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目的研究LASIK术中应用角膜微型板层刀的全新刀片,通过高压消毒处理后制作较薄角膜瓣的效果。方法选择双眼屈光度相近、同时进行双眼LASIK术的患者63例(126眼),术中使用M2的90微型刀头制作角膜瓣,右眼使用全新刀片,左眼使用连续高压消毒3次后的新刀片。术中用A超角膜测厚仪进行角膜厚度测量,计算角膜瓣的厚度。术后观察3个月的视力、屈光度、对比敏感度和角膜地形图(角膜像差)的变化。结果右眼和左眼术前屈光度(等效球镜度)分别为:-2.25～-9.50D,平均(-5.28±1.73)D和-2.00～-9.88D,平均(-5.51±1.62)D(P>0.05);角膜瓣厚度为:(133.9±12.3)μm和(114.7±13.1)μm(P<0.05);术后屈光度分别为:(-0.12±0.23)D和(-0.15±0.12)D(P>0.05);裸眼视力分别为:1.05±0.21和1.05±0.19(P>0.05);高阶像差均方根值(RMS)分别为:(0.68±0.12)μm和(0.66±0.13)μm(P>0.05);对比敏感度:在3.0c/d、6.0c/d、12.0c/d、18.0c/d空间频率的比较中两组数值相近(P>0.05)。结论应用经过高压处理后的新刀片可以制作出优质的、较薄的角膜瓣。
Objective To study the effect of using thin corneal lamina knife in LASIK to make thin corneal flap after high pressure disinfection. Methods Sixty-three eyes (126 eyes) with bilateral binocular refractive power and bilateral LASIK surgery were selected. The corneal flap was made using 90 micro-blades of M2 during operation. New blades were used in the right eye and three times in the left eye after continuous high-pressure sterilization blade. Corneal thickness was measured with A-corneal thickness gauge and the thickness of corneal flap was calculated. Visual acuity, refraction, contrast sensitivity and corneal topography (corneal aberration) were observed after 3 months. Results The preoperative refraction (equivalent spherical scope) of right and left eyes were -2.25 ~ -9.50D, mean (-5.28 ± 1.73) D and -2.00 ~ -9.88D, mean (-5.51 ± 1.62) D (P <0.05). The thickness of corneal flap was (133.9 ± 12.3) μm and (114.7 ± 13.1) μm respectively (P <0.05) .The postoperative refraction was (-0.12 ± 0.23) D and (-0.15 ± 0.12) (P> 0.05). The uncorrected visual acuities were 1.05 ± 0.21 and 1.05 ± 0.19, respectively (P> 0.05). The RMS of higher order aberrations were (0.68 ± 0.12) μm and (0.66 ± 0.13 ) μm (P> 0.05). Contrast sensitivity: The spatial frequency of 3.0c / d, 6.0c / d, 12.0c / d and 18.0c / d were similar (P> 0.05). Conclusion High-quality, thinner corneal flap can be made by using a new high-pressure-treated blade.