飞秒激光辅助准分子激光原位角膜磨镶术与光折射性角膜切削术：对眼表状况的影响。

Femtosecond laser-assisted laser in situ keratomileusis versus photorefractive keratectomy: Effect on ocular surface condition.

机构信息

From Centro de Oftalmología Barraquer (Sauvageot, Julio, Alvarez de Toledo, Charoenrook, Barraquer), the Universitat Autònoma de Barcelona (Sauvageot, Alvarez de Toledo, Charoenrook), the Optics and Optometry Department (Julio), Universitat Politècnica de Catalunya, Tech, Terrassa, and the Universitat Internacional de Catalunya (Barraquer), Barcelona, Spain.

出版信息

J Cataract Refract Surg. 2017 Feb;43(2):167-173. doi: 10.1016/j.jcrs.2016.12.019.

DOI:10.1016/j.jcrs.2016.12.019

PMID:28366362

Abstract

PURPOSE

To compare ocular surface characteristics in eyes after femtosecond laser-assisted laser in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK).

SETTING

Centro de Oftalmologia Barraquer, Barcelona, Spain.

DESIGN

Prospective comparative observational study.

METHODS

Patients with myopia who had femtosecond laser-assisted LASIK or PRK were included. Tear osmolarity, the Ocular Surface Disease Index questionnaire, Schirmer I, corneal sensitivity, tear breakup time (TBUT), and corneal fluorescein staining were evaluated preoperatively and 3, 6, and 12 months postoperatively. The Wilcoxon signed-rank test was used for temporal intragroup analysis, and the Mann-Whitney U test was used for intergroup comparisons.

RESULTS

The study comprised 44 patients (44 eyes) with myopia. Comparison of the parameters between the femtosecond laser-assisted LASIK group (22 eyes) and the PRK group (22 eyes) showed a similar temporal progression postoperatively. Compared with the preoperative evaluation, corneal sensitivity decreased after 3 months (P = .002 and P = .02, respectively) and 6 months (P = .03 and P = .04, respectively). The TBUT reached the highest mean value after 12 months (P = .01 and P = .04, respectively), and tear osmolarity was slightly increased after 1 year, although the mean values remained within the normal range (P = .01 and P = .04, respectively). The only difference between the 2 groups was lower corneal sensitivity in the femtosecond laser-assisted LASIK group after 3 months (P = .02). The ocular surface condition could be considered clinically unaltered after 1 year in both groups.

CONCLUSION

Femtosecond laser-assisted LASIK and PRK techniques seemed to be safe for the ocular surface condition and to have a similar effect on it.

摘要

目的

比较飞秒激光辅助准分子激光原位角膜磨镶术（LASIK）或光性折射角膜切削术（PRK）术后的眼表特征。

设置

西班牙巴塞罗那 Barraquer 眼科中心。

设计

前瞻性比较观察性研究。

方法

纳入近视患者，他们接受了飞秒激光辅助 LASIK 或 PRK。术前和术后 3、6 和 12 个月评估泪液渗透压、眼表疾病指数问卷、Schirmer I 试验、角膜知觉、泪膜破裂时间（TBUT）和角膜荧光素染色。Wilcoxon 符号秩检验用于组内时间的比较，Mann-Whitney U 检验用于组间比较。

结果

这项研究包括 44 名（44 只眼）近视患者。飞秒激光辅助 LASIK 组（22 只眼）和 PRK 组（22 只眼）之间的参数比较显示术后有相似的时间进展。与术前评估相比，术后 3 个月（P=.002 和 P=.02）和 6 个月（P=.03 和 P=.04）时角膜知觉下降。TBUT 在 12 个月时达到最高平均水平（P=.01 和 P=.04），泪液渗透压在 1 年后略有升高，尽管平均值仍在正常范围内（P=.01 和 P=.04）。两组之间的唯一区别是飞秒激光辅助 LASIK 组术后 3 个月时角膜知觉较低（P=.02）。两组术后 1 年均认为眼表状况无明显变化。