全飞秒激光小切口角膜基质透镜取出术(SMILE)角膜帽与飞秒激光辅助的准分子激光角膜原位磨镶术(FS-LASIK)角膜瓣的对比
|
摘要
目的对比全飞秒激光小切口角膜基质透镜取出术(small incision lenticule extraction,SMILE)制作的角膜帽和飞秒激光辅助的准分子激光角膜原位磨镶术(femtosecond laser in situ keratomileusis,FS-LASIK)制作的角膜瓣的特点。方法 100例200眼近视患者根据手术方式分为SMILE组、FS-LASIK组,每组各50例100眼。SMILE组角膜帽及FS-LASIK组角膜瓣厚度均设定为110μm,RTVue-OCT测量术眼角膜0°和90°两条子午线所在截面上特定7个点的角膜帽和角膜瓣厚度值,并对角膜帽和角膜瓣上14个测量点的厚度进行对比。结果术后1周,SMILE组中央区角膜帽厚度为(109.4±2.8)μm,低于FS-LASIK组中央区角膜瓣厚度[(111.2±3.6)μm],差异有统计学意义(t=-3.062,P<0.01)。SMILE组全角膜帽厚度值为(109.3±2.1)μm,亦低于FS-LASIK组全角膜瓣厚度[(111.1±1.8)μm],差异有统计学意义(t=-5.130,P<0.01)。两组在不同离心度的位置,角膜帽和角膜瓣厚度的变异均不大。两组角膜0°和90°经线所在截面的平均角膜帽和角膜瓣厚度差异均无统计学意义(均为P>0.05)。SMILE组中与预计值差值≤5μm的有1170个测量点,而FS-LASIK组中有1226个测量点。结论SMILE制作的角膜帽与FS-LASIK制作的角膜瓣同样具有良好的重现性,且形态均一、规整。
Objective To compare the features of caps created with small incision lenticule extraction( SMILE) versus flaps created with femtosecond laser-assisted in situ keratomileusis( femto-LASIK). Methods Two hundreds eyes of 100 patients were collected in this study and divided into 2 groups according to the operation method: SMILE group( 100 eyes,50 patients) and FS-LASIK group( 100 eyes,50 patients). The expected cap or flap thickness was 110μm for both groups. Fourier-domain optical coherence tomography( R TVue O CT) was used to measure the cap and flap thicknesses of the 7 specified measurements in the 0° and 90° meridians on the corneas,and the thicknesses of 14 measurements on the caps and flaps were compared.Results At one week postoperatively,the central cap thickness of SMILE group [( 109. 4 ±2. 8) μm]w as thinner than central flap thickness of the FS-LASIK group[( 111. 2 ± 3. 6) μm ]( t=-3. 062,P < 0. 01). The mean whole cap thickness was( 109. 3 ± 2. 1) μm in the SMILE group,which was significant low er than the whole flap thickness in the FS-LASIK group[( 111. 1± 1. 8) μm ]( t =-5. 130,P < 0. 01). The caps and flaps morphology show ed uniformity in both groups. There was no significant difference in the mean cap and flap thickness betw een 0°and 90° meridians( all P > 0. 05). The amount of measurement points differ less than 5 μm was1170( 83. 57%) in the SMILE group,1226( 87. 57%) in the FS-LASIK group. Conclusion The corneal caps made by SMILE and the corneal flaps made by FS-LASIK both have good reproducibility,and the shape is uniform and regular.
Objective To compare the features of caps created with small incision lenticule extraction( SMILE) versus flaps created with femtosecond laser-assisted in situ keratomileusis( femto-LASIK). Methods Two hundreds eyes of 100 patients were collected in this study and divided into 2 groups according to the operation method: SMILE group( 100 eyes,50 patients) and FS-LASIK group( 100 eyes,50 patients). The expected cap or flap thickness was 110μm for both groups. Fourier-domain optical coherence tomography( R TVue O CT) was used to measure the cap and flap thicknesses of the 7 specified measurements in the 0° and 90° meridians on the corneas,and the thicknesses of 14 measurements on the caps and flaps were compared.Results At one week postoperatively,the central cap thickness of SMILE group [( 109. 4 ±2. 8) μm]w as thinner than central flap thickness of the FS-LASIK group[( 111. 2 ± 3. 6) μm ]( t=-3. 062,P < 0. 01). The mean whole cap thickness was( 109. 3 ± 2. 1) μm in the SMILE group,which was significant low er than the whole flap thickness in the FS-LASIK group[( 111. 1± 1. 8) μm ]( t =-5. 130,P < 0. 01). The caps and flaps morphology show ed uniformity in both groups. There was no significant difference in the mean cap and flap thickness betw een 0°and 90° meridians( all P > 0. 05). The amount of measurement points differ less than 5 μm was1170( 83. 57%) in the SMILE group,1226( 87. 57%) in the FS-LASIK group. Conclusion The corneal caps made by SMILE and the corneal flaps made by FS-LASIK both have good reproducibility,and the shape is uniform and regular.
引文
[1]VESTERGAARD A,IVARSEN A,ASP S,HJORTDAL J.Femtosecond(FS)laser vision correction procedure for morderate to high myopia:a propective study of R e LEx@flex and comparison w ith a retrospectivestudy of FS-laser in situ keratomileusis[J].A cta O phthalmol,2013,91(4):355-362.
[2]VESTERGAARD A,IVARSEN A,ASP S,HJORTDAL J.Smallincision lenticule extraction for moderate to high myopia:predictability,safety,and patient satisfaction[J].J C ataract Refract Surg,2012,38(11):2003-2010.
[3]TIAN L,ZHOU Y H,WANG N L,ZHANG Q W.Characteristics of flaps created w ith an Intra Lase FS60 femtosecond Iaser versus a Femto LD V femtosecond laser[J].C hin J O ptom O phthalmol V is Sci,2011,13(1):4-8.田磊,周跃华,王宁利,张青蔚.Intra Lase FS60和Femto LDV飞秒激光制作角膜瓣的特点[J].中华眼视光学与视觉科学杂志,2011,13(1):4-8.
[4]XUE C,WANG Y,ZUO T,GENG W L,JIN Y,ZHANG L,ET A L.C omparison study of flap thickness created w ith FemtosecondLASIK and SBK[J].C hin J Pract O phthalmol,2012,30(1):65-68.薛超,王雁,左彤,耿维莉,金颖,张琳,等.飞秒激光LASIK和SBK角膜瓣厚度的对照研究[J].中国实用眼科杂志,2012,30(1):65-68.
[5]MONTS-MICR,RODRGUEZ-GALIETERO A,ALIJ L.Femtosecond laser versus mechanical keratome LASIK for myopia[J].Ophthalmology,2007,114(1):62-68.
[6]MONTS-MICR,RODRGUEZ-GALIETERO A,ALIJ L,C ER VIO A.C ontrast sensitivity after LASIK flap creation w ith a femtosecond laser and a mechanical microkeratome[J].J Refract surg,2007,23(2):188-192.
[7]WU WJ,WANG Y.Clinical research progress of the appncation of femtosecond laser in the laser corneal refractive surgery[J].Int Rev O phthalmol,2013,37(3):205-209.
[8]LI Y,NETTO M V,SHEKHAR R,KRUEGER R R,HUANG D.A longitudinal study of LASIK flap and stromal thickness w ith high-speed optical coherence tomography[J].O phthalmology,2007,114(6):1124-1132.
[9]RADHAKRISHNAN S,ROLLINS AM,ROTH JE,YAZDANFAR S,W EST PHAL V,BAR D EN ST EIN D S,ET AL.R eal-time optical coherence tomography of the anterior segment at 1310 nm[J].Arch Ophthalmol,2001,119(8):1179-1185.
[10]OZGURHAN EB,AGCA A,BOZKURT E,GENCER B,CELIK U,C AN KAYA KI,ET AL.Accuracy and precision of cap thickness in small incision lenticule extraction[J].C lin O phthalmol,2013,7:923-926.
[2]VESTERGAARD A,IVARSEN A,ASP S,HJORTDAL J.Smallincision lenticule extraction for moderate to high myopia:predictability,safety,and patient satisfaction[J].J C ataract Refract Surg,2012,38(11):2003-2010.
[3]TIAN L,ZHOU Y H,WANG N L,ZHANG Q W.Characteristics of flaps created w ith an Intra Lase FS60 femtosecond Iaser versus a Femto LD V femtosecond laser[J].C hin J O ptom O phthalmol V is Sci,2011,13(1):4-8.田磊,周跃华,王宁利,张青蔚.Intra Lase FS60和Femto LDV飞秒激光制作角膜瓣的特点[J].中华眼视光学与视觉科学杂志,2011,13(1):4-8.
[4]XUE C,WANG Y,ZUO T,GENG W L,JIN Y,ZHANG L,ET A L.C omparison study of flap thickness created w ith FemtosecondLASIK and SBK[J].C hin J Pract O phthalmol,2012,30(1):65-68.薛超,王雁,左彤,耿维莉,金颖,张琳,等.飞秒激光LASIK和SBK角膜瓣厚度的对照研究[J].中国实用眼科杂志,2012,30(1):65-68.
[5]MONTS-MICR,RODRGUEZ-GALIETERO A,ALIJ L.Femtosecond laser versus mechanical keratome LASIK for myopia[J].Ophthalmology,2007,114(1):62-68.
[6]MONTS-MICR,RODRGUEZ-GALIETERO A,ALIJ L,C ER VIO A.C ontrast sensitivity after LASIK flap creation w ith a femtosecond laser and a mechanical microkeratome[J].J Refract surg,2007,23(2):188-192.
[7]WU WJ,WANG Y.Clinical research progress of the appncation of femtosecond laser in the laser corneal refractive surgery[J].Int Rev O phthalmol,2013,37(3):205-209.
[8]LI Y,NETTO M V,SHEKHAR R,KRUEGER R R,HUANG D.A longitudinal study of LASIK flap and stromal thickness w ith high-speed optical coherence tomography[J].O phthalmology,2007,114(6):1124-1132.
[9]RADHAKRISHNAN S,ROLLINS AM,ROTH JE,YAZDANFAR S,W EST PHAL V,BAR D EN ST EIN D S,ET AL.R eal-time optical coherence tomography of the anterior segment at 1310 nm[J].Arch Ophthalmol,2001,119(8):1179-1185.
[10]OZGURHAN EB,AGCA A,BOZKURT E,GENCER B,CELIK U,C AN KAYA KI,ET AL.Accuracy and precision of cap thickness in small incision lenticule extraction[J].C lin O phthalmol,2013,7:923-926.