薄角膜瓣对LASIK疗效的影响

Influence of thin flap on laser in situ keratomileusis for myopia

目的:探讨LASIK手术中薄角膜瓣对近视疗效的影响及安全性。方法:回顾性分析LASIK手术中双眼角膜瓣厚度有显著差异的28例(56眼)近视,分为薄角膜瓣组(瓣厚<110μm)和厚角膜瓣组(瓣厚>110μm)。分析2组间在角膜瓣厚度、角膜基质床厚度、术后视力和屈光度稳定性,以及角膜地形图参数上的差异,全部数据用SPSS10.0forWindows进行统计学处理。结果:术前薄瓣组近视度数为(-6.79±3.05)D,最佳矫正视力(BCVA)0.97±0.21,角膜中央厚度531±18.28μm;厚瓣组分别为-6.64±2.87)D,(1.01±0.18和541.54±0.18μm。组间差异无显著性意义(P >0.05。术后平均视力薄瓣组0.94±0.28,厚瓣组为0.86±0.32,残余近视度≥-1.00D者薄瓣组3眼(11%),厚瓣组4眼(14%)。角膜瓣厚度和角膜基质床厚度分别为(97.18±8.32),(333.89±26.94),(139.89±27.40)和(313.57±29.06)μm。组间差异有统计学意义(P <0.01)。角膜地形图SRI、SAI和PVA参数组间差异均无统计学意义(P >0.05)。二组均无危及视力的并发症。结论:在一定限度内,LASIK手术中薄角膜瓣不影响近视疗效,不增加角膜瓣相关并发症风险。计划性薄角膜瓣可提高高度近视疗效及屈光度稳定性。

AIM: To analyze the influence of thin flap on laser in situ keratomileusis (LASIK) for myopia.· METHODS: Fifty-six eyes of 28 myopia patients who had undergone LASIK were analyzed retrospectively. According to the flap thickness, patients were divided into two groups: thin flap group (thickness <110μm) and thick flap group (thickness>110μm). The thickness of flap and bed, postoperative UCVA and residual refractive error were processed by SPSS 10.0 for Windows. The parameter of corneal topograph were statistically analyzed too.· RESULTS: The pre-operative myopic diopter and BCVA were (-6.79±3.05)D and 0.97±0.21 in thin flap group, and (-6.64±2.87)D and 1.01±0.18 in thick flap group, respectively. The CCT was (531±18.28)μm in thin flap group, (541.54±0.18) μm in thick flap group, respectively. The difference between the two groups had no statistical significance (P >0.05). The postoperative BCVA of thin flap group was 0.94±0.28, and 0.86±0.32 in thick flap group, respectively. Three eyes (11%) occurred more than -1.00D and four eyes (14%) in thick flap group. The thickness of flap and bed were (97.18±8.32) μm and (333.89±26.94) μm in thin flap group, and (139.89±27.40) μm and (313.57±29.06)μm in thick flap group, respectively. The difference of thickness between the two groups had statistical signification (P <0.01). The difference of SRI, SAI and PVA had no statistical significance (P >0.05) between the two groups. No severe complication occured.· CONCLUSION: Within a certain limits, LASIK with thin flap is effective and saft for myopia. A thin flap, with a Bowman's layer, induces no significant postoperative complicantion.·