LASIK术中不同冲洗方式对角膜瓣下异物发生率的影响

Effect of rinsing Methods on incidence of foreign body under corneal flap during LASIK

目的探讨准分子激光原位角膜磨镶术(LASIK)中不同冲洗方式对角膜瓣下异物发生率的影响。方法采用前瞻性研究,观察分析300例(600只眼)LASIK手术,均为规范化操作实施LASIK术。术中按不同冲洗方式分组,A组:开放式冲洗法;B组:瓣下冲洗法;C组:开放式冲洗和瓣下冲洗结合法,术毕以裂隙灯显微镜检查,记录并比较瓣下异物的发生率。结果术中发现的角膜瓣下异物总计52只眼,发生率8.7%,其中组织碎屑17只眼、脂质颗粒14只眼、纤维细丝11只眼、血液5只眼、金属碎屑3只眼、睫毛2只眼。A组角膜瓣下异物总计23只眼,发生率11.5%;B组角膜瓣下异物总计20只眼,发生率10%;C组角膜瓣下异物总计9只眼,发生率4.5%。A组与B组比较χ2=0.23,P﹥0.05;A组与C组比较χ2=6.66,P﹤0.05;B组与C组比较χ2=4.44,P﹤0.05。结论采用开放式冲洗和瓣下冲洗结合的方法,可明显降低术后角膜瓣下异物存留的发生率。

Objective To investigate the effect of rinsing methods on incidence of foreign body under corneal flap during LASIK. Methods A prospective study was conducted to observe and analyze 300 cases （ 600 eyes ） that underwent LASIK. Three groups were distinguished according to different rinsing methods. Group A： open rinsing method; group B： close rinsing method; group C： open and close rinsing combined. Flap foreign body incidence after operation were recorded and compared. Results There were 52 case showed foreign bodies, and the occurrence rate was 8.7%. Seventeen cases were tissue debris, fourteen were lipid granules, eleven were thin fiber, five were blood cells, three were metal grains, and two ere eyelashes. There were 23 cases in group A （ incidence 11.5% ） ; 20 cases in group B （ incidence 10% ）, and 9 ca- ses in group C （incidence 4.5% ）. Comparing group A and B, χ2 =0.23, P 〉 0.05; comparing group A and C,χ2 = 6. 66, P 〈 0.05 ; comparing group B and C, χ2 = 4.44, pP 〈 0.05. Conclusion Combination of open and close rinsing methods can significantly reduce incidence of postoperative foreign bodies under corneal flap.