山东大学耳鼻喉眼学报 ›› 2013, Vol. 27 ›› Issue (2): 71-74.doi: 10.6040/j.issn.1673-3770.0.2012.374

• 论著 • 上一篇    下一篇

共焦显微镜观察飞秒激光和机械刀制瓣LASIK术后角膜神经再生

韩时超1,崔传波2,李艳1,郝发香1,申红静1,肖俊杰1   

  1. 1.山东大学附属省立医院眼科, 济南 250021; 2.鲁南眼科医院, 山东 临沂 276002
  • 收稿日期:2012-10-08 发布日期:2013-04-16
  • 通讯作者: 李艳,博士,副教授,硕士生导师。 Email: catherineli66@hotmail.com
  • 作者简介:韩时超,硕士研究生。 Email: hanshichao66@126.com

Comparison of corneal nerve regeneration of femtosecond laser and keratotome for laser in situ keratomileusis using confocal  microscope

HAN Shi-chao1, CUI Chuan-bo2, LI Yan1, HAO Fa-xiang1, SHEN Hong-jing1, XIAO Jun-jie1   

  1. 1. Department of Ophthalmology, Provincial Hospital Affiliated to Shandong University, Jinan 250021, China; 2. Lunan Eye Hospital, Linyi 276002, Shandong, China
  • Received:2012-10-08 Published:2013-04-16

摘要:

目的   应用共焦显微镜观察比较飞秒激光制瓣的准分子激光角膜原位磨镶术(LASIK)和机械刀制瓣的LASIK术后短期再生的上皮下神经纤维的形态学变化。方法   将40例(80眼)屈光不正患者随机分为两组,飞秒激光组20例(40眼),应用VisuMax飞秒激光系统制瓣;机械刀组20例(40眼),应用Moria M2 90 刀头制瓣。分别于术后1周、1个月、3个月行共焦显微镜观察。结果   术后1周两组中仅少数术眼在角膜中央可见短的(<50μm)、弯曲的、不连续的上皮下神经纤维;术后1个月上皮下神经纤维长度较术后1周时长,未见交通支连接;术后3个月飞秒激光组18眼(45.0%)、机械刀组25眼(62.5%)角膜中央上皮下神经纤维长度>200μm,相互间有交通支连接并见类串珠状结构。结论   飞秒激光和机械刀制瓣LASIK术后再生的上皮下神经纤维的形态随时间延长逐渐接近术前,术后3个月机械刀组恢复好于飞秒激光组,但与术前形态仍有差异。

关键词: 准分子激光原位角膜磨镶术, 飞秒激光, 角膜神经, 再生, 共焦显微镜, 角膜刀

Abstract:

Objective   To observe and compare the short-term change of morphology of regenerated subbasal nerve fiber after the femtosecond laser and keratotome for laser in situ keratomileusis (LASIK) using confocal microscope.  Methods   In this study, 40 patients (80 eyes) with refractive error were randomly divided into 2 groups: femtosecond laser was used for LASIK myopic surgery in 20 patients (40 eyes), and keratotome was used in the other 20 patients (40 eyes). The morphology of corneal subbasal nerves was observed with confocal microscope 1 week, 1 month and 3 months after surgery. Results   Only short (<50μm), curved and independent subbasal nerve fibers were observed in a small number of eyes in the two groups 1 week after surgery. The subbasal nerve fibers were longer 1 month after surgery than 1 week after surgery, but no branch connection was found between the nerve fibers. The length of subbasal nerve fibers at central corneal was more than 200μm in 18 eyes(45.0%) in femtosecond group and in 25 eyes(62.5%) in keratotome group, and there were intercommunicating branches and class beaded structures between subbasal nerve fibers at central cornea 3 months after surgery. Conclusion   The postoperative nerve morphology in femtosecond laser group and keratotome group was close to preoperative nerve morphology with time. The regenerated subbasal nerve in keratotome group was better than in femtosecond laser group 3 months after surgery, but there was still difference compared with preoperative morphology.

Key words: Confocal microscope, Femtosecond laser; , Regeneration, Keratotome, Excimer laser in situ keratomileusis; , Corneal nerves; 

中图分类号: 

  • R778.11
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