不同制瓣方式前弹力层下角膜磨镶术术后角膜知觉和角膜神经修复的研究
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摘要
目的
对比分析微型角膜刀与飞秒激光辅助前弹力层下角膜磨镶术(sub-Bowman' s keratomileusis, SBK)术后角膜中央知觉及上皮下神经密度的变化。
方法
接受SBK治疗的近视患者,根据制瓣方式分为FEMTO-LDV飞秒激光组(FEMTO-LDV组)和One Use-Plus微型角膜刀组(OUP组),各25例(50眼)。观察术后1个月、3个月、6个月的裸眼视力(uncorrected visual acuity, UCVA)、角膜中央知觉和上皮下神经等。
结果
视力：术后6个月两组UCVA均大于等于1.0；角膜中央知觉：术后1个月FEMTO-LDV组的角膜中央知觉较OUP组好(t=3.130,p=0.003),术后3个月、6个月两组比较,差异均无统计学意义(t=0.237、-0.837,p=0.813、0.409)；术后6个月两组的角膜中央知觉与术前相比均降低(t=-13.725、-10.092,p=0.000、0.000)。上皮下神经密度：术后1个月、3个月、6个月两组上皮下神经密度差异无统计学意义(t=1.191、0.286、0.224,p=0.238、0.776、0.824)
结论
1.飞秒激光与微型角膜刀制瓣的SBK均获得了良好的裸眼视力。
2.飞秒激光制瓣的SBK术后1个月角膜知觉恢复优于微型角膜刀。
3.飞秒激光与微型角膜刀制瓣的SBK术后中央角膜上皮下神经纤维均在修复。
Purpose
To compare changes in central corneal sensitivity and subbasal nerve density after sub-Bowman's keratomileusis (SBK)with the flap created by a femtosecond laser vs a mechanical microkeratome.
Methods
Patients with myopia had sub-Bowman's keratomileusis were categorized two groups according to the type of flap creation:FEMTO-LDV femtosecond laser group (FEMTO-LDV group) and One Use-Plus microkeratome group (OUP group),there are25cases(n=50eyes) in each group. The uncorrected visual acuity, central corneal sensitivity and subbasal nerve fiber bundles were measured lmonth,3months,6months after operation.
Results
Vision acuity:UCVA for both groups was at least equal to1.0. Central corneal sensation:after1month, mean central corneal sensation was greater in FEMTO-LDV group than that in OUP group (t=3.130,p=0.003).At Postoperative3months and6months the mean central corneal sensation between two groups had no significant difference(t=0.237、-0.837,p=0.813、0.409). Compared with preoperative values, a significant reduction in corneal sensation remained at6months in both groups (t=-13.725、-10.092,p=0.000,0.000). Subbasal nerve density:there was no significant difference of the subbasal nerve density at1month,3months,6months after operation between the two groups (t=1.191、0.286、0.224,、0.238、0.776、0.824)
Conclusions
1. SBK with femtosecond laser or microkeratome both provided good uncorrected visual acuity.
2. Better corneal sensation was found at1month after SBK with femtosecond laser.
3. Subbasal nerve fiber bundles was in reparing after SBK with femtosecond laser and microkeratome.
对比分析微型角膜刀与飞秒激光辅助前弹力层下角膜磨镶术(sub-Bowman' s keratomileusis, SBK)术后角膜中央知觉及上皮下神经密度的变化。
方法
接受SBK治疗的近视患者,根据制瓣方式分为FEMTO-LDV飞秒激光组(FEMTO-LDV组)和One Use-Plus微型角膜刀组(OUP组),各25例(50眼)。观察术后1个月、3个月、6个月的裸眼视力(uncorrected visual acuity, UCVA)、角膜中央知觉和上皮下神经等。
结果
视力：术后6个月两组UCVA均大于等于1.0；角膜中央知觉：术后1个月FEMTO-LDV组的角膜中央知觉较OUP组好(t=3.130,p=0.003),术后3个月、6个月两组比较,差异均无统计学意义(t=0.237、-0.837,p=0.813、0.409)；术后6个月两组的角膜中央知觉与术前相比均降低(t=-13.725、-10.092,p=0.000、0.000)。上皮下神经密度：术后1个月、3个月、6个月两组上皮下神经密度差异无统计学意义(t=1.191、0.286、0.224,p=0.238、0.776、0.824)
结论
1.飞秒激光与微型角膜刀制瓣的SBK均获得了良好的裸眼视力。
2.飞秒激光制瓣的SBK术后1个月角膜知觉恢复优于微型角膜刀。
3.飞秒激光与微型角膜刀制瓣的SBK术后中央角膜上皮下神经纤维均在修复。
Purpose
To compare changes in central corneal sensitivity and subbasal nerve density after sub-Bowman's keratomileusis (SBK)with the flap created by a femtosecond laser vs a mechanical microkeratome.
Methods
Patients with myopia had sub-Bowman's keratomileusis were categorized two groups according to the type of flap creation:FEMTO-LDV femtosecond laser group (FEMTO-LDV group) and One Use-Plus microkeratome group (OUP group),there are25cases(n=50eyes) in each group. The uncorrected visual acuity, central corneal sensitivity and subbasal nerve fiber bundles were measured lmonth,3months,6months after operation.
Results
Vision acuity:UCVA for both groups was at least equal to1.0. Central corneal sensation:after1month, mean central corneal sensation was greater in FEMTO-LDV group than that in OUP group (t=3.130,p=0.003).At Postoperative3months and6months the mean central corneal sensation between two groups had no significant difference(t=0.237、-0.837,p=0.813、0.409). Compared with preoperative values, a significant reduction in corneal sensation remained at6months in both groups (t=-13.725、-10.092,p=0.000,0.000). Subbasal nerve density:there was no significant difference of the subbasal nerve density at1month,3months,6months after operation between the two groups (t=1.191、0.286、0.224,、0.238、0.776、0.824)
Conclusions
1. SBK with femtosecond laser or microkeratome both provided good uncorrected visual acuity.
2. Better corneal sensation was found at1month after SBK with femtosecond laser.
3. Subbasal nerve fiber bundles was in reparing after SBK with femtosecond laser and microkeratome.
引文
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