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Effect of laser in situ keratomileusis used Femtosecond laser and Moria M2 microkeratome on macular thickness and retinal nerve fiber layer thickness
作者:张晶  文章来源:首都医科大学附属北京同仁医院  点击数253  更新时间:2012/9/13  文章录入:毛进  责任编辑:毛进
PURPOSE: To compare the effect of LASIK used Ziemer FEMTO LDV femtosecond laser and Moria M2 automated microkeratome for flap creation on the macular thickness and the peripapillary retinal nerve fiber layer (RNFL).
METHODS: Two hundreds and four eyes of one hundred and two consecutive patients were enrolled in this prospective study and divided into two groups: the Femto LDV Femtosecond Laser group (102 eyes of 51 patients) and Moria M2 microkeratome group (102 eyes of 51 patients). Preoperatively, 30 minutes, 1 day, 3 days, 1 week, 1 month, 3 months and 1 year after LASIK, myopia patients were examined by Fourier-Domain Optical Coherence Tomography (FD-OCT) in macular retinal, ganglion cell complex (GCC) and RNFL thickness. The scan modes were the MM6, GCC and optic ONH scans.
RESULTS: The average foveal and parafoveal retinal thicknesses 30 minutes after the surgery were significantly thicker than that before surgery (Ziemer P<0.001, P=0.003 and Moria M2 P=0.001, P=0.006) while the perifoveal retinal thickness was not changed significantly both in the Ziemer LDV group and Moria M2 group (P=0.586, 0.812). Meanwhile, the average foveal and parafoveal retinal thickness and parasuperior, paranasal retinal thickness in the Moria M2 group were significantly thicker than that in the Ziemer LDV group 30 minutes after the surgery (P all<0.05). The ganglion cell complex thicknesses were not significantly changed 30 minutes, 1 day, 3 days, 1 week, 1 month, 3 months and 1 year compared with that preoperatively both in femtosecond laser and microkeratome groups (P all>0.05). Slight reduction in RNFL thickness 30 minutes after surgery both in two groups (P=0.014, P<0.001), but the influence was less in the femtosecond laser group than in the microkeratome group (P=0.038). However, the RNFL thickness had recovered to the preoperative level only 1 day after surgery.
CONCLUSIONS: Femto LDV femtosecond laser and mechanical microkeratome will lead to the increase in macular central fovea thickness and the decrease in retinal nerve fiber layer thickness values at the early stage after LASIK.  The effect on macular and the RNFL thicknesses in Femto LDV group is smaller than mechanical microkeratome group.
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