飞秒激光和机械刀行LASIK术后角膜神经形态学特征的共焦显微镜观察

Morphologic characteristics of corneal nerve with confocal microscopy in intralase femtosecond laser and mechanical microkeratome for laser in situ keratomileusis

目的在共焦显微镜下观察飞秒激光和机械刀行准分子激光原位角膜磨镶术(LASIK)术后角膜神经的形态差异。方法近视眼患者34例(68只眼),一组行飞秒激光下的LASIK(28只眼),另一组行Moria-2机械刀下的LASIK(40只眼),术后1个月、3个月对两组角膜在共焦显微镜下进行观察。结果术后各时期两组裸眼视力无显著性差异,术后1个月两组角膜瓣界面均可见高反光颗粒,未见完整神经纤维,术后3个月,飞秒激光组角膜神经完整性明显高于机械刀组(P<0.01)。结论飞秒激光行LASIK术后角膜神经的修复快于机械刀。

Objective To assess and compare corneal nerve modifications induced by Intralase PulsionFS femtosecond laser and mechanical microkeratome Moria-2 for laser in situ keratomileusis（LASIK） using confocal microscope.Methods In this study,28 eyes of 14 patients were examined with the confocal microscope in the follow-up of IntraLase femtosecond laser for LASIK myopic surgery.Forty eyes from 20 patients were also examined after mechanical microkeratome Moria-LASIK surgery.In both groups,the patients underwent the first follow-up examination on month 1 and 3 months after surgery.Morphologic modifications of corneal architecture were evaluated,and comparisons were made between the two corneal nerve modifications.Results All eyes showed small reflective particles at the corneal flap interface at 1 month.The mean number of reflective particles was not statistically significantly different at 1 month（P =0.28） using a femtosecond laser and a mechanical microkeratome.At month 3,the number of long-connect nerve was statistically significantly different（P = 0.00）.Conclusion This study reveals corneal nerve regeneration different between the interfaces obtained by femtosecond laser and mechanical microkeratome,the IntraLase LASIK showed more integrity than that induced by the mechanical microkeratome about corneal nerve modifications.