Femtosecond laser-assisted corneal flap cuts: Morphology, accuracy, and histopathology
Femtosecond laser-assisted corneal flap cuts: Morphology, accuracy, and histopathology
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DOI：
10.1167/iovs.05-1123
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发表时间：
2006-07-01
影响因子：
4.4
通讯作者：
Auffarth, Gerd U.
中科院分区：
文献类型：
--
作者：
Holzer, Mike P.;Rabsilber, Tanja M.;Auffarth, Gerd U.
目的.在LASIK手术中，角膜瓣的精确切割是至关重要的。目前的机械微型角膜刀具有非常好的性能记录;然而，在少数情况下，在微型角膜刀通过和角膜瓣切割期间可能发生并发症。飞秒激光提供了机械切割的替代方案，并可提供有关皮瓣形态的其他特征。在这项研究中，我们分析了飞秒激光皮瓣的形态，切割精度和组织病理学。使用Femtec飞秒激光系统（20/10 Perfect Vision，Heidelberg，德国）准备45只新鲜猪尸眼进行飞秒激光皮瓣切割。眼被分配到三个不同的厚度组，分别具有120-，140-，和180-μ m的切割深度。此外，不同的皮瓣直径范围从8.0至9.5毫米和边缘的角度在60和90之间进行。切割后，在显微镜下检查眼睛的准确性和潜在的缺陷，并测量皮瓣厚度和直径。此外，皮瓣准备进一步的组织病理学检查。所有的皮瓣切割都很容易进行，没有任何术中并发症。皮瓣厚度测量显示中值（单位：微米）分别为110.5（预期厚度120）、142.5（预期厚度140）和180.0（预期厚度180）。预期尺寸为8.0 - 9.5 mm的皮瓣直径在+/- 0.4 mm范围内，最大值的中位数为0.3 mm。组织学显示角膜基质结构和正确的铰链成角变化非常低或几乎没有变化。LASIK角膜瓣切割很容易进行，没有任何并发症。准确度和形态非常精确且一致。组织学检查显示切口光滑，铰链成角，与预期一致。
PURPOSE. Precision in corneal flap cutting is essential in LASIK surgery. Current mechanical microkeratomes have a very good performance record; however, in a few cases, complications can occur during the microkeratome pass and flap cut. Femtosecond lasers offer an alternative to the mechanical cut and can provide additional features regarding the flap morphology. In this study, we analyzed femtosecond laser flaps regarding their morphology, cut accuracy, and histopathology.METHODS. Forty-five fresh porcine cadaveric eyes were prepared for femtosecond laser flap cutting with the Femtec femtosecond laser system (20/10 Perfect Vision, Heidelberg, Germany). The eyes were assigned to three different thickness groups, with 120- ,140-, or 180-mu m cut depth, respectively. In addition, different flap diameters ranging from 8.0 to 9.5 mm and rim edge angulations between 60 and 90 were performed. After the cut, the eyes were examined under a microscope regarding accuracy and potential defects, and flap thickness and diameter were measured. In addition, flaps were prepared for further histopathologic examination.RESULTS. All flap cuts were easily performed without any intraoperative complications. Flap thickness measurements revealed a median (in micrometers) of 110.5 (intended thickness 120), 142.5 (intended 140), and 180.0 (intended 180), respectively. The flap diameter for an intended size between 8.0 and 9.5 mm was within a range of +/- 0.4 mm, the median at the maximum was 0.3 mm off. Histopathology revealed very low to almost no changes in the stromal structure of the cornea and correct hinge angulations.CONCLUSIONS. LASIK flap cuts were easily performed without any complications. The accuracy and morphology were very precise and consistent. Histopathology revealed a smooth cut with hinge angulations, as expected.