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两种不同表面消融方法后角膜上皮愈合时间的眼前节光学相干断层扫描评估

Anterior segment optical coherence tomography evaluation of corneal epithelium healing time after 2 different surface ablation methods.

作者信息

Eliaçik Mustafa, Bayramlar Huseyin, Erdur Sevil K, Karabela Yunus, Demirci Goktug, Gulkilik Ibrahim G, Ozsutcu Mustafa

机构信息

Department of Ophthalmology, Medipol Kosuyolu Hospital, Lambaci Sok Koşuyolu Kadiköy 34718, Istanbul, Turkey. Tel. +902 (16) 5446634. E-mail.

出版信息

Saudi Med J. 2015 Jan;36(1):67-72. doi: 10.15537/smj.2015.1.9983.

Abstract

OBJECTIVES

To compare epithelial healing time following laser epithelial keratomileusis (LASEK) and photorefractive keratectomy (PRK) with anterior segment optic coherence tomography (AS-OCT).

METHODS

This prospective interventional case series study comprised 56 eyes of 28 patients that underwent laser refractive surgery in the Department of Ophthalmology, Medipol University Medical Faculty, Istanbul, Turkey, between March 2014 and May 2014. Each patient was randomized to have one eye operated on with PRK, and the other with LASEK. Patients were examined daily for 5 days, and epithelial healing time was assessed by using AS-OCT without removing therapeutic contact lens (TCL). Average discomfort scores were calculated from ratings obtained from questions regarding pain, photophobia, and lacrimation according to a scale of 0 (none) to 5.

RESULTS

The mean re-epithelialization time assessed with AS-OCT was 3.07±0.64 days in the PRK group, 3.55±0.54 days in the LASEK group, and the difference was statistically significant (p=0.03). Mean subjective discomfort score was 4.42±0.50 in the PRK eyes, and 2.85±0.44 in the LASEK eyes on the first exam day (p=0.001). The score obtained on the second (p=0.024), and third day (p=0.03) were also statistically significant. The fourth (p=0.069), and fifth days scores (p=0.1) showed no statistically significant difference between groups.

CONCLUSION

The PRK showed a statistically significant shorter epithelial healing time, but had a statistically significant higher discomfort score until the postoperative fourth day compared with LASEK.

摘要

目的

采用眼前节光学相干断层扫描(AS-OCT)比较准分子激光上皮下角膜磨镶术(LASEK)和准分子激光屈光性角膜切削术(PRK)后的上皮愈合时间。

方法

这项前瞻性干预性病例系列研究纳入了2014年3月至2014年5月期间在土耳其伊斯坦布尔梅迪波尔大学医学院眼科接受激光屈光手术的28例患者的56只眼。每位患者随机选择一只眼行PRK手术,另一只眼行LASEK手术。术后连续5天每天对患者进行检查,在不摘除治疗性隐形眼镜(TCL)的情况下使用AS-OCT评估上皮愈合时间。根据0(无)至5分的评分标准,从有关疼痛、畏光和流泪的问题所获得的评分中计算平均不适评分。

结果

PRK组经AS-OCT评估的平均再上皮化时间为3.07±0.64天,LASEK组为3.55±0.54天,差异具有统计学意义(p=0.03)。在首次检查日,PRK眼的平均主观不适评分为4.42±0.50,LASEK眼为2.85±0.44(p=0.001)。在第二天(p=0.024)和第三天(p=0.03)获得的评分也具有统计学意义。第四(p=0.069)和第五天的评分(p=0.1)在两组之间无统计学差异。

结论

与LASEK相比,PRK的上皮愈合时间在统计学上显著更短,但在术后第四天之前不适评分在统计学上显著更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a72/4362180/a3e04492767f/SaudiMedJ-36-67-g001.jpg

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