90 μm及130 μm角膜瓣LASIK对比探究.docVIP

90 μm及130 μm角膜瓣LASIK对比探究 　【摘要】 观察90 μm超薄角膜瓣与常规130 μm角膜瓣准分子激光原位磨镶术（LASIK）的疗效和并发症，探讨超薄瓣的优缺点。方法 选取自愿使用Moria 9 0 μm一次性刀头和使用常规Moria 130 μm重复使用刀头做角膜瓣行LASIK治疗的患者各50例100眼，术中测量实际角膜瓣厚度，观察两组角膜瓣形态、对合情况、术后反应、并发症，检测两组术前后屈光度、角膜厚度、角膜瓣厚度、剩余角膜基质厚度及术后预测视力。结果 治疗组实际角膜瓣厚度为（92.5±4.9）μm，对照组实际角膜瓣厚度为（138±15）μm，两组角膜瓣形态、对合情况、术后反应和术后预期视力相当。治疗组并发症更少，术前屈光度较大，角膜厚度较小而保留的角膜基质床更厚。结论 90 μm超薄角膜瓣LASIK疗效和常规130μm角膜瓣LASIK相当，保留角膜基质床相对较多，可矫治的屈光度更大，具有更好的安全性和更宽的适应范围。 【关键词】 角膜瓣 准分子激光原位磨镶术 准分子激光 ［Abstract］ Objective To analyze the therapy and complication of corneal flap thickness of 90 μm and 130 μm in LASIK,and to discuss value or disadvantage of the ultrathin 90 μm flap.Methods 100 cases of voluntary were chose,50 cases（100 eyes） used the Moria 90 μm disposable tool,the other 100 eyes used conventional repetitive Moria 130 μm tool to make cornea falp.Measured the actual cornea flap thickness and the cornea flap shape in the surgery,observed complications between two groups.Before and after surgery,we examined and observed the diopter,cornea thickness,cornea flap thickness,surplus corneal stroma thickness,and forecasted the vision postoperative.Results The actual cornea flap thickness was （92.5±4.9）μm in treatment group,and （138±15）μm in the control group.There was no difference in cornea flap shape,anticipated vision between two groups.The complication of the treatment group was less,the diopter was large,the corneal stroma bed thickness was thinner and retained to be thicker.Conclusion Ultrathin cornea flap LASIK retains thicker corneal stroma bed,it may correct bigger diopter,has better security and wider adaptation. ［Key words］ cornea flap;LASIK;excimer laser 准分子激光治疗近视近年来普遍开展，发展很快。准分子激光原位磨镶术（laser in situ keratomileusis ,LASIK）较PRK、LASEK、Epi-LASIK具有术后反应轻、视力恢复快等优点,有较好的稳定性、安全性和可预测性，近视患者普遍乐于接受。目前普遍使用Moria 2旋转式微角膜切开刀做角膜瓣，常规使用130 μm刀头，角膜瓣厚约130～160 μm。由于角膜瓣的厚度直接影响到手术可切削的深度以及保留的角膜基质床厚度。常规LASIK对高度近视或角膜偏薄的患者不能适应。近2年来我院部分患者使用Moria 90 μm一次性刀头做角膜瓣行LASIK 手术，为了解其疗效和安全性，与使用130 μm重复性刀头做角膜瓣的常规LASIK做一对比研究。 1 资料与方法 1.1