飞秒激光制瓣LASIK术后角膜上皮下混浊研究分析

Analysis of corneal haze after thin-flap femtosecond laser in situ keratomileusis for myopia

目的:探讨飞秒激光制瓣LASIK术后角膜上皮下混浊(haze)的原因。方法:对99例198眼采用飞秒激光制作角膜瓣LASIK术。使用FemtoLDV达芬奇飞秒激光作上方带蒂角膜瓣。激光参数:脉冲频率1MHz,预定制角膜瓣厚度110μm,角膜瓣直径8.5～9.0mm。日本TOMEYSP100超声波角膜测厚仪,实际测量厚度为95～103(平均98.00)μm。结果:发现haze10例19眼,haze多发在光学区中央,直径约3.0～4.5mm,小部分在鼻侧。患者术后1,14d;1,3,6mo的平均裸眼视力分别为0.82±0.24,0.94±0.16,0.98±0.17,1.0±0.26,0.97±0.13。而患者发生haze后的术后14d;1,3,6mo之间裸眼视力比较差异无统计学意义(P>0.05),与术前最佳矫正视力(0.98±0.25)比较差异无统计学意义(P>0.05)。结论:飞秒激光制作的薄角膜瓣与haze的发生有关,轻度的haze对患者术后的裸眼视力未产生影响。

· AIM： To investigate the dynamic response of cornea after the femtosecond laser-assisted laser in situ keratomileusis （LASlK） and to evaluate the risk factors for interface haze formation after thin-flap femtosecond laser-assisted LASlK.· METHODS： One hundred and ninety-eight eyes of ninety-nine subjects with age from 19 to 23 years old, spherical equivalent refraction of-2.75- -12.50D and the central corneal thickness was 492 - 558 μm underwent the femtosecond laser LASlK with Femto LDV femtosecond laser-assisted LASIK for myopic correction, were analyzed from November 1, 2011 to March 31, 2012. The surgical parameters were set as follows： laser frequency 1MHz, flap diameter 8. 5- 9. 0 mm and expected flap thickness 110μm, Japan TOMEY SP100 ultrasonic corneal thickness gauge, used for predetermining 110μm thickness for femtosecond flap, the actual measure thickness was 95-103μm, with an average of 98. 00μm. And light scattering were assessed in all eyes that developed haze postoperatively. · RESULTS： Haze was observed in 19 eyes treated, the time of finding the haze was： 2 weeks in 2 cases of 4 eyes, 1 month 8 cases of 15 eyes. There were 14 eyes of grade 0.5. 5 eyes were grade 1. The haze usually occurred in the center of the optical zone, of which the diameter was about 3.0 - 4.5mm, and a small portion of it occurred in the nasal. · CONCLUSION： Interface haze is associated with an ultra thin femtosecond laser flap setting of 95-103μm and younger age among eyes following LASlK for myopia.