摘要
目的探讨和比较角膜瓣的旋切方式与平切方式对准分子激光原位角膜磨镶术(laser in situ keratomileusis,LASIK)术后角膜知觉恢复的影响。方法观察2005年11月～2006年4月在我院行LASIK矫正手术且随诊数据完整者62例(120眼),将其按微型角膜刀制作角膜瓣的类型分为两组:Ⅰ组为角膜瓣平切方式,32例(60眼);Ⅱ组为角膜瓣旋切方式,30例(60眼),两组分别在术前、术后第10天、第1个月、第3个月、第6个月进行角膜知觉的测定和比较。结果Ⅰ组和Ⅱ组术前、术后第10天、第1个月、第3个月、第6个月角膜知觉均值分别为(54.91±3.25)mm、(54.75±3.49)mm,(16.33±4.59)mm、(13.92±5.05)mm,(33.58±8.78)mm、(24.16±5.38)mm,(45.75±7.41)mm、(36.08±4.79)mm,(53.58±6.95)mm、(46.00±5.43)mm。两组数据进行统计学分析,Ⅰ组及Ⅱ组术后第10天、第1个月、第3个月、Ⅱ组术后第6个月角膜知觉均较术前明显下降,差异具有显著性(P<0.01)。两组角膜知觉均在术后第10天时最低,1个月后开始恢复,Ⅰ组术后第6个月时基本正常,Ⅱ组接近正常则需要6个月以上。结论在LASIK手术中,采用角膜瓣的平切方式对角膜神经的损伤小,其术后角膜知觉的恢复早于角膜瓣的旋切方式。
Objective To investigate the effect of different corneal flaps on corneal sensitivity after laser in situ keratomileusis （LASIK）. The flaps were made with a rotating or oscillating micrekeratome. Methods Sixty-two patients （120 eyes） who had received LASIK treatment in the PUMC Hospital from 11/2005 to 4/ 2006 were divided into two groups. Corneal flaps were made with an oscillating micrekeratome in group Ⅰ（60 eyes）, and a rotating micrekeratome in group Ⅱ（60 eyes）. Corneal sensitivity was evaluated preoperatively and at 10 days, 1 month, 3 months and 6 months postoperatively. Results Corneal sensitivity for groups Ⅰ and Ⅱ was measured preoperatively and at 10 days, 1 month, 3 months, and 6 months postoperatively. The respective results for group Ⅰ and group Ⅱwere （54.91±3.25）mm and （54.75±3.49）mm （preoperatively）, （16.33±4.59）mm and （13.92±5.05）mm （at 10 days）, （33.58±8.78）mm and （24.16±5.38）mm （at 1 month）, （45.75±7.41）mm and （36.08 ±4.79）mm （at 3 months）, and （53.58 ±6.95）mm and （46.00±5.43）mm （at 6 months）. Compared to preoperative measurements, corneal sensitivity showed a significant decrease at 10 days, 1 month and 3 months postoperatively in both groups （P〈0.01）, while corneal sensitivity remained significantly low at 6 months postoperatively in group Ⅱ （P〈0.01）. Corneal sensitivity reached the lowest level on day 10 postoperatively for both groups and sensitivity began to recover at about 1 month. For group Ⅰ , corneal sensitivity returned to normal at 6 months postoperatively. For group Ⅱ, corneal sensitivity showed a relatively long-term recovery of more than 6 months. Conclusion Corneal sensitivity recovers more quickly after LASIK with an oscillating micrekeratome procedure than with a rotating mierekeratome. These results indicate that the oscillating micrekeratome causes less damage to corneal nerve fibers during LASIK.
出处
《眼视光学杂志》
2008年第2期123-125,共3页
Chinese Journal of Optometry & Ophthalmology
关键词
角膜知觉
角膜磨镶术
激光原位
方法
角膜瓣
角膜神经
corneal sensitivity
keratomileusis,laser in situ/methods
corneal flap
corneal nerve
