重复使用的LASIK角膜板层切削刀扫描电镜观察

目的：观察准分子激光角膜板层显微切削刀在应用不同手术次数后，与未使用过的新切削刀对比所发生的变化，从而为临床提供客观资料。方法：共收集12只CHIRON显微切削刀，其中2只为未用于手术的新刀（0眼术后），其余为3眼、4眼、5眼、6眼、8眼术后各2只。这些刀片在术后立即收集到原盒中保存以防进一步的损伤。所有切削刀均用HITACHIS－3200扫描电镜观察。结果：本文通过对12只重复使用的板层切削刀进行扫描电镜观察，且与未使用过的新刀相对比，发现未使用过的切削刀质地细腻，刀缘连续性好，随着使用次数的增多，刀质粗糙，出现裂隙和孔洞。结论：角膜板层切削刀随着使用次数增加，刀质的损害程度加重，提示使用此刀的抛弃型尚安全可靠。

Study of LASIK blade comparing new and reused blades by scanning electron microscopy

To detect the changes of Lasik microkeratome blades at different times after Lasik surgery and compare them with the new blades.Methods:A total of 12 CHIRON Microkeratome blades used for Lasik were collected immediately after surgery in our refractive center,then replaced in its original pack to protect it from further damage.All blades were scanned and photographed with a HITACHI S 3200 scanning electron microscope at several magnifications and angles in order to detect the degree of damage of multiple use up to eight times.New blades were used as a control group.Results:there were significant changes on the shaft,noticeable after single use,including less of mild texture surface and edge continuity.The greater the use,the greater the deterioration:notches,roundness irregularity,roughness and dullness along the edge.Scratches of the shaft as well as cracking was detected after only three times use(three eyes).Conclusions:The results show that the greater the number of blades use,the greater the damage occur both on the shaft end and the cutting edge.We strongly recommended that Lasik blades should be disposed after single use,since the damage is developed with the increasing number of use.