Wachtlin J, Schüler A, Hoffmann F
Department of Ophthalmology, Steglitz Medical Center, Free University of Berlin, Germany.
Cornea. 1995 May;14(3):235-42. doi: 10.1097/00003226-199505000-00002.
The layer thickness of the corneal lenticules separated with the Berlin microkeratome and shaped by keratomileusis, keratophakia, keratokyphosis, and intrastromal excimer-laserkeratomileusis was measured with the Universal Measuring Microscope. The vertices of most corneal lenticules showed an undercorrection of the measured values compared with the calculated ones. In keratomileusis, the vertex of the central part of the optical zone of 3.6 mm attained 79 +/- 19 microns instead of 80 microns (99%); in keratophakia, 74 +/- 19 microns instead of 80 microns (93%); in myopic keratokyphosis, 77 +/- 11 microns instead of 105 microns (74%); in hyperopic keratokyphosis, 72 +/- 28 microns instead of 105 microns (69%); and in excimer-laserkeratomileusis, 52 +/- 12 microns instead of 39 microns (120%). The undercorrection of myopic and hyperopic keratokyphosis indicate that this type of nonfreeze keratomileusis is not capable to cut a tissue lens of predicted refraction from compressed corneal tissue. Near symmetrical profiles were achieved in all types of refractive corneal surgery but excimer-laserkeratomileusis had the smallest standard deviation. It was significantly smaller than in hyperopic keratokyphosis (p < 0.05). Intrastromal excimer-laserkeratomileusis of tightly fixed corneal lenticule in the Berlin microkeratome might be the most predictable method of lamellar refractive corneal surgery.
使用万能测量显微镜测量了用柏林微型角膜刀分离并通过角膜磨镶术、角膜晶状体植入术、角膜后凸成形术和基质内准分子激光角膜磨镶术塑形的角膜透镜薄片的层厚。与计算值相比，大多数角膜透镜薄片的顶点显示测量值欠矫。在角膜磨镶术中，3.6毫米光学区中央部分的顶点达到79±19微米，而不是80微米（99%）；在角膜晶状体植入术中，为74±19微米，而不是80微米（93%）；在近视性角膜后凸成形术中，为77±11微米，而不是105微米（74%）；在远视性角膜后凸成形术中，为72±28微米，而不是105微米（69%）；在准分子激光角膜磨镶术中，为52±12微米，而不是39微米（120%）。近视性和远视性角膜后凸成形术的欠矫表明，这种类型的非冷冻角膜磨镶术无法从压缩的角膜组织中切割出具有预测屈光度的组织透镜。除准分子激光角膜磨镶术外，所有类型的屈光性角膜手术均获得了近似对称的轮廓，但准分子激光角膜磨镶术的标准差最小。它显著小于远视性角膜后凸成形术（p<0.05）。在柏林微型角膜刀中对紧密固定的角膜透镜薄片进行基质内准分子激光角膜磨镶术可能是最可预测的板层屈光性角膜手术方法。
