比较准分子激光原位角膜磨镶术中的减法角膜测厚和术后前节光学相干断层扫描。

Comparison of intraoperative subtraction pachymetry and postoperative anterior segment optical coherence tomography of laser in situ keratomileusis flaps.

机构信息

Department of Ophthalmology, Stanford University School of Medicine, Stanford, California 94304, USA.

出版信息

J Cataract Refract Surg. 2011 Oct;37(10):1879-83. doi: 10.1016/j.jcrs.2011.05.024. Epub 2011 Aug 15.

DOI:10.1016/j.jcrs.2011.05.024

PMID:21840682

Abstract

PURPOSE

To prospectively compare intraoperative subtraction pachymetry flap thickness measurements and postoperative anterior segment optical coherence tomography (AS-OCT) flap thickness measurements in eyes that had laser in situ keratomileusis (LASIK) flap creation with a femtosecond laser or a mechanical microkeratome.

SETTING

Stanford Eye Laser Center, Stanford University School of Medicine, Stanford, California, USA.

DESIGN

Comparative case series.

METHODS

Each patient received wavefront-guided LASIK using an Intralase femtosecond laser in 1 eye and a Hansatome mechanical microkeratome in the fellow eye. Flap morphology was assessed with an ultrasound pachymeter intraoperatively and an AS-OCT system postoperatively at 1 year.

RESULTS

Thirty-six eyes (18 patients) were enrolled. Intraoperative subtraction pachymetry consistently underestimated mechanical microkeratome flap thickness compared with postoperative AS-OCT (P<.001). There was no significant difference between intraoperative subtraction pachymetry and postoperative AS-OCT measurements for femtosecond flaps (P=.38). The overall mean variation in flap thickness (ie, mean deviation from targeted flap thickness) was 2.6 μm (range 3 to 11 μm) with the femtosecond laser and 14.2 μm (range 17 to 52 μm) with the mechanical microkeratome (P<.001). Postoperative AS-OCT measurements showed femtosecond flaps had a planar configuration and mechanical microkeratome flaps had a meniscus-shaped configuration.

CONCLUSIONS

The femtosecond laser created more uniformly planar flaps than the mechanical microkeratome as measured by intraoperative subtraction pachymetry and postoperative AS-OCT. Postoperative AS-OCT measurements varied less than intraoperative subtraction pachymetry measurements for mechanical microkeratome flaps.

FINANCIAL DISCLOSURE

Neither author has a financial or proprietary interest in any material or method mentioned.

摘要

目的

前瞻性比较飞秒激光或机械角膜刀行 LASIK 术中角膜瓣厚度的减法测量值与术后眼前节光学相干断层扫描（AS-OCT）瓣厚度的测量值。

设置

美国斯坦福大学医学院斯坦福眼激光中心。

设计

对比病例系列。

方法

每位患者均在一眼接受基于波前像差引导的 Intralase 飞秒激光 LASIK，另一眼接受 Hansatome 机械角膜刀 LASIK。术中应用超声角膜测厚仪，术后 1 年应用 AS-OCT 系统评估角膜瓣形态。

结果

共纳入 36 只眼（18 例患者）。术中角膜减法测量值与术后 AS-OCT 测量值相比，始终低估机械角膜刀角膜瓣厚度（P<.001）。飞秒激光组术中角膜减法测量值与术后 AS-OCT 测量值之间无显著差异（P=.38）。机械角膜刀组角膜瓣厚度的总体平均差异（即，与目标角膜瓣厚度的平均偏差）为 2.6 μm（范围 3 至 11 μm），飞秒激光组为 14.2 μm（范围 17 至 52 μm）（P<.001）。术后 AS-OCT 测量值显示，飞秒激光组的角膜瓣呈平面状，而机械角膜刀组的角膜瓣呈新月形。