Moria M2 90一次性微型板层角膜刀制作角膜瓣的临床研究

Accuracy of corneal flap thickness made with Moria M2 90 disposable microkeratome in laser in situ keratomileusis

目的探讨Moria M2 90一次性微型板层角膜刀制作角膜瓣的可预测性及其影响因素。方法共入选104例(208只眼)拟行准分子激光原位角膜磨镶术(LASIK)患者参加此研究。术中使用Moria M2 90一次性微型板层角膜刀制作角膜瓣,所有患者均使用全新刀头,先右眼制瓣,然后左眼制瓣。制瓣前及制瓣后均使用超声角膜测厚仪测量术眼中央角膜厚度,同时测量角膜瓣直径及蒂长。结果平均角膜瓣厚度为(113.26±12.12)μm,其中右眼平均角膜瓣厚度为(121.42±12.08)μm,左眼平均角膜瓣厚度为(107.24±12.24)μm,两者比较有显著统计学差异(P<0.01)。右眼平均角膜瓣直径(9.46±0.15)mm,平均蒂长(5.16±0.25)mm;左眼平均角膜瓣直径(9.39±0.19)mm,平均蒂长(5.09±0.24)mm,两者比较均无显著性差异(P=0.08和P=0.95)。角膜瓣厚度与患者年龄,术前屈光度,术前角膜曲率及角膜直径均无明显相关性(分别P=0.56,P=0.50,P=0.19,P=0.42),与术前中央角膜厚度呈正相关性(r=0.448,P<0.01)。结论 Moria M2 90一次性微型板层角膜刀制作角膜瓣预测性良好,角膜瓣厚度与术前中央角膜厚度呈正相关性。

Objective To evaluate the accuracy of corneal flap thickness made with Moria M2 90 disposable mi-crokeratome,and to identify the factors that may affect it. Methods Author reviewed 104 myopic patients （208 eyes） who underwent laser in situ keratomileusis （LASIK）using Moria M2 90 disposable microkeratome. The corneal thickness was measured by ultrasound pachymetry before surgery and after corneal flap cut during surgery. Disposable microkeratomes were used for both eyes. Corneal flap cutting started in the right eye and then in the left eye. Results Mean corneal flap thickness was 113. 26 ± 12. 12 μm. It was 121. 42 ± 12. 08 μm for right eyes and 107. 24 ± 12. 24 μm for left eyes. A sig-nificant different was found between right and left eyes （P 〈 0. 01）. Mean flap diameter was 9. 46 ± 0. 15 mm in right eyes and 9. 39 ± 0. 19 mm in left eyes. Mean hinge lengths in right and left eyes were 5. 16 ± 0. 25 mm and 5. 09 ± 0. 24 mm, respectively. No significant different was found between right and left eyes for flap diameter or hinge length. There was no significant correlation between corneal flap thickness and age,preoperative SE,preoperative keratometry,or preoperative corneal diameter. A significant correlation was found between corneal flap thickness and preoperative central corneal thick-ness （CCT;r = 0. 448,P 〈 0. 01）. Conclusion Corneal flap thickness made with disposable Moria M2 90 microkera-tome was accurate. There was a correlation between corneal flap thickness and preoperative CCT.