Comparative study of stromal bed quality by using mechanical, IntraLase femtosecond laser 15-and 30-kHz microkeratomes
Comparative study of stromal bed quality by using mechanical, IntraLase femtosecond laser 15-and 30-kHz microkeratomes
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DOI：
10.1097/ico.0b013e318033e7cc
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发表时间：
2007-05-01
期刊：
影响因子：
2.8
通讯作者：
Tran, Dan B.
中科院分区：
文献类型：
--
作者：
Sarayba, Melvin A.;Ignacio, Teresa S.;Tran, Dan B.
目的：使用机械和飞秒激光微型角膜刀评估激光原位角膜磨镶术（LASIK）中板层角膜切除术的角膜基质床质量。方法：在9个不适合移植的新鲜人类眼球上制作LASIK角膜瓣。我们将样本分为 3 个不同的组，每组 3 个球体。第 1 组是对照组，使用头部为 160 微米的 Hansatome 微型角膜刀制作皮瓣。第 2 组和第 3 组分别由使用 IntraLase 15 kHz 和 30 kHz 飞秒激光以 110 μm 皮瓣厚度设置创建的皮瓣组成。去除所有角膜瓣，并准备角膜基质床用于扫描电子显微镜（SEM）。 SEM 图像的定性表面粗糙度 (QISR) 由 3 名蒙面观察者使用从 I 到 5 的粗糙度分级等级进行分级。还使用专为粗糙度分析设计的软件评估了 SEM 图像的定量表面粗糙度 (QnSR)。采用Mann-Whitney非参数统计分析进行组间比较。结果：第2组和第1组（仅全新刀片）之间的QISR和QnSR评分没有统计学显着性差异。与第 1 组和第 2 组样品相比，第 3 组 30-kHz IntraLase 样品显示出更平滑的基质床。对于 Q1SR（Q1SR = 1.1 +/- 0.17，P < 0.001）而言，这是一个统计上显着的差异，而对于 QnSR（QnSR = 24.4 +/- 0.96，P = 0.05）则显示出临界显着性。结论：IntraLase 15 kHz 飞秒激光 110-μ m 皮瓣和 Hansatome 160-μ m 头使用新的刀片均产生光滑、优质、致密的基质床，由蒙面观察者进行定性评估，并由图像分析软件进行定量评估。 30 kHz 飞秒激光可实现更紧密的点/线分离和更低的每脉冲能量，从而创建更平滑的角膜基质床。
Purpose: To evaluate corneal stromal bed quality of lamellar keratectomy in laser in situ keratomileusis (LASIK) procedures by using mechanical and femtosecond laser microkeratomes.Methods: LASIK corneal flaps were created in 9 fresh human globes not suitable for transplantation. We grouped the samples into 3 different groups of 3 globes each. Group 1 was the control group, in which the flaps were created using a Hansatome microkeratome with a 160-mu m head. Groups 2 and 3 consisted of flaps created at the 110-mu m flap thickness setting using the IntraLase 15- and 30-kHz femtosecond laser, respectively. All the flaps were removed, and the corneal stromal beds were prepared for scanning electron microscopy (SEM). Qualitative surface roughness (QISR) of the SEM images was graded using a roughness grading scale from I to 5 by 3 masked observers. Quantitative surface roughness (QnSR) of the SEM images was also assessed using software designed for roughness analysis. Mann-Whitney nonparametric statistical analysis was performed to compare groups.Results: There was no statistically significant difference in QISR and QnSR scores between group 2 and group 1 (brand-new blade only). Group 3 30-kHz IntraLase samples showed a smoother stromal bed compared with group 1 and 2 samples. This was a statistically significant difference for Q1SR (Q1SR = 1.1 +/- 0.17, P < 0.001) and showed borderline significance for QnSR (QnSR = 24.4 +/- 0.96, P = 0.05).Conclusions: The IntraLase 15-kHz femtosecond laser 110-mu m flaps and the Hansatome 160-mu m head using a new blade both produced smooth, good-quality, compact stromal beds as assessed qualitatively by masked observers and quantitatively by image analysis software. The 30-kHz femotsecond laser permits a tighter spot/line separation and lower energy per pulse, which creates smoother corneal stromal beds.