中华眼视光学与视觉科学杂志
中華眼視光學與視覺科學雜誌
중화안시광학여시각과학잡지
CHINESE JOURNAL OF OPTOMETRY OPHTHALMOLOGY AND VISUAL SCIENCE
2013年
11期
680-683
,共4页
刘才远%汤勇%蒋瑜%潘秀珍%汤元昕%陈萍%虞燕
劉纔遠%湯勇%蔣瑜%潘秀珍%湯元昕%陳萍%虞燕
류재원%탕용%장유%반수진%탕원흔%진평%우연
近视%屈光外科手术%中央角膜厚度
近視%屈光外科手術%中央角膜厚度
근시%굴광외과수술%중앙각막후도
Myopia%Refractive surgical procedures%Central corneal thickness
目的 调查2种不同的准分子激光设备和1种全飞秒激光手术设备用于准分子激光原位角膜磨镶术(LASIK)时对中央角膜厚度切削误差的影响,探索角膜切削误差的变化规律.方法 前瞻性病例对照研究.使用A型超声角膜测厚仪测量分别应用3种不同设备行手术治疗的138例(274眼)患者术前及术后1个月的中央角膜厚度.其中51例(100眼)使用Esiris机器行LASIK手术(Esiris-LASIK),50例(100眼)使用Visx S4-IR机器行LASIK手术(Visx-LASIK组),37例(74眼)使用VisuMax机器行SMILE手术(VisuMax-SMILE组).所有眼按屈光度分为低、中、高度3组,分别计算中央角膜厚度及角膜切削误差,并分析切削误差与不同设备、近视程度、散光程度、角膜切削直径及手术前角膜厚度的关系.采用单样本t检验、双因素方差分析及Pearson相关进行数据分析.结果 3组病例中,近视程度、术前中央角膜厚度及术前散光度对角膜切削误差均没有显著影响,设备或手术方式对角膜切削误差有显著的影响.在Esiris-LASIK组中,角膜的实际切削厚度小于预期切削厚度,差异有统计学意义(低度近视组,t=4.672,P<0.01;中度近视组,t=10.629,P<0.01;高度近视组,t=11.021,P<0.01);Visx-LASIK组中,角膜的实际切削厚度大于预期切削厚度,差异有统计学意义(低度近视组,t=3.910,P<0.01;中度近视组,t=4.922,P<0.01;高度近视组,t=4.807,P<0.01);在VisuMax-SMILE组中,角膜的实际切削厚度与预期切削厚度差异无统计学意义(中度近视组,t=1.158,P>0.05;高度近视组,t=0.836,P>0.05).结论 不同的手术设备会显著影响屈光手术中中央角膜厚度的切削误差.
目的 調查2種不同的準分子激光設備和1種全飛秒激光手術設備用于準分子激光原位角膜磨鑲術(LASIK)時對中央角膜厚度切削誤差的影響,探索角膜切削誤差的變化規律.方法 前瞻性病例對照研究.使用A型超聲角膜測厚儀測量分彆應用3種不同設備行手術治療的138例(274眼)患者術前及術後1箇月的中央角膜厚度.其中51例(100眼)使用Esiris機器行LASIK手術(Esiris-LASIK),50例(100眼)使用Visx S4-IR機器行LASIK手術(Visx-LASIK組),37例(74眼)使用VisuMax機器行SMILE手術(VisuMax-SMILE組).所有眼按屈光度分為低、中、高度3組,分彆計算中央角膜厚度及角膜切削誤差,併分析切削誤差與不同設備、近視程度、散光程度、角膜切削直徑及手術前角膜厚度的關繫.採用單樣本t檢驗、雙因素方差分析及Pearson相關進行數據分析.結果 3組病例中,近視程度、術前中央角膜厚度及術前散光度對角膜切削誤差均沒有顯著影響,設備或手術方式對角膜切削誤差有顯著的影響.在Esiris-LASIK組中,角膜的實際切削厚度小于預期切削厚度,差異有統計學意義(低度近視組,t=4.672,P<0.01;中度近視組,t=10.629,P<0.01;高度近視組,t=11.021,P<0.01);Visx-LASIK組中,角膜的實際切削厚度大于預期切削厚度,差異有統計學意義(低度近視組,t=3.910,P<0.01;中度近視組,t=4.922,P<0.01;高度近視組,t=4.807,P<0.01);在VisuMax-SMILE組中,角膜的實際切削厚度與預期切削厚度差異無統計學意義(中度近視組,t=1.158,P>0.05;高度近視組,t=0.836,P>0.05).結論 不同的手術設備會顯著影響屈光手術中中央角膜厚度的切削誤差.
목적 조사2충불동적준분자격광설비화1충전비초격광수술설비용우준분자격광원위각막마양술(LASIK)시대중앙각막후도절삭오차적영향,탐색각막절삭오차적변화규률.방법 전첨성병례대조연구.사용A형초성각막측후의측량분별응용3충불동설비행수술치료적138례(274안)환자술전급술후1개월적중앙각막후도.기중51례(100안)사용Esiris궤기행LASIK수술(Esiris-LASIK),50례(100안)사용Visx S4-IR궤기행LASIK수술(Visx-LASIK조),37례(74안)사용VisuMax궤기행SMILE수술(VisuMax-SMILE조).소유안안굴광도분위저、중、고도3조,분별계산중앙각막후도급각막절삭오차,병분석절삭오차여불동설비、근시정도、산광정도、각막절삭직경급수술전각막후도적관계.채용단양본t검험、쌍인소방차분석급Pearson상관진행수거분석.결과 3조병례중,근시정도、술전중앙각막후도급술전산광도대각막절삭오차균몰유현저영향,설비혹수술방식대각막절삭오차유현저적영향.재Esiris-LASIK조중,각막적실제절삭후도소우예기절삭후도,차이유통계학의의(저도근시조,t=4.672,P<0.01;중도근시조,t=10.629,P<0.01;고도근시조,t=11.021,P<0.01);Visx-LASIK조중,각막적실제절삭후도대우예기절삭후도,차이유통계학의의(저도근시조,t=3.910,P<0.01;중도근시조,t=4.922,P<0.01;고도근시조,t=4.807,P<0.01);재VisuMax-SMILE조중,각막적실제절삭후도여예기절삭후도차이무통계학의의(중도근시조,t=1.158,P>0.05;고도근시조,t=0.836,P>0.05).결론 불동적수술설비회현저영향굴광수술중중앙각막후도적절삭오차.
Objective To evaluate the precision of laser in situ keratomileusis (LASIK) using two different devices,the Esiris excimer and Visx S4-IR laser systems,and small incision lenticule extraction (SMILE) surgery with the VisuMax femtosecond laser system.Methods This was a prospective case control study.Central corneal thickness was measured by using ultrasonic pachymetry before and 1 month after surgery in 274 consecutive eyes of 138 patients with no previous history of surgery.Corneal refractive surgery was then performed on all patients.Among all eyes,100(51 patients) underwent LASIK with the Esiris excimer laser system; 100(50 patients) underwent LASIK with the Visx S4-IR excimer laser system; and 74(37 patients) underwent SMILE with the VisuMax femtosecond laser system.The changes in central corneal thickness before and after surgery were compared with their theoretically expected values calculated before surgery.The differences between them were defined as the central corneal cutting error,the index of the surgical precision,and were compared for different types of surgery and different magnitudes of refractive errors.An independent sample t test,two-way analysis of variance and Pearson correlation were used for data analysis.Results The extent of myopia,the extent of astigmatism and the central corneal thickness before surgery had no significant effects on the central corneal cutting error.In contrast,the cutting error showed significant differences between groups,suggesting a strong effect based on the equipment and procedure used in the refractive surgery.In the Esiris-LASIK group,there were significant differences (low myopia,t=4.672,P<0.01; moderate myopia,t=10.629,P<0.01; high myopia,t=11.021,P<0.01) between the changes in central corneal thickness and their expected values.Similarly,there were significant differences (low myopia,t=3.910,P<0.01; moderate myopia,t=4.922,P<0.01; high myopia,t=4.807,P<0.01) between the changes in central corneal thickness and their expected values in the Visx-LASIK group.In contrast,the central corneal cutting error was statistically equivalent to zero for both moderate (t=1.158,P>0.05) and high (t=0.836,P>0.05) myopia in the VisuMax-SMILE group.Conclusion There are significant differences in central corneal cutting error when corneal refractive surgeries are performed with different devices.