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使用200kHz飞秒激光系统与传统机械微型角膜刀对接受准分子原位角膜磨镶术(LASIK)的患者角膜瓣侧切角的验证与测量。

Verification and measurement of the side-cut angle of corneal flap in patients undergoing LASIK surgery using FS 200 kHz femtosecond laser system versus conventional mechanical microkeratome.

作者信息

Taha Sarah, Azzam Sarah, Anis Mohamed, Zaazou Cherif, Hosny Mohamed

机构信息

Department of Ophthalmology, Cairo University Hospital, Cairo, Egypt.

出版信息

Clin Ophthalmol. 2019 Jun 10;13:985-992. doi: 10.2147/OPTH.S201150. eCollection 2019.

DOI:10.2147/OPTH.S201150
PMID:31354232
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6572716/
Abstract

This is a prospective nonrandomized interventional clinical trial conducted to measure and verify the intended versus the achieved LASIK flap side-cut angle in two groups of patients, Femtosecond laser-assisted in-situ keratomileusis (FS-LASIK) using Wavelight FS200 (Alcon Laboratories Inc. Fort Worth, TX, USA) and the conventional mechanical microkeratme (Moria M 90). This prospective clinical trial was conducted on 40 eyes of 20 patients (20 eyes in each group) in the interval between December 2017 and August 2018. Heidelberg anterior segment OCT was done for the patients 2 weeks postoperatively to measure the corneal flap side cut angle. The achieved side-cut angles of all the patients in the first group (the femtosecond laser-assisted in-situ keratomileusis group) were equal to or more inverted than the intended angle (110-115°) in all the study candidates with a minimum angle (110°) and maximum angle (155°). Unlike the achieved side-cut angle in the second group (the mechanical microkeratome group) in which all the achieved side-cut angle were acute with a minimum angle (30°) and maximum angle (65°) which is more acute than the intended side-cut angle (70°). In our study we found that the femtoLASIK technology was capable of making the flap side-cut angle more obtuse than the intended angle, unlike the achieved flap side-cut angle done using the mechanical microkeratome which was more acute than the intended angle in 100% of cases.

摘要

这是一项前瞻性非随机干预性临床试验,旨在测量和验证两组患者中准分子激光原位角膜磨镶术(LASIK)瓣侧切角的预期值与实际值,一组使用威视FS200飞秒激光(美国德克萨斯州沃思堡爱尔康实验室公司)进行飞秒激光原位角膜磨镶术(FS-LASIK),另一组使用传统机械微型角膜刀(Moria M 90)。这项前瞻性临床试验于2017年12月至2018年8月期间,对20例患者的40只眼(每组20只眼)进行。术后2周对患者进行海德堡眼前节光学相干断层扫描,以测量角膜瓣侧切角。在所有研究对象中,第一组(飞秒激光原位角膜磨镶术组)所有患者的实际侧切角均等于或大于预期角度(110 - 115°),最小角度为110°,最大角度为155°。与第二组(机械微型角膜刀组)不同,该组所有实际侧切角均为锐角,最小角度为30°,最大角度为65°,比预期侧切角(70°)更尖锐。在我们的研究中,我们发现飞秒激光原位角膜磨镶术技术能够使瓣侧切角比预期角度更钝,这与使用机械微型角膜刀所获得的瓣侧切角不同,后者在100%的病例中比预期角度更尖锐。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/07bd/6572716/b11e214c7f27/OPTH-13-985-g0007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/07bd/6572716/f925390d5f75/OPTH-13-985-g0001.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/07bd/6572716/b11e214c7f27/OPTH-13-985-g0007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/07bd/6572716/f925390d5f75/OPTH-13-985-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/07bd/6572716/98a10c5f1754/OPTH-13-985-g0002.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/07bd/6572716/df9e13782a79/OPTH-13-985-g0006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/07bd/6572716/b11e214c7f27/OPTH-13-985-g0007.jpg

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本文引用的文献

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Ophthalmology. 2014 Dec;121(12):2311-6. doi: 10.1016/j.ophtha.2014.07.015. Epub 2014 Aug 30.
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Microkeratome versus femtosecond flaps: accuracy and complications.角膜刀与飞秒瓣:准确性和并发症。
Curr Opin Ophthalmol. 2014 Jul;25(4):270-4. doi: 10.1097/ICU.0000000000000070.
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The role of corneal innervation in LASIK-induced neuropathic dry eye.
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角膜神经支配在 LASIK 诱导的神经病理性干眼中的作用。
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Effects of variation in depth and side cut angulations in LASIK and thin-flap LASIK using a femtosecond laser: a biomechanical study.飞秒激光 LASIK 和薄瓣 LASIK 中深度和侧切口角度变化的影响:一项生物力学研究。
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Comparison of the IntraLase femtosecond laser and mechanical keratomes for laser in situ keratomileusis.用于准分子原位角膜磨镶术的飞秒激光与机械角膜刀的比较。
J Cataract Refract Surg. 2004 Apr;30(4):804-11. doi: 10.1016/j.jcrs.2003.10.026.