Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing, China.
Invest Ophthalmol Vis Sci. 2012 Aug 15;53(9):5536-44. doi: 10.1167/iovs.11-8786.
We compared the regeneration characteristics of injured corneal subbasal nerve fibers (CSNFs) and keratocyte reaction following LASIK with a femtosecond laser (FS-LASIK), One Use-Plus Sub-Bowman's keratomileusis (OUP-SBK), and M2 90 microkeratome to provide a more suitable treatment strategy.
A total of 22 eyes that underwent FS-LASIK, 32 eyes that underwent OUP-SBK, and 26 eyes that underwent conventional LASIK were analyzed by confocal microscopy. Morphologic modifications of corneal architecture were evaluated postsurgically at 1, 3, and 6 months, and comparisons were made by ANOVA analysis.
The density of stromal keratocytes in the FS-LASIK group was higher than that of OUP-SBK and conventional LASIK groups at 1 month postsurgery (P < 0.05), while in the OUP-SBK group it was higher than that of the FS-LASIK and conventional LASIK groups at 3 months postsurgery (P < 0.05). Regeneration of CSNFs was detected in 90% of eyes in all three groups around 3 mm of the peripheral flap at 1 month postoperation. CSNFs in 6.3% of the eyes in the OUP-SBK group were even observed around the peripheral flap at 6 mm 3 months after surgery, CSNFs were found in 62.5% of eyes (conventional LASIK), 72% of eyes (OUP-SBK), and 64.3% of eyes (FS-LASIK) around 3 mm near the center of the flap. While at 6 months, CSNFs were found in 100% of the eyes in all three groups.
Keratocyte reactions after FS-LASIK and OUP-SBK were a little more severe than that after conventional LASIK. The repairing velocity of subbasal nerve fibers in the OUP-SBK group was a little faster than that of the FS and conventional LASIK groups.
我们比较了飞秒激光辅助 LASIK（FS-LASIK）、One Use-Plus 亚氏角膜磨镶术（OUP-SBK）和 M2 90 微型角膜刀治疗后角膜基质下神经纤维（CSNF）的再生特征和角膜细胞反应，以期提供更合适的治疗策略。
通过共聚焦显微镜分析了 22 只接受 FS-LASIK 手术、32 只接受 OUP-SBK 手术和 26 只接受常规 LASIK 手术的眼。术后 1、3 和 6 个月评估角膜结构形态学变化，采用方差分析进行比较。
FS-LASIK 组术后 1 个月基质角膜细胞密度高于 OUP-SBK 组和常规 LASIK 组（P < 0.05），OUP-SBK 组术后 3 个月高于 FS-LASIK 组和常规 LASIK 组（P < 0.05）。术后 1 个月，所有三组在周边瓣周围 3mm 处均检测到 CSNF 再生，约 90%的眼。术后 3 个月，OUP-SBK 组有 6.3%的眼甚至在周边瓣 6mm 处观察到 CSNF，而 FS-LASIK 组有 62.5%的眼（常规 LASIK）、72%的眼（OUP-SBK）和 64.3%的眼（FS-LASIK）在瓣中心附近 3mm 处观察到 CSNF。术后 6 个月，三组所有眼均可见 CSNF。
FS-LASIK 和 OUP-SBK 术后角膜细胞反应比常规 LASIK 稍重。OUP-SBK 组 CSNF 的修复速度比 FS 和常规 LASIK 组稍快。
