两种飞秒激光制瓣LASIK手术后角膜内皮细胞变化的比较

Comparison of corneal endothelium after Intralase and Ziemer femtosecond laser in situ keratomileusis

目的比较Intralase和Ziemer飞秒激光制瓣准分子激光原位角膜磨镶术(laser in situ keratomileusis,LASIK)手术后角膜内皮细胞数量及形态的改变。方法分别在手术前,术后1 d、1周、1个月应用Konan FA-3709P型非接触角膜内皮显微镜检测角膜中心区的单位面积内的角膜内皮细胞密度(corneal endothelial cell density,CD)、角膜内皮细胞面积的变异系数(coefficient of variation,CV)、六边形角膜内皮细胞比率(percentage of hexagonal endothelium,6A)。结果两组术后1 d、1周、1个月CD与术前比无明显下降,两组间差异无统计学意义。术后1 d两组CV均较术前明显升高。术后1 d、1周及1个月两组间CV差异无统计学意义。术后1 d、1周、1个月两组6A均较术前明显下降,组间差异无统计学意义。术后1个月,Intralase组和Ziemer组的等效球镜度分别为(0.03±0.71)D和(-0.04±0.56)D,两组间比较,差异有统计学意义(t=-3.125,P=0.002)。结论 Intralase及Ziemer飞秒激光LASIK手术术后早期单位面积内的CD未见明显改变,但CV较术前轻度升高,且6A较术前略有下降。但是,两种飞秒激光术后组间CD、CV及6A差异无统计学意义。

Objective To compare the short-term effect of corneal endothelium after Intralase and Ziemer femtosecond laser in situ keratomileusis（ LASIK）. Methods Preoperatively,1 day,1 week and 1month after Intralase and Ziemer femtosecond laser in situ keratomileusis,myopia patients were examined by Konan FA-3709 P noncontact specular microscope. The mean cell density（ CD）,coefficient of variation（ CV）,and hexagonality（ 6A） of the corneal endothelial cells were determined. Results The changes of CD at 1day,1 week,1 month after surgery were not statistically significantly different both in Intralase and Ziemer-LASIK and the difference between the two groups was not statistically significant. The CVs in both groups 1 day,1 week,1 month after surgery compared with preoperative CV were significantly higher. The differences of CV between the two groups were not statistically significantly different after surgery. The 6As in both groups 1 day,1 week and 1 month after surgery compared with preoperative 6A decreased significantly. The differences in 6A between the two groups were not statistically significantly different after surgery. Conclusions The CDs of Intralase and Ziemer femtosecond-LASIK groups do not change after surgery. The CVs slightly increase and 6As were slightly decrease after surgery in both groups.