Zhang Chi, Ding Hui, He Miao, Liu Lina, Liu Liangping, Li Gang, Niu Bing, Zhong Xingwu
Zhongshan Ophthalmic Center and State Key Laboratory of Ophthalmology, Sun Yat-sen University, Guangzhou 510060, China.
Department of Ophthalmology, The First People's Hospital of Foshan, Foshan 528000, China.
PLoS One. 2016 Mar 3;11(3):e0149503. doi: 10.1371/journal.pone.0149503. eCollection 2016.
To evaluate the short-term changes in ocular surface measures and tear inflammatory mediators after femtosecond lenticule extraction (FLEx) and small-incision lenticule extraction (SMILE) procedures.
Eighteen subjects (18 eyes) underwent FLEx and 23 subjects (23 eyes) underwent SMILE in this single-center and prospective study. Central corneal sensitivity, Schirmer I test (SIT), noninvasive tear breakup time (NI-TBUT), tear meniscus height, corneal fluorescein (FL) staining, and ocular surface disease index (OSDI) were assessed in all patients. Concentrations of interleukin-1α (IL-1α), tumor necrosis factor-α (TNF-α), nerve growth factor (NGF), interferon-γ (IFN-γ), transforming growth factor-β1 (TGF-β1) and matrix metalloproteinase-9 (MMP-9) in collected tears were measured by multiplex antibody microarray.
Central corneal sensitivity was reduced in both groups, but the scores in the SMILE group were higher than those in the FLEx group at all time points postoperatively (P<0.01). Lower FL scores and longer NI-BUT were observed in the SMILE group 1 week after surgery (P<0.05). OSDI scores in both groups increased rapidly at 1 day and 1 week postoperatively, then returned to their preoperative levels within 1 month (P<0.05). There were no significant differences in SIT or tear meniscus height between the two groups. Lower and faster recovery of tear NGF, TGF-β1 and IL-1α concentration were found in the SMILE group compared to the FLEx group postoperatively. No significant difference was found in tear TNF-α, IFN-γ and MMP-9 for either group before or after surgery. Tear NGF, TGF-β1 and IL-1α show a correlation with ocular surface changes after FLEx or SMILE surgery.
SMILE has superiority over FLEx in early ocular surface changes and NGF, TGF-β1 and IL-1α may contribute to the process of ocular surface recovery.
ClinicalTrials.gov NCT02540785.
评估飞秒透镜切除术（FLEx）和小切口透镜切除术（SMILE）术后眼表指标和泪液炎症介质的短期变化。
在这项单中心前瞻性研究中，18名受试者（18只眼）接受了FLEx手术，23名受试者（23只眼）接受了SMILE手术。对所有患者评估中央角膜敏感性、Schirmer I试验（SIT）、非侵入性泪膜破裂时间（NI-TBUT）、泪液弯月面高度、角膜荧光素（FL）染色和眼表疾病指数（OSDI）。通过多重抗体微阵列检测收集的泪液中白细胞介素-1α（IL-1α）、肿瘤坏死因子-α（TNF-α）、神经生长因子（NGF）、干扰素-γ（IFN-γ）、转化生长因子-β1（TGF-β1）和基质金属蛋白酶-9（MMP-9）的浓度。
两组中央角膜敏感性均降低，但SMILE组术后各时间点的评分均高于FLEx组（P<0.01）。术后1周，SMILE组的FL评分较低，NI-BUT较长（P<0.05）。两组的OSDI评分在术后1天和1周迅速升高，然后在1个月内恢复到术前水平（P<0.05）。两组间SIT或泪液弯月面高度无显著差异。与FLEx组相比，SMILE组术后泪液NGF、TGF-β1和IL-1α浓度降低且恢复更快。两组手术前后泪液TNF-α、IFN-γ和MMP-9均无显著差异。泪液NGF、TGF-β1和IL-1α与FLEx或SMILE手术后的眼表变化相关。
在早期眼表变化方面，SMILE优于FLEx，NGF、TGF-β1和IL-1α可能有助于眼表恢复过程。
ClinicalTrials.gov NCT02540785。
