准分子激光手术中OUP-SBK刀头制作超薄角膜瓣矫治近视的疗效分析

目的分析准分子激光手术中采用OUP-SBK刀头制作超薄角膜瓣矫治近视的疗效。方法准分子激光近视手术的患者578例,随机分为薄角膜瓣组378例745只眼和厚角膜瓣组200例389只眼。分别在手术后1d、1周、1和3个月随访检查裸眼视力（uncorrected visual acuity,UCVA）、最佳矫正视力（the best corrected visual acuity,BSCVA）、屈光度,并对数据进行统计学分析。结果手术前薄角膜瓣组球镜和柱镜较厚角膜瓣组偏大,差异有显著意义（P〈0.05）;手术后UCVA达到1.0的百分率,术后1 d薄角膜瓣组为90.2%,厚角膜瓣组为91.4%;术后3个月薄角膜瓣组为95.6%,厚角膜瓣组为96.6%;差异均无显著意义（P〉0.05）;手术后3个月BSCVA较术前丢失1行的比例薄角膜瓣组为11.0%,厚角膜瓣组8.8%,差异没有显著意义（P〉0.05）。手术后3个月屈光度±0.50 D以内薄角膜瓣组为90.6%,厚角膜瓣组为92.6%;±1.00D以内薄角膜瓣组为97.5%,厚角膜瓣组为97.4%;差异均无显著意义（P〉0.05）。结论利用OUP-SBK刀头制作超薄角膜瓣矫正近视安全有效,手术效果稳定,可为患者保留更多的基质床厚度,扩大近视的矫治范围,有助于高度近视且角膜薄的患者以及二次手术矫治屈光回退提供机会。

Clinical Effectivity of Ultra-flap for on Treatment of Myopia by One Use Plus (oup)-(Sub-Bowman Keratomileusis) SBK Microkeratome

Objective To inveatigate the clinical effectivity of the Moria One use plus（OUP）-Sub-Bowman keratomileusis（SBK） for the treatment of myopia. Methods All cases were divided randomly into two groups according to microkeratome,the thin-flap group（OUP-SBK） and the thick-flap group（Moria2-130 Ixm）.All cases were examined uncorrected visual acuity（UCVA）,the best corrected visual acuity（BSCVA） and refraction post-operation 1 d,1 week,1month and 3 months.All data were analyzed statistically by SPSS 13.0. Results The mean refraction diopter of thin-flap group was higher than thick-flap group.The rate of eyes whose UCVA was higher than 1.0 was 90.2% in thin-flap group vs 91.4% in thick-flap group 1 day post-operation,and 95.6% and 96.6% 3 months post-operation,which was without statistical difference between two groups during all of the above times（P0.05）.The rate of eyes whose BSCVA was loss 1 line was 11% in thin-flap group vs 8.8% in thick-flap group,there was no statistical difference between two groups（P0.05）.The rate of eyes whose refracted diopter was within ±0.50 D was 89% in thin-flap group vs 91.2% in thick-flap group,and had no statistical difference between two groups.The rate of eyes whose refracted diopter was within ±1.00D was 97.5% in thin-flap group vs 97.4% in thick-flap group,and also had no statistical difference between two groups. Conclusions It is feasible and reliable to make ulrathin flap in LASIK by OUP-SBK for the treatment of myopia.It can remain more corneal stroma and increase rectification scope,and give more chances for high myopia and twice operation.