IntraLase FS60飞秒激光与Moria M2微型角膜刀制作LASIK角膜瓣的效果比较

目的 探讨应用IntraLase FS60飞秒激光与Moria M2微型角膜刀制作准分子激光原位角膜磨镶术（laser in situ keratomileusis,L ASIK）角膜瓣的特点.方法 选取IntraLase FS60组（激光组）患者100例200眼及Moria M2微型角膜刀组（角膜刀组）99例198眼,应用RTVueOCT傅立叶光学相干断层扫描仪分别测量LASIK术后1周每个角膜上0°和90°两条子午线所在截面上特定7个点的角膜瓣厚度.两组角膜瓣预计值均为110 μm.结果 术后1周激光组制作的角膜瓣形态均一、规整,形状近似规则的平面,两条子午线间角膜瓣厚度无明显差异（f=1.582,P=0.114）.角膜刀制作的角膜瓣呈周边厚,中央薄的新月形,两条子午线间角膜瓣厚度无明显差异（t=1.010,P=0.313）.激光组与角膜刀组相比,仅中央点两者厚度无明显差别,其余各点两者间均存在明显差异（P＜0.05）.激光组角膜瓣实际厚度与预计值的差值（7.15 ±4.89） μm明显小于角膜刀组（18.97±1 1.56）μm,差异有统计学意义（P＜0.01）.结论 飞秒激光组制作的LASIK角膜瓣比微型角膜刀制作的LASIK角膜瓣更精确;重现性更好;形态更均一、更规整.

Comparison of the morphology of flaps created by IntraLase FS60 femtosecond laser and Moria M2 mechanical microkeratome

Objective To assess and compare the morphology of laser in situ keratomileusis （LASIK） flaps created by In- tralase FS60 femtosecond laser and the Moria M2 microkeratome. Methods 199 patients were evaluated and 200 eyes in Intralase group and 198 eyes in the microkeratome group. The RTVue optical coherence tomography （OCT） device was used to measure the morphology of LASIK flaps one week postoperatively. Nominal flap thickness was 110 μm for all four FS systems. Results The flaps in the Intralase group were regular and uniform, showing an almost planar configuration, and the difference of flap thicknesses in the horizontal and vertical meridians was not significant （ t = 1. 582, P = 0.114）. The flaps created with the Moria M2 microkeratome were thinnest in the central zone. Thickness increased towards the periphery, resulting in a meniscus shape. The difference of flap thicknes- ses in the horizontal and vertical meridians was not significant （t = 1. 010, P = 0.313）. The mean deviation between the achieved and attempted flap thickness was smaller in the Intralase group （7.15 ± 4.89 ） μm than that in the Moria M2 group （ 18.97± 11.56） μm （ P 〈 0.01 ）. Conclusions The morphologies of flaps created by Intalase femtosecond laser are more uniform and accurate than those created by the Moria M2 microkeratome.