LASIK术中制作薄角膜瓣的并发症及处理

目的回顾分析在准分子激光原位角膜磨镶术（LASIK）术中使用Moria M2显微角膜刀（110刀头）制作薄角膜瓣时发生并发症的原因，总结出预防这些并发症的方法以及相应的处理措施。方法在使用美国VIXS S4准分子激光治疗仪进行LASIK手术的3386例6162眼中，均应用Moria M2（110刀头）显微角膜刀制作薄角膜瓣。记录术中制作角膜瓣的并发症，分析引起并发症的原因，并对术中发生的角膜瓣并发症进行及时妥善处理，采取相应的治疗对策。结果术中与角膜瓣有关的并发症有：游离瓣2例2眼、钮扣瓣4例4眼、碎瓣1例1眼、洗衣板样角膜瓣1例1眼、出现“岛屿现象”，即角膜基质床有不规则隆起，呈孤立的片状或条状者6例6只眼，计14例14眼，占总手术的0．23％。出现这些并发症的主要原因有：显微角膜刀真空泵的负压影响、吸引环的选择、患者本身的危险因素等等。这些并发症经过及时、妥善、正确的处理，预后均良好。结论Moria M2显微角膜刀（110刀头）制作薄角膜瓣是安全有效的，熟练掌握机器的性能及提高手术技巧可有助于减少并发症，增强手术的安全性，获得良好的手术效果。

Management of complications of making the thin corneal flaps with Moria M2 automatic microkeratome in LASIK

OBJECTIVE To analysis retrospectively the reason of the complications of making thin corneal flaps （110 μm）with Moria M2 automatic microkeratome in LASIK, and to find out the method of taking precautions against and treating to these complications. METHODS Six thousand one hundred and sixty - two（ in 3386cases）corneal flaps were made using Moria M2 automatic microkeratome in LASIK. The complications of the corneal flaps and the reason of these complications were recorded（written down）. RESULTS The complications of making thin corneal flaps with Moria M2 automatic microkeratome in LASIK included free flap （ 2cases 2eyes）, button flap （ 4cases 4eyes）, ruptured flap （ 1 case 1 eye）, washboard flap （ 1 case 1 eye）, island phenomenon （6cases 6eyes）. These complications occurred in 14casesl4eyes （0.23 % ）. The main reasons for these complications were： minus pressure from the vacuumpump, the choice of the suction ring, patient risk factors, etc. These complications can be cured by timely, proper and correct treatment. CONCLUSIONS Moria M2 automatic microkeratome is an effective and safe instnmaent for making thin corneal flaps in LASIK. The complications of the corneal flaps can be decreased by having in hand the function of Moria M2 automatic microkeratome and improving surgical technique.