目的:通过测量术眼角膜瓣厚度,观察准分子手术制瓣方式的安全性及可预测性。为临床工作提供帮助。方法:将手术眼按照制瓣方式分为四组:飞秒制瓣组(A组)、Moria-Ⅱ90刀制瓣组(B组)、Moria-Ⅱ110刀制瓣组(C组)、EK制瓣组(D组)。用A超测量角膜及基质床厚度,计算得出实际瓣厚度。所得数据进行统计学分析。结果:制瓣平均厚度A组90.95±10.82μm,B组133.61±11.97μm,C组147.70±16.16μm,D组66.35±11.95μm,各组瓣厚统计学差异明显。制瓣厚度影响因素中,A组与等效球镜低度相关。B组与等效球镜中度相关,与术中档位、术前眼压、平均曲率低度相关。D组与制瓣方法中度相关,与等效球镜低度相关。A组锥镜两次使用;B,C组旋转刀两次使用;D组左右眼制瓣厚度无显著差异。结论:几组制瓣均很稳定,但在制瓣厚度上有明显差异。屈光度数可能是影响制瓣厚度的因素之一。飞秒激光制瓣比常规板层角膜刀在预测性和灵活性方面更有优势。EK手术因其制瓣最薄而手术最安全

AIM:To observe the safety and predictability of excimer laser surgery by measuring the thickness of corneal flap,and to provide help for clinic.METHODS:The operative eyes were divided into 4 groups according to the preparation types of corneal flap.Fifty-five eyes were treated with laser in situ keratomileusis with 90μm femtosecond laser flap preparation (group A).Sixty-one eyes were treated with laser in situ keratomileusis with Moria-Ⅱ 90 microkeratomy flap preparation (group B).Thirty eyes were treated with laser in situ keratomileusis with Moria-Ⅱ110 microkeratomy flap preparation (group C).One hundred and five eyes were treated with laser assisted subepithelial keratectomy (group D).Ultrasonic pachymetry was employed to measure the flap thickness of these four groups.The results were analyzed with t-test or linear-regression by SPSS software.RESULTS:The average thickness of these 4 groups were 90.95±10.82μm (group A),133.61±11.97μm (group B),147.70±16.16μm (group C),66.35±11.95μm (group D).They were compared with t-test and showed statistical difference.Correlations between the thickness and the preoperative parameters were analyzed.Group A showed a weak correlation with the spherical equivalent diopter.Group B revealed a moderate correlation with the spherical equivalent diopter and weak correlation with the preoperative intraocular pressure,the average curvature of the cornea,the stall of the microkeratomy of Moria-Ⅱ.Group D showed moderate correlation with flap preparation,weak correlation with spherical equivalent diopter.There was no statistical difference between the thickness of the flap and the used times of the cone in group A,as well as the used times of the blade in Moria-Ⅱ in group B and C and the eyes either right or left in group D.CONCLUSION:Although the thickness was stable in every group,there was difference in the average thickness of these 4 groups.Spherical equivalent diopter may be one reason for the influence of the corneal thickness.It is more predictable and flexible in the thickness of the corneal flap with femtosecond than with the microkeratomy of Moria-Ⅱ.With the thinnest flap thickness,LASEK is the safest operation

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