三种全激光角膜屈光手术技术要点与前景

Main techniques points and prospects of three all laser corneal refractive surgery

近视激光手术已经迈人“无刀”的全激光时代，其特点是手术的安全性、准确性和可预测性都有很大程度提高。现有的全激光手术可分为3类：飞秒激光联合准分子激光手术、单准分子激光手术和单飞秒激光手术。全激光手术具有提高角膜制瓣和基质切削的准确性，减少手术器械对角膜的接触损伤，减少术后角膜生物力学的改变等优点，是目前屈光手术发展的大方向和趋势。笔者对这3种全激光手术各自的技术要点，包括患者的选择、手术的优势、手术的缺点及并发症、术后的矫正效果、视觉质量等方面和全激光角膜屈光手术的技术发展前景进行详细的科学阐述。

Corneal refractive surgery has entered an all laser era of bladeless operation techniques, characterized by its improved safety, accuracy and predictability. There are 3 kinds of all laser corneal refractive surgery： Femtosecond laser-assisted laser in situ keratomileusis; Single excimer laser refractive surgery; Single femtosecond laser refractive surgery. The advantages of all laser corneal refractive surgery include increasing the accuracy of creating flap and corneal stroma ablation, decreasing surgical instruments＇ damage to the cornea and reducing corneal biomechanical changes, which become the main direction and trends of corneal refractive surgery. This article reviews the technological feature and development prospects of three all-laser corneal refractive surgery in detail, including the patient selection, the advantages and complications of surgery, refractive outcomes, visual quality etc.