Ziemer飞秒激光与Moria M2 90刀头制作角膜瓣的厚度与特点比较

Comparison of flaps created with Ziemer LDV Femotolaser and the Moria M2 microkeratome

目的应用前节OCT测量比较Ziemer飞秒激光和Moria M2微型角膜刀90刀头制作的LASIK角膜瓣的特点。设计前瞻性比较性病例系列。研究对象88例近视患者176眼行LASIK,随机分为Ziemer飞秒激光和Moria M2微型角膜刀90刀头制作角膜瓣各44例88眼。方法术后1周应用RTVue OCT测量两组患者角膜上0°、45°、90°和135°4条子午线所在截面上特定7个点的角膜瓣厚度,并对角膜瓣上28个测量点的角膜瓣厚度值进行统计分析。主要指标角膜瓣厚度和角膜瓣形态。结果术后1周,飞秒激光组中央角膜瓣厚度为(106.03±6.64)μm,平均角膜厚度(107.38±5.46)μm,均明显低于Moria M2 90组的中央角膜瓣厚度(134.41±11.31)μm和平均角膜瓣厚度(139.38±8.91)μm(P均<0.01),飞秒激光组与角膜瓣预期厚度值110μm更接近,差值为(7.15±4.89)μm,而机械板层刀组角膜瓣厚度值与预计厚度110μm的差值为(29.51±14.31)μm(P<0.01)。结论飞秒激光制作角膜瓣的厚度更薄,全角膜瓣厚度平均值更接近预期的110μm,其角膜瓣的均一性和预测性更好,是薄瓣LASIK手术的首选。

Objective The aim of this trial was to compare the features of corneal flaps created using Ziemer LDV femtosecond laser and the Moria M2 microkeratome 90 μm-knifc. Design Prospective comparative case series. Participants One hundred and sev- enty-six eyes of 88 patients were enrolled in this clinical trial. The patients were randomized divided into the Ziemer LDV femtoseeond laser group and Moria M2 microkeratome 90μm-knife with matching demography. Methods Fourier-domain optical coherence tomogra- play （RTVue OCT） was used to measure flap thickness using 28 settings on the 176 corneas at one week postoperatively. The features of the LASIK flaps were analyzed on the basis of the outcomes. Main Outcome Measures The thickness and shape of corneal flap. Re- suits The mean flap thickness of the Ziemer LDV fcmtosecond laser group was considerably thinner than that of the Moria M2 micro- keratome 90 μm-knife group （106.03±6.64 μm versus134.41±11.31 μm） （P〈0.01）. The mean deviation between the achieved and at- tempted flap thickness was smaller in the Ziemer LDV group （7.15±4.89 μm） than in the Moria M2 90 group （29.51±14.31μm） （P〈 0.01）. Conclusion The shape of flaps created using the Ziemer femtosecond laser is more uniform and closer to the expected thickness of 110μm than the ones created using the Moria M2 90 microkeratome. And Ziemer femtosecond laser should be the first choice for thin flap Lasik. （Ophtholmol CHN, 2013, 22： 261-265）