飞秒激光术中角膜基质不透明气泡层的相关因素及其对手术效果的影响

Related factors of opaque bubble layer during femtosecond laser surgery and its influence on the efficacy of operation

目的探讨飞秒激光术中角膜基质不透明气泡层的相关因素及其对手术效果的影响。方法选取2013年6月至8月在我院行飞秒激光手术60例（120眼），男24例（48眼），女36例（72眼）。年龄18～42岁，平均（32．86±4．41）岁。术前等效球镜-3．0D～-9．5D，平均（-8．37±1．87）D。术前最佳矫正视力均为1．0或以上。根据手术过程中是否发生不透明气泡层将其分为两组，采用SPSS16．0软件分析两组术前数据、术中参数、术后1d、1周、1月的视力和屈光度，探讨引起不透明气泡层的相关因素及其对术后效果的影响。结果比较术前两组中央角膜厚度、角膜直径，及术中压平锥镜接触定位时间，差异均有统计学意义（P〈0．05）。比较术后1d、1周、1月的视力和屈光度，差异均无统计学意义（P〉0．05）。结论飞秒激光术中，角膜较厚者和直径较小者易发生不透明气泡层，压平锥镜接触时间、激光能量和频率也与不透明气泡层的发生有关；不透明气泡层不影响术后视力或屈光度。

Objective To discuss the cause of opaque bubble layer （OBL） during femtosecoud laser surgery and its influence on the efficacy of operation. Methods One hundred and twenty eyes of 60 patients who had received femtosecond laser were screened out in our hospital. Of which, 24 males and 36 females were included. The age range was 18 to 42 years old, with an average age of （32.86 ±4.41 ） years. The preoperative BCVA of all patients were 1.0 or better and preoperative spherical equivalents were from - 3.0 D to -9.5 D with an average of （ -8.37 ± 1.87） D. According to whether getting OBL, patients were divided into two groups. Preoperative and intraoperative parameters, visual acuity and diopter at 1 day, 1 week and 1 month after operation were compared between two group to find the cause of OBL and its clinical impacts. These analyses were performed using the SPSS 16.0 software package. Results The difference of preoperative central corneal thickness, corneal diameter and intraoperative corneal flatten time was statistically significantly different （ P 〈 0.05 ）. There were not statistically significantly different （ P 〉 0.05 ） when compared the visual acuity and diopter at 1 day, 1 week and 1 month after operation. Conclusion Patients with thicker or smaller cornea are more susceptible to OBL. The corneal flatten time, energy and frequency of excimer laser also have relation with OBL. The OBL do not influence postoperative visual acuity and diopter.