与自动角膜板层成形刀相比，使用汉森角膜刀时术中角膜瓣并发症发生率更低。

Lower intraoperative flap complication rate with the Hansatome microkeratome compared to the Automated Corneal Shaper.

作者信息

Walker M B, Wilson S E

机构信息

Department of Ophthalmology, The University of Washington School of Medicine, Seattle 98195-6485, USA.

出版信息

J Refract Surg. 2000 Jan-Feb;16(1):79-82. doi: 10.3928/1081-597X-20000101-11.

DOI:10.3928/1081-597X-20000101-11

PMID:10693623

Abstract

PURPOSE

The purpose of this study was to retrospectively compare the incidence of intraoperative flap complications, such as partial flaps, donut-shaped flaps, central corneal cuts, and complete caps with the Hansatome and Automated Corneal Shaper (ACS) microkeratomes.

METHODS

All laser in situ keratomileusis (LASIK) procedures performed by a single surgeon with the Hansatome or Automated Corneal Shaper in which intraocular pressure was verified with a pneumotonometer were reviewed.

RESULTS

A total of 90 eyes had LASIK with the ACS microkeratome. Six of the ACS eyes (6.7%) had intraoperative flap complications (4 partial flaps, 1 donut-shaped flap, 0 central corneal cuts, 1 complete cap). Partial flaps and donut-shaped flaps were replaced without laser application and the procedure repeated 2 to 3 months later. Two of these eyes lost 2 lines and one lost 1 line of spectacle-corrected visual acuity at 6 months after repeat LASIK. The eye with the donut-shaped flap was treated with transepithelial photorefractive keratectomy (PRK) and had no change in spectacle-corrected visual acuity at 6 months after PRK. The eye with the complete cap had no change in spectacle-corrected visual acuity after laser ablation. Five hundred ninety-eight (598) eyes had LASIK with the Hansatome microkeratome. Two of the Hansatome eyes (0.3%) had a flap complication (1 partial flap and 1 donut-shaped flap). The first eye retained spectacle-corrected visual acuity at 6 months after repeat LASIK. The second eye had transepithelial PRK to eliminate the donut shaped flap with no loss of spectacle-corrected visual acuity at 6 months after surgery. The difference in flap complications between the two procedures was statistically significant (P < .01). There were no flap displacements following surgery in either group.

CONCLUSION

Intraoperative flap complications are less likely to occur with the Hansatome microkeratome than with the ACS microkeratome.

摘要

目的

本研究旨在回顾性比较使用汉森刀（Hansatome）和自动角膜板层刀（ACS）制作角膜瓣时术中角膜瓣并发症的发生率，如部分角膜瓣、甜甜圈形角膜瓣、中央角膜切口和完整角膜帽。

方法

回顾由单一外科医生使用汉森刀或自动角膜板层刀进行的所有准分子原位角膜磨镶术（LASIK）手术，术中使用眼压计测量眼压。

结果

共有90只眼使用ACS自动角膜板层刀进行LASIK手术。其中6只ACS组眼（6.7%）出现术中角膜瓣并发症（4例部分角膜瓣、1例甜甜圈形角膜瓣、0例中央角膜切口、1例完整角膜帽）。部分角膜瓣和甜甜圈形角膜瓣未行激光治疗即重新制作，2至3个月后重复手术。其中2只眼在重复LASIK术后6个月时，矫正视力下降2行，1只眼下降1行。甜甜圈形角膜瓣的患眼接受了经上皮准分子激光角膜切削术（PRK），PRK术后6个月矫正视力无变化。完整角膜帽的患眼在激光消融后矫正视力无变化。598只眼使用汉森刀进行LASIK手术。其中2只汉森刀组眼（0.3%）出现角膜瓣并发症（1例部分角膜瓣和1例甜甜圈形角膜瓣）。第一只眼在重复LASIK术后6个月时保留了矫正视力。第二只眼接受经上皮PRK以消除甜甜圈形角膜瓣，术后6个月矫正视力未下降。两种手术的角膜瓣并发症差异有统计学意义（P < .01）。两组术后均未出现角膜瓣移位。