目的:对Hansatome自动旋转式显微角膜刀及AmadeusⅡ自动平推式显微角膜刀制作准分子激光原位角膜磨镶术(LASIK)角膜瓣厚度进行对比分析。方法:对来我院行LASIK的患者50例100眼,随机分成两组,一组用Hansatome显微角膜刀160μm刀头制作角膜瓣,另一组用AmadeusⅡ显微角膜刀140μm刀头制作角膜瓣。对所有患者进行术前中央角膜厚度测量及术中角膜基质床厚度测量,从而计算角膜瓣厚度。所有的患者均先行右眼手术再行左眼。对两组患者实际切削的角膜瓣厚度进行对比,同时对两种显微角膜板层刀制作角膜瓣厚度左右眼之间进行对比分析。结果:Hansatome组实际角膜瓣厚度67～158(平均98.70±18.04)μm;AmadeusⅡ组实际角膜瓣厚度69～171(平均110.60±16.47)μm,两种角膜刀制作角膜瓣厚度差异有统计学意义(P=0.001)。Hansatome组右眼104.40±18.78μm,左眼93.00±15.61μm,两眼角膜瓣厚度差异有统计学意义(P=0.01);AmadeusⅡ组右眼115.12±18.74μm,左眼105.20±12.29μm,P=0.024,患者左眼角膜瓣均比右眼要薄,差异有统计学意义。结论:在LASIK术中角膜板层刀制作的角膜瓣厚度与预计值有一定的偏差,术中测量角膜瓣厚度有重要的参考价值。

AIM:To analyze corneal flap thickness of laser in situ keratomileusis(LASIK) by Hansatome microkeratome and Amadeus II microkeratome.METHODS:Totally 50 patients(100 eyes) were divided into two groups randomly.The LASIK procedures were performed with Hansatome microkeratome using a 160μm head in group 1 and Amadeus II microkeratome using a 140μm head in group 2.The preoperative central corneal thickness and the stromal bed thickness after the flap was lifted were measured by ultrasound pachymetry.All patients were performed LASIK on right eye firstly and then left eye.The actual corneal flap thickness created by two different microkeratomes and the difference between the left and right eye of patients by the same microderatome were compared.RESULTS:The mean actual corneal flap thickness created by Hansatome and Amadeus II were 98.70±18.04μm(range from 67 to 158μm) and 110.60±16.47μm(range from 69 to 171μm),respectively.The difference between these two kinds of microkeratomes was statistically significant(P= 0.001).In the Hansatome group,the flap thickness in the right eye and left eye were 104.40±18.78μm and 93.00±15.61μm(P=0.01),while in the Amadeus II group,the flap thickness in the right eye and left eye were 115.12±18.74μm and 105.20±12.29μm(P=0.024).The corneal flap thickness of left eye was thinner than the right eye in each groups and the difference between two groups was statistically significant.CONCLUSION:The corneal flap thickness created by microkeratome was different from the expected value.Intraoperative measurement of corneal flap thickness was important for LASIK surgery.

R779.63

中国广东省医学科学技术研究基金资助项目(No.B2-010231)~~