J Refract Surg. 2019 Oct 1;35(10):632-641. doi: 10.3928/1081597X-20190826-03.
To evaluate the longitudinal changes in epithelial thickness after photorefractive keratectomy (PRK) and correlate these with refractive changes.
This prospective study included 52 eyes of 52 candidates for myopic PRK. Along with standard ophthalmic examinations, corneal epithelial thickness mapping by anterior segment optical coherence tomography was performed. Epithelial thickness maps of 9-mm diameter were divided into 25 sectors, including a central 2-mm zone and eight octants within para-central (2 to 5 mm), midperipheral (5 to 7 mm), and peripheral (7 to 9 mm) annular zones. All PRK treatments were performed using the Technolas Teneo 317 model 2 excimer laser (Bausch & Lomb, Rochester, NY) and an aspheric profile with a 6-mm diameter optical zone. Follow-up was at 1, 3, and 6 months.
Repeated thickness measures before and after PRK at different follow-up times showed a significant difference in thickness separately in various zones (P < .001). A significant decrease in thickness was seen 1 month after PRK in all zones. Afterward, epithelial thickening continued in all zones and reached the preoperative thickness in the midperipheral and peripheral zones 6 months later, whereas the thickness in the central 5-mm zone was significantly thicker than before surgery. There was also a significant correlation between changes in spherical equivalent and epithelial thickness from before to 6 months postoperatively in the paracentral and peripheral zones.
There was a marked decrease in the epithelial thickening pattern at 1 month after PRK, with gradual thickening at 3 and 6 months. Changes in epithelial thickness and spherical equivalent were significant only for the para-central peripheral zone. [J Refract Surg. 2019;35(10):632-641.].
评估光折射性角膜切削术(PRK)后上皮厚度的纵向变化,并将其与屈光变化相关联。
这项前瞻性研究包括 52 名近视 PRK 候选者的 52 只眼。除了标准的眼科检查外,还通过眼前节光学相干断层扫描进行角膜上皮厚度测绘。直径为 9mm 的上皮厚度图分为 25 个扇区,包括中央 2mm 区和中央旁(2 至 5mm)、中周边(5 至 7mm)和周边(7 至 9mm)环形区的 8 个八分区。所有 PRK 治疗均使用 Technolas Teneo 317 模型 2 准分子激光(Bausch & Lomb,Rochester,NY)和 6mm 直径光学区的非球面轮廓进行。随访时间为 1、3 和 6 个月。
在不同随访时间点,PRK 前后的重复厚度测量显示,在各个区域的厚度分别存在显著差异(P<.001)。所有区域在 PRK 后 1 个月,厚度均明显变薄。此后,所有区域的上皮均持续增厚,并在 6 个月后达到中周边和周边区域的术前厚度,而中央 5mm 区的厚度明显高于术前。在中央旁和周边区域,从术前到术后 6 个月,等效球镜度数和上皮厚度的变化之间也存在显著相关性。
PRK 后 1 个月,上皮增厚模式明显减少,3 个月和 6 个月时逐渐增厚。仅在中央旁和周边区域,上皮厚度和等效球镜度数的变化具有显著意义。[J Refract Surg. 2019;35(10):632-641.]。