Jhanji Vishal, Chan Tommy C Y, Li Wai Ying, Lim Rayne R, Yu Marco C Y, Law Kasin, Yi Peng, Yip Yolanda W Y, Wang Yumeng, Ng Tsz Kin, Chaurasia Shyam S, Mohan Rajiv R
J Refract Surg. 2017 Feb 1;33(2):96-103. doi: 10.3928/1081597X-20161102-02.
To study the differences in early corneal cellular events and biomechanical properties after femtosecond laser-assisted LASIK performed using conventional or inverted side-cut angles.
In the laboratory study, left eyes of 24 rabbits underwent LASIK flap creation with a 70° or 115° side-cut. The contralateral eyes served as controls. The corneas were harvested 24 hours postoperatively. In the clinical study, 2 eyes of each patient (n = 29) were randomized to corneal flap creation with 70° or 115° side-cut angles during LASIK. The Ocular Response Analyzer (ORA; Reichert Ophthalmic Instruments, Depew, NY) was used to assess biomechanical properties of the cornea.
In rabbit eyes, epithelial ingrowth was observed more frequently in flaps with 70° side cuts compared to flaps with 115° side-cuts. Corneas with 70° side-cuts showed significantly increased apoptotic cells compared to 115° side-cuts in the central (P = .001) and peripheral (P = .004) regions. Fifty-eight eyes of 29 patients were included in the clinical study. An overall reduction in Goldmann-correlated intraocular pressure, corneal-compensated intraocular pressure, corneal resistance factor, corneal hysteresis measurements, p1 area, p2 area, and p1 area 1 and p2 area 1 was noted 37 ± 2 months after surgery (P < .001). No significant difference was observed in the change of any of these parameters between both groups (P ≥ .146).
Significant differences in wound healing were observed in rabbit corneas that underwent LASIK with conventional or inverted side-cuts. Variation in flap side-cut angles did not alter the long-term biomechanical properties measured with the ORA in patients after LASIK. [J Refract Surg. 2017;33(2):96-103.].
研究使用传统或反向侧切角度进行飞秒激光辅助准分子原位角膜磨镶术（LASIK）后早期角膜细胞事件和生物力学特性的差异。
在实验室研究中，对24只兔的左眼采用70°或115°侧切创建LASIK角膜瓣。对侧眼作为对照。术后24小时摘取角膜。在临床研究中，29例患者的每只眼睛随机分为在LASIK手术中采用70°或115°侧切角度创建角膜瓣。使用眼反应分析仪（ORA；Reichert眼科仪器公司，纽约州迪皮尤）评估角膜的生物力学特性。
在兔眼中，与115°侧切的角膜瓣相比，70°侧切的角膜瓣上皮内生更常见。与115°侧切相比，70°侧切的角膜在中央（P = 0.001）和周边（P = 0.004）区域的凋亡细胞显著增加。29例患者的58只眼睛纳入临床研究。术后37±2个月，观察到Goldmann相关眼压、角膜补偿眼压、角膜阻力因子、角膜滞后测量、p1面积、p2面积以及p1面积1和p2面积1总体降低（P < 0.001）。两组之间这些参数的变化均未观察到显著差异（P≥0.146）。
在采用传统或反向侧切进行LASIK的兔角膜中观察到伤口愈合存在显著差异。LASIK术后患者中，角膜瓣侧切角度的变化未改变使用ORA测量的长期生物力学特性。[《屈光手术杂志》。2017；33(2):96 - 103。]
