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飞秒激光原位角膜磨镶术与小切口基质透镜切除术角膜生物愈合情况的比较

Comparison of Corneal Biological Healing After Femtosecond LASIK and Small Incision Lenticule Extraction Procedure.

作者信息

Xia Lei, Zhang Jing, Wu Junshu, Yu Keming

机构信息

a State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center , Sun Yat-sen University , Guangzhou , People's Republic of China.

b Department of Ophthalmology, the East Area of Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital , Chengdu , People's Republic of China.

出版信息

Curr Eye Res. 2016 Sep;41(9):1202-8. doi: 10.3109/02713683.2015.1107590. Epub 2016 Feb 1.

Abstract

PURPOSE

To assess and compare the dry-eye-associated parameters and corneal biomechanical status after small-incision lenticule extraction (SMILE) and femtosecond laser-assisted in situ keratomileusis (FS-LASIK).

METHODS

Sixty-five patients' (128 eyes) were collected between November 2012 and April 2013. Thirty-five (69 eyes) underwent SMILE and thirty (59 eyes) underwent FS-LASIK. Visual acuity, manifest refraction, tear break-up time (TBUT), Schirmer's test (ST), corneal sensitivity, Ocular Surface Disease Index (OSDI), corneal hysteresis (CH) and corneal resistance factor (CRF) were evaluated preoperatively and 1 day, 1 week, 1 month, 3 and 6 months postoperatively.

RESULTS

There was no significant difference in visual outcomes of SMILE and FS-LASIK (p = 0.208). TBUT, ST, CH and CRF decreased significantly after surgery in both groups (all p < 0.05); however, the decrease of TBUT, ST and CRF in the SMILE group was not as significant as that in the FS-LASIK group (all p < 0.05) and the change of CH value was comparable in both groups (p = 0.052).Corneal sensitivity was significantly decreased in the FS-LASIK group postoperatively (p < 0.05), but not significantly changed in the SMILE group (p > 0.05). OSDI scores were significantly increased after surgery for the two groups (all p < 0.05), and the scores were much higher in the FS-LASIK group than in the SMILE group (p = 0.000).

CONCLUSION

The corneal biological healing of SMILE surgery was superior to FS-LASIK in the early period.

摘要

目的

评估并比较小切口基质透镜切除术(SMILE)和飞秒激光原位角膜磨镶术(FS-LASIK)后干眼相关参数及角膜生物力学状态。

方法

收集2012年11月至2013年4月期间65例患者(128只眼)。35例(69只眼)接受SMILE手术,30例(59只眼)接受FS-LASIK手术。术前及术后1天、1周、1个月、3个月和6个月评估视力、显验光、泪膜破裂时间(TBUT)、泪液分泌试验(ST)、角膜敏感性、眼表疾病指数(OSDI)、角膜滞后(CH)和角膜阻力因子(CRF)。

结果

SMILE和FS-LASIK的视觉效果无显著差异(p = 0.208)。两组术后TBUT、ST、CH和CRF均显著下降(均p < 0.05);然而,SMILE组TBUT、ST和CRF的下降不如FS-LASIK组显著(均p < 0.05),且两组CH值变化相当(p = 0.052)。FS-LASIK组术后角膜敏感性显著下降(p < 0.05),而SMILE组无显著变化(p > 0.05)。两组术后OSDI评分均显著升高(均p < 0.05),且FS-LASIK组评分远高于SMILE组(p = 0.000)。

结论

SMILE手术早期角膜生物愈合优于FS-LASIK。

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