庞辰久，宋晓虹，王丽娅

河南省眼科研究所，河南省眼科中心，河南郑州450003

A comparison of corneal flap featurescreated by the Zyoptix XP and the
Hansatome microkeratome
PANG Chenjiu．SONG Xiaohong．WANG Liya．
Henan Eye Institute，Henan Eye Cen把r，Zhengzhou China，450003

[Abstract]Objective To compare the corneal flap features cre．ated by laser in situ keratomileusis(LASIK)using either the Zyop—tix XP or the Hansatome microkeratome．Methods A Zyaptix XP1 20 mierokeratome with an 8．5 mm suction ring or fl Hansatome160 microkeratome with all 8．5 mrn suction ring were used on 50eyes in 25 myopic patients each group．The thickness of thecorneal flap wag measured with ultrasound pachymetry and flapdimensions were measured with a caliper during the operation．Theflap features for the two groups were compared using a t-test andlinear regression analysis．Results There were no statistically significantdifferences between the two groups when preoperativecorneal curvature．diameter and thickness were compared(P>0．05)．Flap thickness was(124．04±15．29)¨m in the Zyoptix XP microkerat伽e group and (115．38±11．86)lxm in the Hansatome micmkeratonlegroup．The thickness measurements for the two groups showedstatistically significant differences (t=2．938．P=O．005)．Flap thick—nes8 had no statistically significant correlations with preoperativecorneal curvature，diameter or thickness in the XP group(P>o．05)but there w∞a weak significant correlation between flap thicknessand corneal thickness in the Haugatome group(r---0．280。P=O．049)．The horizontal and vertical flaps and hinge size were(9．05 4-0．14)Run，(8．22±0．29)mm and(4．63±0．46)ram，respectively，inthe XP group and(8．704-0．37)mm，(8．07=t：0．25)mm and(4．694-0．42)mm．respectively，in the Hansatome group．There were signiGieant differences in horizontal and vertical size between the twogroups(P<0．05)but no significant difference in hinge size(t=-0．694。P=0．490)．There were no significant correlations when hori—zontal and vertical flap sizeswere compared to pr∞perative cornealcurvature，diameter and thickness(P>0．05)，but there were significantcorrelations when hinge size was compared to corneal curvature(r=0．456，P=0．001)and diameter r=-O．356，P=0．01 1)inthe Zyoptix XP group．There was a significant correlation betweenflap dimension and preoperative corneal curvature(r=O．561，P=0．000)but no significant correlations with corneal diameter(r=
0．174，P=0．226)and thickness(r=一0．184，P=0．202)in theHansatome group．Conclusion The Zyoptix can create thicker andlarger corneal flaps than the Hansatomemicrokeratome，Flap thick—ness and dimension were not affected by preoperative corneal curvature，
diameter or thickness when using the Zyoptix XP microkeratome．Both the Zyoptix XP and the Hansatome microkeratomescreated high-quality flaps safely and consistently．
[Key words] keratomileusis，laser in situ／methods；mierokeratome；Zyoptix XPHansatome；colTleal flap

【摘要] 目的比较Zyoptix XP与Hansatome角膜板层刀制作角膜瓣的特点．为临床使用提供参考。方法50例(100眼)近视眼患者随机分成两组，每组25例(50眼)，分别用Zyoptix XP 120刀头、8．5 mm负压环与Hansatome角膜板层刀160刀头、8．5 mm负压环制作角膜瓣。制瓣前后分别用超声角膜测厚仪测量角膜厚度．计算实际角膜瓣厚度。制瓣后分别测量角膜瓣横径、纵径和蒂的长度，进行成组的两两比较t检验以及相关性分析，评价两种角膜板层刀制瓣特点。结果Zyoptix XP与Hansatome两组患者手术前角膜曲率、直径以及厚度差异均无统计学意义f乃0．05)。Zyoptix XP 120刀头与Hansatome角膜板层刀160刀头制作的角膜瓣厚度分别为(124．04±15．29)斗m和(115．38±11．86)卜m，两者差异有统计学意义(f=2．938，肚0．005)；XP板层刀制作的角膜瓣的厚度与手术前角膜曲率、直径以及厚度均无相关性(P>0．05)；

Hansatome板层刀制作的角膜瓣的厚度与手术前角膜曲率和直径无相关性(P>O．05)，但与角膜厚度呈正相关(r=O．280，P-0．049)。XP板层刀制作的角膜瓣的横径、纵径和蒂长度分别为(9．05±O．14)mm、(8．22±0．29)mm和(4．63±0．46)mm，Hansatome板层刀制作的角膜瓣的横径、纵径和蒂长度分别为(8．70+O．37)mm、(8．07±0．25)mm和(4．69±0．42)mm；两组横径和纵径分别相比，差异均有统计学意义(P<O．05)；蒂长度的差异无统计学意g(t=--O．694．P=0．490)。Zyoptix XP板层刀制作的角膜瓣横径、纵径与手术前角膜曲率、直径以及角膜厚度均无相关性(P>0．05)，角膜瓣蒂的长度与角膜曲率呈正相关(r=0．456，P=0．001)，与角膜直径呈负相关忙一0．356，P=0．01 1)，与角膜厚度无相关性仍0．05)。Hansatome板层刀制作的角膜辩的大小与角膜曲率呈正相关(r--O．561，P=0．000)，与角膜直径和角膜厚度无相关性(P>0．05)。结论使用Zyoptix XP 120刀头、8．5 mm负压环制作的角膜瓣较使用Hansatome角膜板层刀160刀头、8．5 mm负压环制作的角膜瓣厚，角膜瓣也较大．且Zyoptix XP板层／'7制瓣厚度与大小不受术眼角膜曲率、直径和厚度的影响，但两种角膜板层刀均有良好的安全性和稳定性。

[关键词] 角膜磨镶术，激光原位／方法；板层刀；ZyoptixXP：Hansatome：角膜瓣

[中图分类号] R779．63 [文献标识码】A

[文章编号] 1008一1801(2008)05—0356—03

准分子激光原位角膜磨镶术(1aser in situ keratomileusis。LASIK)的关键步骤之一是制作完美的角膜瓣。可以说制作良好的角膜瓣是LASIK手术成功的基础。Hansatome角膜板层刀fBaush&LombSurgical)以其优良的性能而被广泛采用．但在使用过程中其对左、右眼手术要分别进行装配，略显繁琐，而Zyoptix XP角膜板层刀系统(Baush&LombSurgical)的装配更加简便，更利于操作。我们对两者的制瓣特点进行对比，为临床应用提供指导。

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