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飞秒激光辅助 LASIK 术后 6 个月角膜形态的区域性变化。

Regional changes in corneal shape over a 6-month follow-up after femtosecond-assisted LASIK.

机构信息

Eye Hospital, Wenzhou Medical University, Wenzhou, China; Institution of Ocular Biomechanics, Wenzhou Medical University, Wenzhou, China.

Eye Hospital, Wenzhou Medical University, Wenzhou, China.

出版信息

J Cataract Refract Surg. 2019 Jun;45(6):766-777. doi: 10.1016/j.jcrs.2018.12.017. Epub 2019 Mar 12.

Abstract

PURPOSE

To assess the regional changes in corneal shape after femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) in patients with different myopia extents.

SETTING

Eye Hospital, Wenzhou Medical University, Wenzhou, China.

DESIGN

Retrospective case series.

METHODS

A retrospective study of myopic eyes treated with FS-LASIK was conducted to assess the shape changes within different corneal regions after surgery. Corneal curvature was measured in the central region (0 mm to 3.0 mm diameter), pericentral region (3.0 mm to 6.0 mm diameter) and peripheral region (6.0 mm to 9.0 mm diameter) preoperatively and from 1 week to 6 months postoperatively.

RESULTS

The study comprised 608 myopic eyes. During the 6-month follow-up, the anterior cornea became steeper in the central and pericentral regions, but flatter in the peripheral region (P < .01), representing a partial, gradual, yet significant reversal of the immediate change in corneal shape after laser ablation. In contrast, the posterior surface experienced significantly less change than the anterior surface, with the cornea becoming slightly flatter (P < .01) in the central region at 1 week postoperatively, and steeper elsewhere (P < .05), and then remaining stable during the rest of the follow-up. On the other hand, the anterior astigmatism had significant decreases in the central region (P < .01) and slight increases in the peripheral region (P < .01) 1 week postoperatively, and that remained stable over the follow-up period. In contrast, there were little or non-significant changes in the posterior astigmatism throughout the follow-up (P > .05).

CONCLUSIONS

Postoperative corneal shape changes were different in different regions. There were shape changes in individual corneal regions during the 6-month follow-up period that represented reverse trends; however, the changes were much smaller than the short-term changes observed 1 week after surgery.

摘要

目的

评估不同近视程度患者行飞秒激光辅助准分子激光原位角膜磨镶术(FS-LASIK)后角膜形态的区域性变化。

设置

中国温州医科大学附属眼视光医院。

设计

回顾性病例系列研究。

方法

对行 FS-LASIK 治疗的近视眼进行回顾性研究,评估术后不同角膜区域的形态变化。术前及术后 1 周至 6 个月,分别对中央区(0 mm 至 3.0 mm 直径)、旁中央区(3.0 mm 至 6.0 mm 直径)和周边区(6.0 mm 至 9.0 mm 直径)进行角膜曲率测量。

结果

该研究纳入 608 只近视眼。在 6 个月的随访中,中央区和旁中央区的角膜前表面变陡,而周边区的角膜前表面变平(P<.01),这代表了激光消融后角膜形态的即刻变化呈部分、逐渐但显著的逆转。相比之下,后表面的变化明显小于前表面,术后 1 周中央区角膜略微变平(P<.01),其他部位变陡(P<.05),随后在其余随访期间保持稳定。另一方面,中央区的角膜前散光在术后 1 周时显著减小(P<.01),周边区略有增加(P<.01),且在随访期间保持稳定。相比之下,后散光在整个随访过程中变化很小或无显著变化(P>.05)。

结论

不同区域的术后角膜形态变化不同。在 6 个月的随访期间,各个角膜区域的形态发生变化,呈现出相反的趋势;然而,这些变化比术后 1 周观察到的短期变化小得多。

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