One Use-Plsu SBK微型板层角膜刀椭圆形负压吸引环制作LASIK角膜瓣的特点

Characteristic of LASIK corneal flap creation by oval vacuum suction ring of One Use-Plsu SBK microkeratome

目的观察Moria公司的OneUse-PlusSBK微型板层角膜刀圆形及椭圆形负压吸引环制作LASIK角膜瓣的特点及术中并发症,评估两种形态负压吸引环制作角膜瓣的安全性、预测性。方法使用椭圆形负压吸引环行LASIK手术65例(130眼)作为试验组,同期使用圆形负压吸引环62例(124眼)作为对照组,预设角膜瓣厚度均为100μm。术中使用卡尺测量角膜瓣直径,术后1周使用傅立叶域光学相干断层扫描仪测量角膜瓣厚度。结果试验组角膜瓣水平径为(8.72±0.32)mm,垂直径为(8.84±0.35)mm;对照组角膜瓣水平径为(8.53±0.33)mm,垂直径为(8.92±0.36)mm;两组比较试验组角膜瓣水平径大于对照组(t=2.740,P<0.05),垂直径差异无统计学意义(P>0.05)。试验组和对照组角膜瓣直径与术前角膜直径、角膜厚度及角膜中央K值均无明显相关性(均为P>0.05)。试验组角膜瓣厚度为(108.61±10.06)μm,对照组角膜瓣厚度为(107.65±5.78)μm,两组差异有统计学意义(t=4.805,P<0.05)。对照组角膜瓣厚度集中分布在101～110μm(62.9%),试验组角膜瓣厚度集中趋势差。试验组术中角膜瓣缘出血5眼(3.8%),鲸尾征14眼(10.8%);对照组角膜瓣缘出血24眼(19.4%),鲸尾征46眼(37.1%)。结论椭圆形负压吸引环制作的角膜瓣安全性较好,但预测性较差。

Objective To observe the corneal flap characteristics and complication by round and oval vacuum suction ring of One Use-Plsu SBK microkeratome,and assess the safety and predictability of two types of vacuum suction ring.Methods A total of 65 patients（130 eyes） received oval ring as experimental group,and at the same time 62 patients（124 eyes） received round ring as control group,the intended flap thickness were both 100 μm.The flap diameter was measured by caliper rule.One week after surgery,the flap thickness was measured by optical coherence tomography.Results Horizontal and vertical flap diameters in experimental group were（8.72±0.32）mm and（8.84±0.35）mm,which in control group were（8.53±0.33）mm and（8.92±0.36）mm,there was statistical difference in horizontal flap diameter between two groups（t=2.740,P0.05）,but no statistical difference in vertical flap diameter（P0.05）.Flap diameter of two groups was not correlated with preoperative corneal diameter,corneal thickness and corneal central K value（both P0.05）.Corneal flap thickness in experimental group and control group were（108.61±10.06）μm and（107.65±5.78）μm,there was statistical difference（t=4.805,P0.05）.The centralized distribution of corneal flap thickness in control group was from 101 μm to 110 μm（62.9%）,which in experimental group had poor centralized trend.Corneal flap edge hemorrhage and edge epithelial defect in experimental group were in 5 eyes（3.8%） and 14 eyes（10.8%）,which in control group were in 24 eyes（19.4%） and 46 eyes（37.1%）.Conclusion Corneal flap created by oval vacuum suction ring has good safety,but the predictability is poor.