中华眼科杂志
中華眼科雜誌
중화안과잡지
Chinese Journal of Ophthalmology
2013年
4期
305-308
,共4页
廉井财%张士胜%张静%叶盛
廉井財%張士勝%張靜%葉盛
렴정재%장사성%장정%협성
激光,飞秒%角膜%外科皮瓣%角膜磨镶术,激光原位%激光,准分子%对比研究
激光,飛秒%角膜%外科皮瓣%角膜磨鑲術,激光原位%激光,準分子%對比研究
격광,비초%각막%외과피판%각막마양술,격광원위%격광,준분자%대비연구
Laser,femtosecond%Cornea%Surgical flaps%Keratomileusis,laser in situ%Lasers,excimer%Comparative study
目的 探讨准分子激光原位角膜磨镶术(LASIK)中采用飞秒激光和前弹力层下准分子激光原位角膜磨镶术(SBK)角膜刀制作110μm角膜瓣的相关影响因素.方法 病例对照研究.在对60例(120只眼)近视眼患者进行LASIK,术中分别使用飞秒激光(FS200型,美国Alcon公司)和SBK角膜刀(法国Moria公司)制作110 μm角膜瓣各30例(60只眼),先右眼后左眼,术中测量制瓣前中心角膜及制瓣后中心角膜厚度.样本均数的方差齐性检验采用Levene法,各组样本均数的正态性分布检验经Kolmogorov-Smirnov法结果为正态性分布.术前的基线资料比较采用单因素方差分析；患者左右眼间角膜瓣厚度的比较采用配对t检验.角膜瓣厚度与手术前各种相关因素的关系分析采用逐步回归分析.结果 飞秒激光组患者右眼和左眼的平均角膜瓣厚度分别为(114.0±6.6)和(111.4±7.6)μm,差异无统计学意义(t=1.59,P=0.12).经逐步回归证实飞秒激光制作角膜瓣厚度与手术前年龄、屈光度、角膜厚度、曲率、角膜横径等均无关.角膜刀组患者右眼和左眼的角膜瓣厚度分别为(110.6±7.4)和(108.2±6.1)μm,差异无统计学意义(t=2.019,P=0.054).经逐步回归,只有手术前角膜厚度纳入方程,与年龄、曲率、角膜直径、角膜瓣直径等无关:角膜瓣厚度=67.769+0.076×角膜厚度(F=5.626,P=0.021).角膜瓣厚度和手术前角膜厚度呈正相关(r=0.297,P=0.021).结论 FS200飞秒激光和SBK角膜刀均可很好制作出110 μm左右厚度的角膜瓣.FS200飞秒激光制瓣个性化程度更高,SBK角膜刀的角膜瓣厚度与术前角膜厚度呈正相关.
目的 探討準分子激光原位角膜磨鑲術(LASIK)中採用飛秒激光和前彈力層下準分子激光原位角膜磨鑲術(SBK)角膜刀製作110μm角膜瓣的相關影響因素.方法 病例對照研究.在對60例(120隻眼)近視眼患者進行LASIK,術中分彆使用飛秒激光(FS200型,美國Alcon公司)和SBK角膜刀(法國Moria公司)製作110 μm角膜瓣各30例(60隻眼),先右眼後左眼,術中測量製瓣前中心角膜及製瓣後中心角膜厚度.樣本均數的方差齊性檢驗採用Levene法,各組樣本均數的正態性分佈檢驗經Kolmogorov-Smirnov法結果為正態性分佈.術前的基線資料比較採用單因素方差分析；患者左右眼間角膜瓣厚度的比較採用配對t檢驗.角膜瓣厚度與手術前各種相關因素的關繫分析採用逐步迴歸分析.結果 飛秒激光組患者右眼和左眼的平均角膜瓣厚度分彆為(114.0±6.6)和(111.4±7.6)μm,差異無統計學意義(t=1.59,P=0.12).經逐步迴歸證實飛秒激光製作角膜瓣厚度與手術前年齡、屈光度、角膜厚度、麯率、角膜橫徑等均無關.角膜刀組患者右眼和左眼的角膜瓣厚度分彆為(110.6±7.4)和(108.2±6.1)μm,差異無統計學意義(t=2.019,P=0.054).經逐步迴歸,隻有手術前角膜厚度納入方程,與年齡、麯率、角膜直徑、角膜瓣直徑等無關:角膜瓣厚度=67.769+0.076×角膜厚度(F=5.626,P=0.021).角膜瓣厚度和手術前角膜厚度呈正相關(r=0.297,P=0.021).結論 FS200飛秒激光和SBK角膜刀均可很好製作齣110 μm左右厚度的角膜瓣.FS200飛秒激光製瓣箇性化程度更高,SBK角膜刀的角膜瓣厚度與術前角膜厚度呈正相關.
목적 탐토준분자격광원위각막마양술(LASIK)중채용비초격광화전탄력층하준분자격광원위각막마양술(SBK)각막도제작110μm각막판적상관영향인소.방법 병례대조연구.재대60례(120지안)근시안환자진행LASIK,술중분별사용비초격광(FS200형,미국Alcon공사)화SBK각막도(법국Moria공사)제작110 μm각막판각30례(60지안),선우안후좌안,술중측량제판전중심각막급제판후중심각막후도.양본균수적방차제성검험채용Levene법,각조양본균수적정태성분포검험경Kolmogorov-Smirnov법결과위정태성분포.술전적기선자료비교채용단인소방차분석；환자좌우안간각막판후도적비교채용배대t검험.각막판후도여수술전각충상관인소적관계분석채용축보회귀분석.결과 비초격광조환자우안화좌안적평균각막판후도분별위(114.0±6.6)화(111.4±7.6)μm,차이무통계학의의(t=1.59,P=0.12).경축보회귀증실비초격광제작각막판후도여수술전년령、굴광도、각막후도、곡솔、각막횡경등균무관.각막도조환자우안화좌안적각막판후도분별위(110.6±7.4)화(108.2±6.1)μm,차이무통계학의의(t=2.019,P=0.054).경축보회귀,지유수술전각막후도납입방정,여년령、곡솔、각막직경、각막판직경등무관:각막판후도=67.769+0.076×각막후도(F=5.626,P=0.021).각막판후도화수술전각막후도정정상관(r=0.297,P=0.021).결론 FS200비초격광화SBK각막도균가흔호제작출110 μm좌우후도적각막판.FS200비초격광제판개성화정도경고,SBK각막도적각막판후도여술전각막후도정정상관.
Objective To determine flap thickness variation in 110 μm thickness flap made by FS200 femtosecond laser and sub-Bowman keratiomileusis (SBK) microkeratome for studying the potential factors that affect the flap thickness.Methods It was a case-control study.Sixty patients were divided into two groups for laser in situ keratomileusis.The corneal flaps were made by using Alcon Wavelight FS200 femtosecond laser or MORIA SBK microkeratome.Central corneal flap thickness was calculated by subtraction pachymetry.Age,central corneal thickness (CCT),spherical equivalent refraction,mean keratometry and corneal diameter were recorded preoperatively for statistics.Results This study comprised 120 eyes of 60 patients; 60 eyes were treated with each group.In Alcon Wavelight FS200 femtosecond laser group,the mean corneal flap thickness in the right and left eyes was (114.0 ± 6.6) and (111.4 ± 7.6)μm,respectively.The difference in corneal flap thickness between the right eye and the left eye (2.6 ±9.1) μm was not statistically significant (t=1.59,P=0.12).Corneal flap thickness had no relationship with the age,preoperatively CCT,spherical equivalent refraction,corneal curvature and corneal diameterthrough stepwise regression analysis.In SBK microkeratome group,the mean corneal flap thickness in theright eye and the left eye was (110.6 ±7.4) and (108.2 ±6.1) μm respectively.The difference in corneal flap thickness between the right eye and the left eye (2.4 ± 6.6) μm was not statistically significant (t =2.019,P =0.054).Corneal flap thickness was positively correlated with preoperative CCT through stepwise regression analysis (r =0.29,P =0.021).Corneal flap thickness equaled to 67.77 + 0.076 · CCT (F =5.63,P =0.021).Corneal flap thickness had no relationship with the age,spherical equivalent refraction,corneal curvature and corneal diameter.Conclusions Both FS200 femtosecond laser and SBK microkeratome can be used for making a good 110 μm thickness flap.Central corneal flap thickness was positively correlated with the preoperative CCT using the SBK microkeratome.
