From the Department of Ophthalmology (Lee), International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, the Eyereum Eye Clinic (Kang), Seoul, and the Institute of Vision Research (Lee, Kim), Department of Ophthalmology, Yonsei University College of Medicine, Seoul, South Korea; the Department of Ophthalmology & Visual Science and Department of Biomedical Engineering (Roberts), Ohio State University, Columbus, Ohio, USA; Rio de Janeiro Corneal Tomography and Biomechanics Study Group (Ambrósio), Rio de Janeiro, Brazil; the School of Engineering (Elsheikh), University of Liverpool, Liverpool, United Kingdom.
From the Department of Ophthalmology (Lee), International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, the Eyereum Eye Clinic (Kang), Seoul, and the Institute of Vision Research (Lee, Kim), Department of Ophthalmology, Yonsei University College of Medicine, Seoul, South Korea; the Department of Ophthalmology & Visual Science and Department of Biomedical Engineering (Roberts), Ohio State University, Columbus, Ohio, USA; Rio de Janeiro Corneal Tomography and Biomechanics Study Group (Ambrósio), Rio de Janeiro, Brazil; the School of Engineering (Elsheikh), University of Liverpool, Liverpool, United Kingdom.
J Cataract Refract Surg. 2017 Dec;43(12):1495-1503. doi: 10.1016/j.jcrs.2017.08.019.
To evaluate the changes in biomechanically corrected intraocular pressure (IOP) and new dynamic corneal response parameters measured by a dynamic Scheimpflug analyzer before and after transepithelial photorefractive keratectomy (PRK) and femtosecond laser-assisted laser in situ keratomileusis (LASIK).
Yonsei University College of Medicine and Eyereum Eye Clinic, Seoul, South Korea.
Retrospective case series.
Medical records of patients having transepithelial PRK or femtosecond-assisted LASIK were examined. The primary outcome variables were biomechanically corrected IOP and dynamic corneal response parameters, including deformation amplitude ratio 2.0 mm, stiffness parameter at first applanation, Ambrósio relational thickness through the horizontal meridian, and integrated inverse radius before the procedure and 6 months postoperatively.
Of the 129 patients (129 eyes) in the study, 65 had transepithelial PRK and 64 had femtosecond-assisted LASIK. No significant differences in biomechanically corrected IOP were noted before and after surgery. The deformation amplitude ratio 2.0 mm and integrated inverse radius increased, whereas the stiffness parameter at first applanation and the Ambrósio relational thickness through the horizontal meridian decreased after surgery (P < .001). The changes in deformation amplitude ratio 2.0 mm and integrated inverse radius were smaller in transepithelial PRK than femtosecond-assisted LASIK (P < .001). Using analysis of covariance, with refractive error change or corneal thickness change as a covariate, the changes in deformation amplitude ratio 2.0 mm and integrated inverse radius were smaller in transepithelial PRK than femtosecond-assisted LASIK (P < .001).
The dynamic Scheimpflug analyzer showed stable biomechanically corrected IOP measurement before and after surgery. The changes in dynamic corneal response parameters were smaller with transepithelial PRK than with femtosecond-assisted LASIK, indicating less of a biomechanical effect with transepithelial PRK.
评估经上皮准分子激光角膜切削术（PRK）和飞秒激光辅助准分子激光原位角膜磨镶术（LASIK）前后，动态 Scheimpflug 分析仪测量的生物力学校正眼压（IOP）和新的动态角膜反应参数的变化。
韩国首尔延世大学医学院和 Eyereum 眼科诊所。
回顾性病例系列。
检查接受经上皮 PRK 或飞秒辅助 LASIK 的患者的病历。主要观察指标为生物力学校正 IOP 和动态角膜反应参数，包括变形幅度比 2.0mm、首次压平的刚性参数、水平子午线通过的 Ambrósio 关系厚度和术前和术后 6 个月的综合倒数半径。
本研究共纳入 129 例（129 只眼）患者，其中 65 例行经上皮 PRK，64 例行飞秒辅助 LASIK。手术前后生物力学校正 IOP 无显著差异。术后变形幅度比 2.0mm 和综合倒数半径增加，而首次压平的刚性参数和水平子午线通过的 Ambrósio 关系厚度降低（P<.001）。与飞秒辅助 LASIK 相比，经上皮 PRK 术后变形幅度比 2.0mm 和综合倒数半径的变化较小（P<.001）。使用协方差分析，以屈光度变化或角膜厚度变化为协变量，经上皮 PRK 术后变形幅度比 2.0mm 和综合倒数半径的变化小于飞秒辅助 LASIK（P<.001）。
动态 Scheimpflug 分析仪在手术前后均可稳定测量生物力学校正 IOP。经上皮 PRK 术后动态角膜反应参数的变化小于飞秒辅助 LASIK，表明经上皮 PRK 的生物力学效应较小。
