飞秒激光和OUP角膜板层刀制瓣的猪眼角膜基质床表面形态特点比较

目的比较飞秒激光（LDV FS，瑞士Zieme公司）和One Use-Plus（OUP）（法国Moria公司）角膜板层刀制瓣后角膜基质床表面的形态特征。方法实验研究。分别采用850 mW脉冲能量飞秒激光和OUP全自动机械角膜切割刀对12只新鲜猪眼球进行制瓣，每组6只眼。术后用扫描电镜（S-3500N日本日立公司）对角膜瓣边缘及角膜基质床表面的结构进行观察和对比分析。结果飞秒激光制作角膜瓣，角膜基质床表面光滑，可见组织间桥，侧切部位组织排列规则，边缘清晰，对周围区组织影响小；OUP角膜板层刀制瓣组整体角膜基质床边缘不太规则，有大量翘起的角膜纤维组织，不太光滑，侧切面与基质床和上皮表面分界不明显，有纵行划痕，对周围区角膜组织影响较大。结论与OUP角膜板层刀制瓣法相比，飞秒激光制瓣后角膜基质床表面更光滑，结构更规则。

A study of femtosecond laser and the Moria One Use-Plus microkeratome flaps by comparing the surface characteristics of the porcine corneal stromal bed

ObjectiveTo analyze the difference in flaps made with either a femtosecond laser or a microkeratome by comparing the surface characteristics of the porcine cornea. MethodsExperimental study. Corneal flaps were made with a Femto LDV （Switzerland， Ziemer Ophthalmic Systems） femtosecond laser with a pulse energy of 850 mW or with an One Use-Plus （OUP） automatic mechanical microkeratome （Moria-M2） in fresh porcine eyes， 6 eyes in each group. Scanning electron microscopy （S-3500N Hitachi High-Technologies Corp） was used to observe and compare the ultrastructural characteristics of the stroma bed surface and flap edge after making the corneal flap． ResultsThe corneal stroma had evaporated and a smooth surface was created by photodisruption in the femtosecond laser group. Residual tissue bridges could be observed under the scanning electron microscope． The edges were regular and the edge was clear with a small damage zone after cutting with the femtosecond laser． However， many elevated fibril tissues could be seen on the corneal surface after making the flap with the Moria OUP microkeratome． The lateral section and substrate bed were not distinct since the longitudinal cut greatly affected the surrounding area of the corneal tissue. ConclusionThe microstructure of the corneal stroma bed surface is smoother and sharper after making a corneal flap with a femtosecond laser than with the Moria OUP microkeratome．