Investigation of Femtosecond Laser-Enabled Keratoplasty Wound Geometry Using Optical Coherence Tomography
Investigation of Femtosecond Laser-Enabled Keratoplasty Wound Geometry Using Optical Coherence Tomography
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DOI：
10.1097/ico.0b013e3182041fd3
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发表时间：
2011-08-01
期刊：
影响因子：
2.8
通讯作者：
Huang, David
中科院分区：
文献类型：
--
作者：
Heur, Martin;Tang, Maolong;Huang, David
目的：应用光学相干断层扫描(OCT)测量飞秒激光角膜移植(FLEK)术后伤口几何形态。设计：前瞻性非随机临床研究和实验室研究。参与者：在学术转诊中心接受穿透性角膜移植的患者。方法：用OCT测量和分析连续8例FLEK患者8只眼的伤口结构。用飞秒激光对3个眼库角膜进行板层切割，用OCT测量创口直径。结果：术后平均每10岁1个月，缝线全部拆除。没有发现伤口裂开的病例，在OCT上移植物与宿主组织的对接情况良好。拆线后1个月矫正视力平均为20/35，平均散光度数：显性屈光度为5.0度，电脑地形图为8.7度。测得的移植物直径比激光测定值小2.5%(P-0.007)。眼库角膜的切割直径也略小于激光治疗。结论：FLEK具有伤口愈合快、伤口几何形状可预测的优点。测量的伤口几何形状与激光设置很好地吻合，除了可以用激光切割过程中的角膜压平机制解释的微小的系统偏差。OCT是测量FLEK术后实际移植物直径的有用工具。
Purpose: To measure the wound geometry after femtosecond laser-enabled keratoplasty (FLEK) using optical coherence tomography (OCT).Design: Prospective nonrandomized clinical study and laboratory study.Participants: Patients who were candidates for penetrating keratoplasty at an academic referral center.Methods: Wound architecture was measured and analyzed by OCT in 8 eyes of 8 consecutive patients who underwent FLEK. Femtosecond laser lamellar cuts were performed on 3 eye bank corneas, and the wound diameters were measured by OCT.Results: Sutures were completely removed on average at 1 month per decade of age after surgery. No cases of wound dehiscence were noted, and graft-host tissue apposition appeared excellent on OCT. The mean spectacle-corrected visual acuity 1 month after suture removal was 20/35, and mean astigmatism was 5.0 diopters by manifest refraction and 8.7 diopters by computerized topography. The measured graft diameter was smaller than the laser setting by 2.5% (P - 0.007). The cut diameters of the eye bank corneas were also slightly smaller than the laser setting.Conclusions: FLEK offers benefits of rapid wound healing and predictable wound geometry. The measured wound geometry agreed well with laser setting other than a small systematic deviation that could be explained by the mechanics of corneal applanation during the laser cut. OCT is a useful tool to measure the actual graft diameter after FLEK.