Shen Yang, Su Xiangjian, Liu Xiu, Miao Huamao, Fang Xuejun, Zhou Xingtao
Key Lab of Myopia, Ministry of Health, P.R. China, 19 Baoqing Road, Shanghai, 200031, China.
Department of Ophthalmology, EYE & ENT Hospital of Fudan University, Shanghai, China, 83 Fenyang Road, Shanghai, 200031, China.
BMC Ophthalmol. 2016 Nov 18;16(1):205. doi: 10.1186/s12886-016-0381-3.
Corneal biomechanical properties are always compromised after corneal refractive surgeries thus leading to underestimated intraocular pressure (IOP) that complicates the management of IOP. We investigated the changes in postoperative baseline of IOP values measured with noncontact tonometer (NCT), ocular response analyzer (ORA) and corvis scheimpflug technology (CST) in the early phase after small incision lenticule extraction (SMILE).
Twenty-two eyes (-6.76 ± 1.39D) of 22 moderate and high myopes, (28.36 ± 7.14 years, 12 male and 10 female) were involved in this prospective study. IOP values were measured using a non-contact tomometer (NCT-IOP), an ocular response analyzer (corneal-compensated IOP, IOPcc and Goldmann-correlated IOP, IOPg) and a Corvis scheimpflug technology tonometer (CST-IOP) preoperatively, at 20 min and 24 h, postoperatively. Repeated measures analysis of variance (RM-ANOVA), Pearson's correlation analysis and multiple linear regression models (stepwise) were performed. Cut-off P values were 0.05.
Except for IOPcc, NCT-IOP, IOPg, and CST-IOP values significantly decreased after SMILE procedure (All P values <0.05). ΔCCT, as well as ΔMRSE and ΔKm, did not significantly correlated with ΔNCT-IOP, ΔIOPcc, ΔIOPg or ΔCST-IOP, (all P values >0.05). Multiple linear regression models (stepwise) showed that the practical post-operative IOP value was the main predictor of the theoretical post-operative NCT-IOP, IOPcc and IOPg values (all P values <0.001). The postoperative applanation time 1 (AT1) value (B = 8.079, t = 4.866, P < 0.001), preoperative central corneal thickness (CCT) value (B = 0.035, t = 2.732, P = 0.014) and postoperative peak distance (PD) value (B = 0.515, t = 2.176, P = 0.043) were the main predictors of the theoretical post-operative CST-IOP value.
IOP values are underestimated when assessed after SMILE by using NCT-IOP, IOPg and CST-IOP. The practical postoperative IOPcc value and theoretical post-operative CST-IOP value may be more preferable for IOP assessment in the early phase after SMILE.
Current Controlled Trials ChiCTRONRC13003114 . Retrospectively registered 17 March 2013.
角膜屈光手术后角膜生物力学特性总是受到损害，从而导致眼压（IOP）被低估，这使眼压管理变得复杂。我们研究了小切口透镜切除术（SMILE）后早期使用非接触眼压计（NCT）、眼反应分析仪（ORA）和Corvis Scheimpflug技术（CST）测量的眼压值术后基线的变化。
本前瞻性研究纳入了22例中高度近视患者（28.36±7.14岁，男12例，女10例）的22只眼（-6.76±1.39D）。术前、术后20分钟和24小时使用非接触眼压计（NCT-IOP）、眼反应分析仪（角膜补偿眼压，IOPcc和Goldmann相关眼压，IOPg）和Corvis Scheimpflug技术眼压计（CST-IOP）测量眼压值。进行重复测量方差分析（RM-ANOVA）、Pearson相关分析和多元线性回归模型（逐步法）。截断P值为0.05。
除IOPcc外，SMILE手术后NCT-IOP、IOPg和CST-IOP值均显著降低（所有P值<0.05）。ΔCCT以及ΔMRSE和ΔKm与ΔNCT-IOP、ΔIOPcc、ΔIOPg或ΔCST-IOP均无显著相关性（所有P值>0.05）。多元线性回归模型（逐步法）显示，实际术后眼压值是理论术后NCT-IOP、IOPcc和IOPg值的主要预测因素（所有P值<0.001）。术后压平时间1（AT1）值（B = 8.079，t = 4.866，P < 0.001）、术前中央角膜厚度（CCT）值（B = 0.035，t = 2.732，P = 0.014）和术后峰值距离（PD）值（B = 0.515，t = 2.176，P = 0.043）是理论术后CST-IOP值的主要预测因素。
SMILE术后使用NCT-IOP、IOPg和CST-IOP评估眼压时眼压值被低估。实际术后IOPcc值和理论术后CST-IOP值可能更适合用于SMILE术后早期的眼压评估。
当前对照试验ChiCTRONRC13003114。2013年3月17日回顾性注册。
