Melles G R, Rietveld F J, Beekhuis W H, Binder P S
Cornea Service, Rotterdam Eye Hospital, The Netherlands.
Cornea. 1999 Jan;18(1):80-6.
To describe a surgical technique to visualize the depth of corneal incisions and lamellar stromal dissections during surgery.
In porcine cadaver eyes, the aqueous was exchanged by air. Thus an air-to-endothelium interface (i.e., a useful optical surface) was created at the posterior corneal surface. The air-to-endothelium interface was used as a reference plane to visualize the corneal thickness and the relative depth of corneal incisions and dissections. Freehand peripheral corneal incisions, tangential keratotomy incisions, and lamellar stromal dissections were made at an intended corneal depth of 60, 80, and 99%. Light microscopy was used to measure the relative depth of the incisions and dissections.
Achieved depth for peripheral corneal incisions averaged 65.2+/-5.3%, 78.8+/-5.1%, and 93.4+/-6.0%, respectively (p<0.05); and for tangential keratotomy incisions, 68.2+/-7.3%, 83.2+/-4.4%, and 95.8+/-3.6%, respectively (p<0.05). Achieved depth for lamellar stromal dissections averaged 58.3+/-9.4%, 81.1+/-3.4%, and 94.4+/-1.5%, respectively (p<0.05). Microperforations occurred with three incisions made at 99% intended depth.
During surgery, the depth of incisions and lamellar dissections relative to the corneal thickness can be visualized by filling the anterior chamber with air (i.e., by creating an optical interface at the posterior corneal surface).
描述一种在手术过程中可视化角膜切口深度和板层基质剥离深度的手术技术。
在猪尸体眼内，用空气置换房水。由此在角膜后表面形成了气-内皮界面（即一个有用的光学表面）。气-内皮界面被用作参考平面，以可视化角膜厚度以及角膜切口和剥离的相对深度。在预期角膜深度为60%、80%和99%处进行徒手周边角膜切口、切线角膜切开术切口和板层基质剥离。使用光学显微镜测量切口和剥离的相对深度。
周边角膜切口实际达到的深度分别平均为65.2±5.3%、78.8±5.1%和93.4±6.0%（p<0.05）；切线角膜切开术切口分别为68.2±7.3%、83.2±4.4%和95.8±3.6%（p<0.05）。板层基质剥离实际达到的深度分别平均为58.3±9.4%、81.1±3.4%和94.4±1.5%（p<0.05）。在预期深度99%处进行的三个切口出现了微小穿孔。
在手术过程中，通过向前房内注入空气（即在角膜后表面创建一个光学界面），可以可视化切口和板层剥离相对于角膜厚度的深度。
