CAJ | 학술논문

目的观察准分子激光原位角膜磨镶术(laser insitu keratomileusis,LASIK)和飞秒激光基质透镜切除术(Femto-Second Lenticule Extraction,FLEx)术后瓣缘切口的愈合情况.方法临床病例不同术式对照研究.对2011年10月至2012年8月在南京中医药大学第一附属医院眼科行LASIK手术患者20例(40只眼)、FLEx手术患者20例(40只眼),术后行激光共聚焦显微镜检查,观察角膜瓣组织在上皮层、前弹力层及基质层于术后1周、1个月和3个月时愈合及组织动态变化.结果两种手术方式的角膜瓣缘在术后均可能于前弹力层及基质层形成缝隙.飞秒激光瓣缘切口较机械刀切口明显整齐,但比机械刀更容易产生缝隙和上皮栓;FLEx手术后瓣缘缝隙宽度自前弹力层至角膜瓣底层呈逐渐增宽趋势(P＜0.01),且以瓣蒂所在位置对侧方位最宽(P＜0.01).结论飞秒激光和机械刀产生的的瓣缘愈合过程有显著区别,推测FLEx术后角膜瓣基质组织反应较LASIK术式明显,从而造成角膜瓣向心性皱缩是导致这种差异的原因.
목적 관찰준분자격광원위각막마양술(laser insitu keratomileusis,LASIK)화비초격광기질투경절제술(Femto-Second Lenticule Extraction,FLEx)술후판연절구적유합정황.방법 림상병례불동술식대조연구.대2011년10월지2012년8월재남경중의약대학제일부속의원안과행LASIK수술환자20례(40지안)、FLEx수술환자20례(40지안),술후행격광공취초현미경검사,관찰각막판조직재상피층、전탄력층급기질층우술후1주、1개월화3개월시유합급조직동태변화.결과 량충수술방식적각막판연재술후균가능우전탄력층급기질층형성봉극.비초격광판연절구교궤계도절구명현정제,단비궤계도경용역산생봉극화상피전;FLEx수술후판연봉극관도자전탄력층지각막판저층정축점증관추세(P＜0.01),차이판체소재위치대측방위최관(P＜0.01).결론 비초격광화궤계도산생적적판연유합과정유현저구별,추측FLEx술후각막판기질조직반응교LASIK술식명현,종이조성각막판향심성추축시도치저충차이적원인.
Objective To observe the tissue healing of cornea flap margin after laser in situ keratomileusis (LASIK) and Femto-Second Lenticule Extraction (FLEx).Methods Confocal microscopy was used to observe comea flap margin tissue 1 week,1 month and 3 months after surgery in 80 eyes of 40 LASIK and FLEx patients.Results Two flap-formation techniques created empty spaces at the flap margin with epithelial cells filling in Bowan's and stroma layers after operation.Flap border created by the Femtosecond Laser (FS) was more regularly,but with more empty spaces and epithelial plug.The width of empty spaces broadened as the increasing of depth,and the maximum was in the contralateral side of flap pedicel.Conclusions There is significant difference between LASIK and FLEx in tissue healing of comea flap margin.It presumes that concentric shrinkage of flap created by stroma edema after FLEx is probably the cause of this difference.