传统与个体化LASIK术中实际角膜切削深度的对比研究

Comparison of corneal ablation depth during individual and conventional LASIK

目的:对比研究传统与个体化准分子激光原位角膜磨镶术(laser in situ keratomileusis,LASIK)中实际角膜切削深度的差异。方法:前瞻性对照研究,随机选取采用Technolas 217z100型准分子激光机进行LASIK手术的中低度近视及近视散光患者87例161眼,分为传统切削组和个体化切削组。术中采用光学相干厚度测量仪(online optical coherence pachymetry,OCP)实时监测所有患者的角膜厚度,并记录掀瓣后激光切削前及切削后的角膜基质厚度,计算出实际角膜切削深度。比较各组实际角膜切削深度与理论切削深度的差异及两组实际角膜切削深度与理论切削深度差值的组间差异。结果:传统切削组实际角膜切削深度为94.37±22.76μm,理论切削深度为85.69±21.19μm,差异有统计学意义(P<0.05)。个体化切削组实际角膜切削深度为90.08±15.98μm,理论切削深度为76.30±13.65μm,差异有统计学意义(P<0.05)。传统切削组实际角膜切削深度较理论切削深度增加8.68±6.30μm,个体化切削组实际角膜切削深度较理论切削深度增加13.78±7.63μm,差异有统计学意义(P<0.05)。个体化切削组实际角膜切削深度与理论切削深度差值较传统切削组切削深度差值增加5.10±1.10μm。结论:传统LASIK及个体化LASIK术中实际角膜切削深度均比理论切削深度增加。个体化LASIK中实际角膜切削深度偏差较传统LASIK切削深度偏差更大。

AIM：To compare the difference of actual corneal ablation depth during individual and conventional laser in situ keratomileusis（LASIK）.METHODS：Prospective comparative study.161 eyes of 87 low and moderate myopia patients accepted refractive surgery with the Technolas 217z100 excimer laser system.Two groups were divided according to the type of operation：conventional LASIK and individual LASIK.The corneal thickness was continuously assessed intraoperatively with online optical coherence pachymetry（OCP）.The residual stromal thickness before and after laser ablation were recorded,and then the actual corneal ablation depth was calculated.The values of actual and theoretical ablation depth,and the difference in the two groups were compared.RESULTS：：In conventional-LASIK group,the actual corneal ablation depth and theoretical ablation depth were 94.37±22.76μm and 85.69±21.19μm respectively（P0.05）;In individual-LASIK group,the actual corneal ablation depth and theoretical ablation depth were 90.08±15.98μm and 76.30±13.65μm respectively,（P0.05）.In conventional-LASIK group,the actual corneal ablation depth was increased in 8.68±6.30μm than the theoretical ablation depth.In individual-LASIK group,the actual corneal ablation depth was increased in 13.78±7.63μm than the theoretical ablation depth（P0.05）.The difference in individual-LASIK group was about 5.10±1.10μm thicker than that in conventional-LASIK group.CONCLUSION：Actual ablation depth was thicker than theoretical ablation depth in both conventional LASIK and individual LASIK.The difference of actual corneal ablation depth and theoretical ablated depth in individual LASIK is more than that in conventional LASIK.