准分子原位角膜磨镶术和准分子激光上皮下角膜磨镶术对视网膜神经纤维层厚度的影响。

Effect of laser in situ keratomileusis and laser-assisted subepithelial keratectomy on retinal nerve fiber layer thickness.

作者信息

Sharma Namrata, Sony Parul, Gupta Anita, Vajpayee Rasik B

机构信息

Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.

出版信息

J Cataract Refract Surg. 2006 Mar;32(3):446-50. doi: 10.1016/j.jcrs.2005.12.069.

DOI:10.1016/j.jcrs.2005.12.069

PMID:16631055

Abstract

PURPOSE

To evaluate and compare the influence of laser in situ keratomileusis (LASIK) and laser-assisted subepithelial keratectomy (LASEK) on the peripapillary retinal nerve fiber layer (RNFL) thickness.

SETTING

Observational case series.

METHODS

Twenty nonglaucomatous patients with mild to moderate myopia were included. One eye in each patient was randomly selected to have LASIK (Group 1, n = 20), and LASEK was performed in the fellow eye (Group 2, n = 20). The RNFL thickness measurements were performed using optical coherence tomography (OCT) preoperatively and 1 day and 1 month postoperatively. The RNFL thickness parameters were compared using repeated-measures 1-way analysis of variance (ANOVA) followed by multiple comparison tests in both groups. The main outcome parameter was RNFL thickness as determined by OCT before and after LASIK and LASEK.

RESULTS

The mean age of the patients was 21 years +/- 3.2 (SD). The mean preoperative spherical equivalent was -4.23 +/- 1.71 diopters (D) in Group 1 and -4.16 +/- 1.68 D in Group 2. The mean ablation depth was 73.35 +/- 27.85 microm and 66.35 +/- 23.64 microm in groups 1 and 2, respectively. In Group 1, the mean average RNFL thickness, inferior average, superior average, temporal average, and nasal average were 98.2 +/- 5.6 microm, 128.6 +/- 11.9 microm, 120.38 +/- 10.2 microm, 65. 8+/- 7.1 microm, and 80.5 +/- 18.8 microm, respectively. None of the RNFL thickness parameters or RNFL ratios were found to have a significant change after surgery. In Group 2, the average RNFL thickness, inferior average, superior average, temporal average, and nasal average were 98.47 +/- 5.9 microm, 128.38 +/- 14.3 microm, 125.1 +/- 8.8 microm, 66.4 +/- 8.2 microm, 73.6 +/- 15.8 microm, respectively. No significant change was observed in any of the parameters following surgery. No significant alterations were noted in the RNFL parameters following LASIK or LASEK.

CONCLUSIONS

Laser in situ keratomileusis and LASEK did not significantly affect the RNFL thickness parameters postoperatively.

摘要

目的

评估并比较准分子原位角膜磨镶术（LASIK）和准分子激光上皮瓣下角膜磨镶术（LASEK）对视乳头周围视网膜神经纤维层（RNFL）厚度的影响。

设置

观察性病例系列。

方法

纳入20例非青光眼的轻至中度近视患者。每位患者的一只眼随机接受LASIK手术（第1组，n = 20），另一只眼行LASEK手术（第2组，n = 20）。术前、术后1天和1个月使用光学相干断层扫描（OCT）测量RNFL厚度。两组均采用重复测量单因素方差分析（ANOVA），随后进行多重比较检验，比较RNFL厚度参数。主要观察指标是LASIK和LASEK术前及术后由OCT测定的RNFL厚度。

结果

患者的平均年龄为21岁±3.2（标准差）。第1组术前平均等效球镜度为-4.23±1.71屈光度（D），第2组为-4.16±1.68 D。第1组和第2组的平均消融深度分别为73.35±27.85微米和66.35±23.64微米。在第1组中，平均RNFL厚度、下方平均厚度、上方平均厚度、颞侧平均厚度和鼻侧平均厚度分别为98.2±5.6微米、128.6±11.9微米、120.38±10.微米、65.8±7.1微米和80.5±18.8微米。术后未发现RNFL厚度参数或RNFL比率有显著变化。在第2组中，平均RNFL厚度、下方平均厚度、上方平均厚度、颞侧平均厚度和鼻侧平均厚度分别为98.47±5.9微米、128.38±14.3微米、125.1±8.8微米、66.4±8.2微米、73.6±15.8微米。术后任何参数均未观察到显著变化。LASIK或LASEK术后RNFL参数未发现明显改变。