飞秒激光制瓣LASIK术的临床观察

Clinical observation of laser in situ keratomileusis (LASIK) with corneal flap created by femtosecond laser

目的观察应用飞秒激光制作角膜瓣的准分子激光原位角膜磨镶术(LASIK)的安全性及其并发症。方法应用Intralase FS 60飞秒激光仪和VISX Star S 4准分子激光仪对屈光不正患者300例(600眼)施行飞秒激光制瓣LASIK术。术前检查包括验光、最佳矫正视力(BCVA)、角膜厚度、角膜地形图等常规检查项目,术后1d、1w、1m、3m和6m常规复查裸眼视力和验光等。结果术后6个月的屈光状态,平均等效球镜为(-0.30±0.75)D,585眼(97.5%)的裸眼视力大于或等于1.0,560眼(93.3%)的裸眼视力等于或超过术前最佳矫正视力(BCVA)。并发症包括球结膜下出血、切口出血、前房气泡、角膜基质广泛微空化泡和掀瓣困难。结论应用飞秒激光制作角膜瓣的LASIK术是矫正屈光不正安全、有效的方法,可预测性好,但也有一些不同于微型角膜刀的独特并发症。

OBJECTIVE To investigate the safety, predictability and effectiveness of laser in situ keratomileusis （LASIK） with laser flap created by femtosecond laser. METHODS Six hundred eyes of 300 patients with refractive error received LASIK with VISX Star S4 excimer laser system and intralase femtosecond laser. Refraction,best corrected visual acuity （BCVA）, corneal thickness, corneal topography were examined before LASIK. Uncorrected visual acuity and refraction were examined lday, lweek andl, 3, 6 months after LASIK. RESULTS At 6 months after operation, the mean residual spheroequivalent of refraction was （-0.30±0.75）D.585 eyes （97.5%）had uncorrected visual acuity of 1.0 or better, 560 eyes（93.3 ）had uncorrected visual acuity equal to or better than preoperative best corrected visual acuity. The intraoperative complications included acuity. The intraoperative complications included subcon junctival hemorrhage, incision hemorrhage, anterior chamber gas bubbles, micro-bubbles inside the corneal stroma and failure to lift the flap. CONCLUSIONS LASIK With femtosecond laser flap creation was a safe, effective procedure for the correction of refractive error with good predictability. It may have some unique complications other than LASIK with microkeratomes.