飞秒激光制瓣负压吸引对视网膜神经纤维层厚度和神经节细胞复合体厚度的影响

Effects of suction on RNFL and GCC thickness in femtosecond laser flapping

目的探讨准分子激光原位角膜磨镶术(laserinsitukeratomileusis,LASIK)中飞秒激光制瓣过程负压吸引对近视患者视网膜神经纤维层(retinal nerve fiber layer,RNFL)厚度和视网膜神经节细胞复合体(ganglion cell compound,GCC)厚度的影响。方法选取69例(138眼)拟行飞秒激光LASIK术的近视患者。分别于术前及术后1周、1个月应用RTVueFD-OCT检测视盘旁RNFL厚度和GCC厚度,扫描模式分别为视盘ONH及GCC程序。比较术后1周、1个月RNFL厚度和GCC厚度与术前的差异。结果术后1周、1个月视盘旁3.45mm直径范围内RNFL厚度分别为(105.62±10.90)μm和(105.43±10.89)μm,与术前(105.92±9.91)μm比较,差异均无统计学意义(t=-0.486、-0.727,P=0.682、0.468)。术后1周、1个月GCC厚度为(94.34±6.97)μm和(94.02±6.36)μm,与术前(94.55±6.57)μm比较,差异均无统计学意义(t=-0.571、-1.810,P=0.569、0.072)。视网膜上半部GCC厚度术后1周为(94.99±7.58)μm,与术前(95.20±6.76)μm比较,差异无统计学意义(t=-0.452,P=0.652),而术后1个月GCC厚度为(94.41±6.43)μm,较术前变薄(t=-2.470,P=0.015)。视网膜上半部RNFL厚度及视网膜下半部RNFL厚度和GCC厚度术后1周、1个月与术前相比,差异均无统计学意义(均为P>0.05)。结论飞秒激光LASIK术后短期内对患者RNFL厚度和GCC厚度无显著影响,但远期影响仍需进一步观察。

Objective To evaluate the effects of suction on retinal nerve fiber layer （RNFL） and ganglion cell compound （GCC） thickness after femtosecond laser flapping in LASIK. Methods A total of 69 patients （ 138 eyes） with myopia planed to perform femtosecond laser in LASIK were chosen. At 1 week, l month after LASIK, RN- FL and GCC thickness were examined by RTVue FD-OCT with optic ONH and GCC pro- cedure. The thickness of RNFL and GCC at postoperative 1 week, lmonth were com- pared with pre-operation. Results RNFL thickness within the area 3.45mm diameter around the optic disc at postoperative 1 week and 1 month were （ 105.52 ± 10.90）μm and （105.43 ± 10.89 ） μm, compared with pre-operation （ 105.92 _± 9.91 ）μm, there was no statistical difference（ t = -0.485, -0.727 ;P = 0. 582,0.458）. GCC thickness at post- operative 1 week and 1 month were （ 94.34 ± 6.97 ）μm and （94.02 _± 6.35 ）μm, com- pared with pre-operation （ 94.55 _± 6.57 ）μm, there was no statistical difference （ t = - 0. 571, - 1.8 0 ;P = 0.559,0.072）. In upper haft of retina, GCC thickness at postopera- tive 1 week was （94.99 _± 7.58 ）μm, compared with pre-operation （95.20± 6.75 ）μm, there was no statistical difference（ t = - 0.452 ,P = 0. 552）, but GCC thickness at postop- erative 1 month （94.41 ± 6.43 ） μm were significantly thinner than pre - operation（ t = -2. 470 ,P = 0.015 ）. There was no statistical difference in RNFL thickness in whole reti- na and GCC thickness in lower half of retina between postoperative 1 week, 1 month and pre - operation （ all P 〉 0.05 ）. Conclusion Femtosecond laser in LASIK has no obviously effect on RNFL and GCC thickness in postoperative short term, but the effect in long term need further observation.