目的:观察90刀头超薄角膜瓣和110刀头常规角膜瓣在低中度近视患者手术前后的诸多指标的对比研究,探讨超薄瓣LASIK手术的优缺点。方法:根据患者知情原则及患者自愿选择分为两组:组1(使用常规Moria110μm刀头组)81例159眼;组2(使用Moria90μm一次性刀头组)73例145眼。术中测量实际角膜瓣厚度,观察两组角膜瓣形态、对合情况、术后反应、并发症,检测两组角膜厚度、角膜瓣厚度、剩余角膜基质厚度及术后预测视力、眼压等指标。结果:组1实际角膜瓣厚度为134.0±2.5μm,组2为93.5±5.9μm,两组差异有统计学意义(P<0.05)。两组角膜瓣形态、对合情况、术后反应和术后预期视力及眼压差异无统计学意义(P>0.05)。90超薄瓣组并发症更少,保留的角膜基质床更厚(P<0.05)。结论:90超薄角膜瓣LASIK与110常规角膜瓣LASIK相比,能取得同样良好的矫治效果,而超薄角膜瓣LASIK可矫治的屈光度更大,保留的角膜基质床更多,具有更好的安全性、稳定性和更宽的适应范围,将成为不同程度近视患者的首选术式。

AIM:To observe ultra-thin-flap and thick-flap LASIK in treatment of low and moderate myopia before and after operation and to analyze the advantage or limitation in ultra-thin-flap LASIK.METHODS:A total of 154 cases of low and moderate myopia were chosen,81 cases(159 eyes) underwent the Moria 110 thick-flap LASIK in group 1,the other 73 cases(145 eyes) underwent the Moria 90 ultra-thin-flap LASIK in group 2.The actual corneal flap thickness and the corneal flap shape in the surgery,the complication between two groups before and after surgery,the cornea thickness,corneal flap thickness,surplus corneal stroma thickness,postoperative vision and intraocular pressure were observed.RESULTS:The actual corneal flap thickness of group 1 was 134.0±2.5μm;and that of group 2 was 93.5±5.9μm.There was significant difference between two groups (P< 0.05).There was no significant difference between two groups (P>0.05) in corneal flap shape,the complication,vision and intraocular pressure postoperative.There was fewer complication and thicker surplus corneal stroma thickness in group2 (P< 0.05).CONCLUSION:Ultra-thin-flap LASIK can produce the same good effect as the thick-flap LASIK.But the former can retain thicker corneal stroma bed,it can do wider diopter treatment with better security and wider adaptation scope,and will be the best choice for myopia people.

R779.63

2010年湖南省教育厅立项课题资助项目(No.10C1244)~~