手推式板层刀与自动旋转刀制瓣在LASIK手术中应用比较

目的 比较两种制瓣方法的优劣及疗效.方法 随机抽取我院2004年6～8月LASIK手术患者400例,其中手推式板层刀制瓣患者200例396只眼,自动旋转刀制瓣患者200例394只眼.制瓣后用同一台激光机行激光治疗.术后1、3 d,1、2周,1个月复查视力、电脑验光、测眼压、角膜地形图、裂隙灯检查,比较两组患者术中术后并发症及疗效.结果 术中出现游离瓣和不全瓣者手推刀组有5只眼(1.26%),旋转刀组有2只眼(0.51%);术后手推刀组2只眼(0.50%)出现瓣皱褶和瓣移位,旋转刀组术后2只眼出现瓣溶解(0.51%).术后视力比较,两组差异无显著意义(P＞0.05).术后1个月BUT检查,两组比较差异有显著意义(P＜0.01).术后裂隙灯检查和地形图分析两组差异无显著意义.结论 两种制瓣方法均有良好效果.1个月BUT检查,手推刀所作鼻侧蒂优于旋转刀作上方蒂.

Comparison of Using of LASIK with Osillating and Rotating Microkeratome

Objective To compare the priority and the postoperative effect between two kinds of microkeratomes.Methods Laser in situ keratomileusis(LASIK)was done in 400 patients(790 eyes)randomly with rotating microkeratome(394 eyes,group A)or oscillating microkeratome(396 eyes,group B).Postoperatively,patients were checked at 1 day,3 day,1week,2 weeks and 1 month.The outcomes of complications and effects of 2 groups were compared and analyzed.Results There were 5 eyes that appeared free or incomplete corneal flap in the group A(1.26%),while in the group B were 2 eyes(0.51%);2 eyes appeared flap fold and move in the group A(0.51%),while 2 eyes appeared flap melt in the group B(0.51%).There were no significant differences of the postoperative visual acuities between two groups(P>0.05),but at 1 month postoperatively,the difference of break up time(BUT)was statistically significant between two groups(P<0.01).Their were no significant differences of the corneal topographic map analysis and slit lamp microscope examination.Conclusions LASIK operations with rotating microkeratome and oscillating microkeratome are both effective.The oscillating microkeratome group(group A)is superior to the rotating microkeratome group(group B)on BUT 1 month after operation.