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准分子激光原位角膜磨镶术治疗近视后角膜上皮和基质厚度轮廓的术后变化

Postoperative Changes in Corneal Epithelial and Stromal Thickness Profiles After Photorefractive Keratectomy in Treatment of Myopia.

作者信息

Chen Xiangjun, Stojanovic Aleksandar, Liu Yanhua, Chen Yunyun, Zhou Yang, Utheim Tor Paaske

出版信息

J Refract Surg. 2015 Jul;31(7):446-53. doi: 10.3928/1081597X-20150623-02.

Abstract

PURPOSE

To study the corneal epithelial and stromal thickness profile changes after photorefractive keratectomy (PRK) for myopia.

METHODS

Retrospective analysis of the postoperative corneal epithelial and stromal thickness profile changes in 46 left eyes of 46 patients treated with PRK for myopia. Corneal and epithelial thickness maps within the central 6 mm were obtained by anterior segment spectral-domain optical coherence tomography preoperatively and at 1, 3, and 6 months postoperatively. Stromal thickness was calculated by subtracting the epithelial thickness from the total corneal thickness. Correlations between postoperative thickness changes and the amount of correction, treatment zone, and preoperative epithelial thickness were analyzed.

RESULTS

Compared to preoperative values, the central 2 mm and the paracentral 2- to 5-mm zone epithelium was 5.20 ± 3.43 and 5.72 ± 3.30 µm thicker, respectively, at 3 months postoperatively (P < .05). No significant difference was detected between 3 and 6 months postoperatively. The stromal thickness did not change between 1 and 6 months postoperatively. The spherical equivalent (SE) changed from -2.82 ± 1.54 diopters (D) preoperatively to -0.06 ± 0.42 D at 1 month postoperatively, and remained stable thereafter. There was a trend toward greater epithelial thickening with a larger amount of programmed SE correction, smaller treatment zone, and thinner preoperative epithelium. No correlation between epithelial thickness change and postoperative change in refraction was detected.

CONCLUSIONS

The corneal epithelial thickness increased after PRK up to 3 months postoperatively. It was affected by the amount of myopia treated, treatment zone, and preoperative epithelial thickness. The postoperative epithelial thickening did not affect the refractive outcomes.

摘要

目的

研究准分子激光角膜切削术(PRK)治疗近视后角膜上皮和基质厚度的变化情况。

方法

回顾性分析46例接受PRK治疗近视患者的46只左眼术后角膜上皮和基质厚度的变化情况。术前及术后1个月、3个月和6个月通过眼前节光谱域光学相干断层扫描获取中央6mm范围内的角膜和上皮厚度图。基质厚度通过总角膜厚度减去上皮厚度计算得出。分析术后厚度变化与矫正量、治疗区及术前上皮厚度之间的相关性。

结果

与术前值相比,术后3个月时中央2mm及旁中央2至5mm区域的上皮分别增厚5.20±3.43μm和5.72±3.30μm(P<.05)。术后3个月和6个月之间未检测到显著差异。术后1至6个月基质厚度未发生变化。等效球镜度(SE)术前为-2.82±1.54屈光度(D),术后1个月变为-0.06±0.42D,此后保持稳定。随着计划的SE矫正量增加、治疗区减小和术前上皮变薄,上皮增厚的趋势更明显。未检测到上皮厚度变化与术后屈光变化之间的相关性。

结论

PRK术后角膜上皮厚度增加,持续至术后3个月。它受治疗的近视量、治疗区和术前上皮厚度的影响。术后上皮增厚不影响屈光结果。

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