038)均无相关性(P＞0.05).8.5、9.5 mm负压环的角膜厚度分别为(537.14±35.81)、(541.45±39.64) μm,角膜中央最大K值分别为(45.35±1.59)、(44.25±1.41)D.相关性分析显示,角膜瓣横径与术前角膜中央最大K值呈正相关(r=0.580,0.451；P＜0.001).结论 FEMTO LDV型飞秒激光仪制作角膜瓣预测性好,角膜瓣横径是角膜瓣厚度的影响因素.
目的 探討準分子激光原位角膜磨鑲術(LASIK)中應用FEMTO LDV型飛秒激光儀製作角膜瓣的可預測性及影響角膜瓣厚度及橫徑的相關因素.方法 繫列病例研究.將260例近視眼按預設角膜瓣厚度分為110μm組(208隻眼)和90μm組(52隻眼),角膜瓣橫徑8.5～9.5 mm.對角膜瓣實際橫徑與預設角膜瓣橫徑及角膜瓣實際厚度與預設角膜瓣厚度分彆進行差異性分析,對相關影響因素進行多元逐步同歸分析.結果 110 μm組與90μm組的角膜瓣厚度測量值分彆為(104.81±3.09)、(95.12±7.65) μm,與目標值比較,差異均無統計學意義(t=- 1.743,-1.892;P＞0.05).110μm組及90μm組患者的角膜厚度分彆為(550.81±32.88)、(509.13±23.25) μm,年齡分彆為(24.80±5.08)、(25.20±6.11)歲,角膜中央最大K值分彆為(45.01±1.55)、(45.20±1.59)D,角膜瓣橫徑分彆為(9.04±0.19)、(8.98±0.23)mm,眼壓分彆為(15.73±2.44)、( 14.65±1.50)mm Hg(1mmHg=0.133 kPa).相關性分析顯示,兩組角膜瓣厚度與角膜瓣橫徑呈負相關(r=-0.143,-0.315;P ＜0.05),與患者術前年齡(r=-0.160,0.024)、角膜厚度(r=0.054,0.074)、角膜中央最大K值(r=-0.011,-0.212)及眼壓(r=-0.008,0.038)均無相關性(P＞0.05).8.5、9.5 mm負壓環的角膜厚度分彆為(537.14±35.81)、(541.45±39.64) μm,角膜中央最大K值分彆為(45.35±1.59)、(44.25±1.41)D.相關性分析顯示,角膜瓣橫徑與術前角膜中央最大K值呈正相關(r=0.580,0.451；P＜0.001).結論 FEMTO LDV型飛秒激光儀製作角膜瓣預測性好,角膜瓣橫徑是角膜瓣厚度的影響因素.
목적 탐토준분자격광원위각막마양술(LASIK)중응용FEMTO LDV형비초격광의제작각막판적가예측성급영향각막판후도급횡경적상관인소.방법 계렬병례연구.장260례근시안안예설각막판후도분위110μm조(208지안)화90μm조(52지안),각막판횡경8.5～9.5 mm.대각막판실제횡경여예설각막판횡경급각막판실제후도여예설각막판후도분별진행차이성분석,대상관영향인소진행다원축보동귀분석.결과 110 μm조여90μm조적각막판후도측량치분별위(104.81±3.09)、(95.12±7.65) μm,여목표치비교,차이균무통계학의의(t=- 1.743,-1.892;P＞0.05).110μm조급90μm조환자적각막후도분별위(550.81±32.88)、(509.13±23.25) μm,년령분별위(24.80±5.08)、(25.20±6.11)세,각막중앙최대K치분별위(45.01±1.55)、(45.20±1.59)D,각막판횡경분별위(9.04±0.19)、(8.98±0.23)mm,안압분별위(15.73±2.44)、( 14.65±1.50)mm Hg(1mmHg=0.133 kPa).상관성분석현시,량조각막판후도여각막판횡경정부상관(r=-0.143,-0.315;P ＜0.05),여환자술전년령(r=-0.160,0.024)、각막후도(r=0.054,0.074)、각막중앙최대K치(r=-0.011,-0.212)급안압(r=-0.008,0.038)균무상관성(P＞0.05).8.5、9.5 mm부압배적각막후도분별위(537.14±35.81)、(541.45±39.64) μm,각막중앙최대K치분별위(45.35±1.59)、(44.25±1.41)D.상관성분석현시,각막판횡경여술전각막중앙최대K치정정상관(r=0.580,0.451；P＜0.001).결론 FEMTO LDV형비초격광의제작각막판예측성호,각막판횡경시각막판후도적영향인소.
Objective To observe the predictability of corneal flap creation with the FEMTO LDV femtosecond laser and analyze preliminarily the factors correlating to the thickness and diameter of the flap.Methods It was a study of serial cases.260 eyes of 130 consecutive patients were treated with the FEMTO LDV.The eyes were assigned to two groups according to intended flap thickness,110 μm (208eyes) and 90μm (52 eyes).Intended flap diameter varied from 8.5 to 9.5 mm.Difference analysis of flap diameter and intended diameter as well as flap thickness and intended thickness were made.The data was analyzed with SPSS to sum up a multiple stepwise regression formula that could express their quantitative relationship.Results The 90 μm flap group had a average flap thickness of (95.12 ±7.65)μm,while for the 110 μm group the average flap thickness was (104.81 ±t 3.09 )μm.The difference between right and left eyes was not statistically significant ( t110 μm =- 1.223,t90 μm =- 1.343,P ＞ 0.05 ).Corneal flap thickness was inversely correlated with flap diameter ( r110 μm =- 0.143,r90μm =- 0.315,P ＜ 0.05 ),but was not related to preoperative patient age,corneal thickness,keratometric value K or intraocular pressure (r110μm =-0.160,0.054,-0.011,-0.363; r90:=0.024,0.074,-0.212,-0.434,all P＞0.05).Corneal flap diameter was positively correlated with preoperative corneal keratometric value K and thickness ( P ＜0.001,P ＜0.05).Multiple stepwise regression analysis showed flap diameter was an influencing factor for flap thickness.Preoperative corneal keratometric value K and thickness were influencing factors for flap diameter. Conclusions The LASIK flap creation with the FEMTO LDV laser has relatively good predictability.Flap diameter is an influencing factor for flap thickness.
