Durrie Vision, Overland Park, KS, USA.
J Refract Surg. 2009 Dec;25(12):1098-102. doi: 10.3928/1081597X-20091117-09.
To compare the effect of femtosecond thinflap LASIK and photorefractive keratectomy (PRK) on postoperative endothelial cell density.
In a prospective, randomized, contralateral, single-center clinical trial, 25 patients (mean age: 30+/-5 years [range: 21 to 38 years]) underwent PRK in one eye and thin-flap LASIK in the fellow eye for the correction of myopia using a wavefront-guided platform. The central corneal endothelial cell density was measured using the NIDEK Confoscan 4 preoperatively, and at 1 and 3 months postoperatively. Changes in endothelial cell density were analyzed over time between the two refractive techniques.
In PRK, the average preoperative endothelial cell density was 3011+/-329 cells/mm(2), which decreased to 2951+/-327 cells/mm(2) at 1 month (P=.5736) and 2982+/-365 cells/mm(2) at 3 months (P=.6513). In thinflap LASIK, the average preoperative endothelial cell density was 2995+/-325 cells/mm(2), which decreased to 2977+/-358 cells/mm(2) at 1 month (P=.5756) and 2931+/-369 cells/mm(2) at 3 months (P=.4106). No statistically significant difference was found between the two groups at 1 (P=.7404) or 3 (P=.3208) months postoperatively.
No statistically significant change was noted in endothelial cell density following either PRK or thin-flap LASIK for the treatment of myopia. Furthermore, no statistically significant difference was found between the two groups out to 3 months postoperatively, indicating that thin-flap LASIK is as safe as PRK with regards to endothelial health.
比较飞秒激光薄瓣 LASIK 和光性折射角膜切削术(PRK)对术后内皮细胞密度的影响。
在一项前瞻性、随机、对侧、单中心临床试验中,25 名患者(平均年龄:30+/-5 岁[范围:21 至 38 岁])在一只眼接受 PRK 治疗,另一只眼接受飞秒激光薄瓣 LASIK 治疗,使用波前引导平台矫正近视。在术前、术后 1 个月和 3 个月使用尼德克 Confoscan 4 测量中央角膜内皮细胞密度。分析两种屈光技术之间随时间变化的内皮细胞密度变化。
在 PRK 中,平均术前内皮细胞密度为 3011+/-329 个细胞/mm²,术后 1 个月时降至 2951+/-327 个细胞/mm²(P=.5736),术后 3 个月时降至 2982+/-365 个细胞/mm²(P=.6513)。在飞秒激光薄瓣 LASIK 中,平均术前内皮细胞密度为 2995+/-325 个细胞/mm²,术后 1 个月时降至 2977+/-358 个细胞/mm²(P=.5756),术后 3 个月时降至 2931+/-369 个细胞/mm²(P=.4106)。术后 1 个月(P=.7404)和 3 个月(P=.3208)时两组间无统计学差异。
近视治疗中 PRK 或飞秒激光薄瓣 LASIK 后内皮细胞密度无统计学显著变化。此外,术后 3 个月时两组间无统计学差异,表明飞秒激光薄瓣 LASIK 对内皮细胞健康与 PRK 一样安全。