FEMTOLDV飞秒激光制瓣LASIK术治疗近视疗效观察

Clinical observation of LASIK with the corneal flap created by FEMTO LDV femtosecond laser for myopia

目的:评价FEMTO LDV飞秒激光制瓣准分子激光原位角膜磨镶术(laser in situ keratomileusis,LASIK)治疗近视的临床效果。方法:应用FEMTO LDV飞秒激光制瓣,设定角膜瓣厚度110μm。EC5000-CXⅢ准分子激光仪行LASIK手术治疗近视患者143例283眼。术前检查包括验光、最佳矫正视力(best corrected visual acuity,BCVA)、角膜厚度、ObscanⅡ等。术中测量其中35眼的角膜床厚度,推算其角膜瓣的厚度。观察术中及术后角膜瓣情况,手术并发症,术后裸眼视力(uncorrected visual acuity,UCVA),屈光度,角膜地形图,平均随访3mo。结果:术中出现过小瓣(直径<5mm)3眼,角膜边缘切开不完全5眼,切口出血8眼,术后球结膜下出血6眼。35眼角膜瓣厚度108.75±8.52(98～117)μm,误差(实测值与预设值之差)6.49±8.62(3～12)μm,实际角膜瓣厚度与术前预先设计的角膜瓣厚度差异无统计学意义(P>0.05)。术后3mo平均等效球镜-0.29±0.47(-1.50～+1.00)DS,251眼(88.7%)裸眼视力达到或超过术前最佳矫正视力。结论:FEMTO LDV飞秒激光制瓣LASIK术治疗近视并发症少、疗效确切、安全。

AIM： To evaluate the clinical effect of laser in situ keratomileusis（ LASIK） with the corneal flap created by FEMTO LDV femtosecond laser for myopia.METHODS： The corneal flap was created by the FEMTO LDV femtosecond laser,and the thickness of the flap was110μ m. A total of 143 myopic patients（ 283 eyes） were treated with the EC5000- CXIII element laser. The optometry of the eye, best corrected visual acuity（ BCVA） the thickness of the cornea,and ObscanⅡ were examined before the operation. The thickness of the flap was calculated by measuring the thickness of corneal bed during the operation in 35 eyes. The conditions of the corneal flap, complications, uncorrected visual acuity（ UCVA）,diopter,corneal topography were observed during and after the operation and were checked for 3mo follow-up.RESULTS： During the operation,it appeared small flap（ diameter 5mm） in 3 eyes,corneal margin incised incompletely in 5 eyes and incision bleeding in 8 eyes.Postoperative subconjunctival hemorrhage appeared in 6eyes. The thickness of corneal flap in 35 eyes was 108.75±8.52μ m（ 98-117μ m） and the error was 6.49±8.62μ m（ 3-12μ m）. There was no significant difference between the actual flap thickness and the preset flap thickness（ P〉0. 05）. The average equivalent spherical refractive w as-0.29±0.47（-1.50 to ＋1.00） DS after the operation for 3mo and the UCVA met or exceeded preoperative BCVA in 251eyes（ 88.7%）.CONCLUSION： The operation of myopia by LASIK flap created by FEMTO LDV femtosecond laser has fewer complications,and the effect is definite and safe.