Dawood Yousif Farhan, Al Hassany Usama, Issa Ammar F
Department of Ophthalmology, College of Medicine, University of Anbar, Anbar, Iraq.
Department of Ophthalmology, Ibn Al Haitham Teaching Eye Hospital, Baghdad, Iraq.
J Ophthalmic Vis Res. 2017 Oct-Dec;12(4):368-373. doi: 10.4103/jovr.jovr_173_16.
To study changes in flap thickness made with two different microkeratome heads across different corneal locations using anterior segment optical coherence tomography (OCT).
In this prospective, non-randomized, consecutive case series, subjects who had their laser keratomileusis (LASIK) flaps made using 90 μm (MSU90) or 130 μm (MSU130) disposable M2 microkeratome heads were examined using OCT. The measurements were performed at three locations (central and 2.5 mm to either side) at 1 day, 1 week, and 1 month postoperatively.
The central flap thickness was 123 ± 15, 130 ± 14, and 127 ± 13 μm, respectively, at 1 day, 1 week, and 1 month postoperatively in the MSU90 group (41 eyes) and 142 ± 20, 147 ± 19, and 143 ± 15 μm, respectively, in the MSU130 group (47 eyes). At 1 month, peripheral flap thickness was 161 ± 17 and 159 ± 13 μm, respectively, at 2.5 mm to the right and left of corneal center in the MSU90 group. The corresponding figures were 170 ± 14 and 167 ± 13 μm, respectively, in the MSU130 group. There was a statistically significant difference between the two groups at all locations ( < 0.001). No statistically significant change in flap thickness was detected in either group at any assessment time. There was a partial positive correlation (after controlling for preoperative manifest refractive spherical equivalent) between central flap thickness and preoperative ultrasound central pachymetry ( = 0.739, = 0.036) in the MSU90 group but not in the MSU130 group.
Using OCT, changes in flap thickness were minimal in the first month after LASIK. Flap thickness correlated strongly with central corneal thickness if a 90 μm head was used.
使用眼前节光学相干断层扫描（OCT）研究使用两种不同的微型角膜刀头在不同角膜位置制作的角膜瓣厚度变化。
在这个前瞻性、非随机、连续病例系列中，对使用90μm（MSU90）或130μm（MSU130）一次性M2微型角膜刀头制作准分子激光原位角膜磨镶术（LASIK）角膜瓣的受试者进行OCT检查。在术后1天、1周和1个月时在三个位置（中央以及两侧各2.5mm处）进行测量。
MSU90组（41只眼）术后1天、1周和1个月时中央角膜瓣厚度分别为123±15μm、130±14μm和127±13μm，MSU130组（47只眼）分别为142±20μm、147±19μm和143±15μm。在术后1个月时，MSU90组角膜中心右侧和左侧2.5mm处的周边角膜瓣厚度分别为161±17μm和159±13μm。MSU130组相应的数据分别为170±14μm和167±13μm。两组在所有位置均存在统计学显著差异（<0.001）。在任何评估时间，两组的角膜瓣厚度均未检测到统计学显著变化。在MSU90组中，中央角膜瓣厚度与术前超声中央角膜厚度之间存在部分正相关（在控制术前明显屈光球镜等效值后，r = 0.739，P = 0.036），而在MSU130组中则不存在。
使用OCT检查发现，LASIK术后第一个月角膜瓣厚度变化极小。如果使用90μm的刀头，角膜瓣厚度与中央角膜厚度密切相关。
