Krueger R R, Juhasz T, Gualano A, Marchi V
Saint Louis University Eye Institute, Department of Ophthalmology, Saint Louis University School of Medicine, Missouri 63104, USA.
J Refract Surg. 1998 Jul-Aug;14(4):467-9. doi: 10.3928/1081-597X-19980701-15.
To introduce the clinical use of the Nd:YLF picosecond laser as a nonmechanical microkeratome.
A commercially available Nd:YLF picosecond laser (25 microJ/pulse, 30 psec, 1053 nm) was used to deliver intrastromal pulses of focused high power laser light to generate a flap for laser in situ keratomileusis (LASIK) and perform picosecond laser keratomileusis (PLK) in two partially sighted patients with high myopia.
Case #1: A 6 mm, 150 microns flap for LASIK was successfully created and the underlying stroma treated with an excimer laser for a target correction of -15.00 D of myopia. Good corneal clarity and a refractive change of -14.00 D was recorded 2 months postoperatively. Case #2: Both eyes of a high myope (-22.00 D right eye, -21.50 D left eye) underwent picosecond laser keratomileusis, removing a 3.2 mm diameter lenticule of 120 microns thickness under a 200 microns flap. Postoperative refraction was -2.00 D at 7 months in the right eye and -0.75 D at 2 months in the left eye with improvement of spectacle-corrected visual acuity from 20/200 to 20/70 in each eye.
The Nd:YLF picosecond laser can be safely used in creating a corneal flap for LASIK and in performing picosecond laser keratomileusis for high myopia. Future refinements in the laser will include a larger flap diameter and femtosecond pulsing capability.
介绍钕：钇锂氟化物皮秒激光作为非机械性微型角膜刀的临床应用。
使用市售的钕：钇锂氟化物皮秒激光（25微焦/脉冲，30皮秒，1053纳米），向基质内输送聚焦的高功率激光脉冲，为两名高度近视的低视力患者制作用于准分子原位角膜磨镶术（LASIK）的角膜瓣，并进行皮秒激光角膜磨镶术（PLK）。
病例1：成功制作了一个用于LASIK的6毫米、150微米厚的角膜瓣，并用准分子激光对其下方基质进行治疗，目标是矫正-15.00 D的近视。术后2个月角膜清晰度良好，屈光变化为-14.00 D。病例2：一名高度近视患者（右眼-22.00 D，左眼-21.50 D）的双眼接受了皮秒激光角膜磨镶术，在200微米厚的角膜瓣下切除了一个直径3.2毫米、厚度120微米的透镜状组织。右眼术后7个月的屈光度为-2.00 D，左眼术后2个月的屈光度为-0.75 D，每只眼的矫正视力从20/200提高到了20/70。
钕：钇锂氟化物皮秒激光可安全用于制作LASIK的角膜瓣以及对高度近视进行皮秒激光角膜磨镶术。该激光未来的改进将包括更大的角膜瓣直径和飞秒脉冲能力。
