B & VIIT Eye Center, Seoul, South Korea.
Department of Ophthalmology, Yonsei University Wonju College of Medicine, 20, Ilsan-ro, Wonju, Gangwon-do, 26426, South Korea.
BMC Ophthalmol. 2020 Jul 18;20(1):296. doi: 10.1186/s12886-020-01570-2.
To evaluate corneal epithelial thickness change during medical treatment for eyes with myopic regression after femtosecond laser-assisted in situ keratomileusis (FS-LASIK).
This study included 84 eyes of 54 subjects diagnosed with myopic regression after FS-LASIK and treated using topical steroid and anti-glaucoma drugs. Corneal epithelial thickness was measured using Fourier-domain optical coherence tomography before and after treatment. Subjects were divided into three groups based on their corneal epithelial thickness at the time of myopic regression and regression analyses were used to investigate the association between corneal epithelial thickness, visual acuity, and refraction. Logistic regression and receiver operating characteristic (ROC) curve analysis was performed to determine whether corneal epithelial thickness could predict the success of treatment, improvements of ≥ two lines in uncorrected distance visual acuity and ≥ 0.5 diopter in refraction or K.
Corneal epithelial thickness decreased with greater change in the center as myopic regression subsided during medical treatment. Subgroup with the thickest epithelium (≥ 62 μm) showed a higher success rate and greater changes in refraction and vision. Reduced magnitude of corneal epithelial thickness showed significant correlations with changes of K and refractive error (all P < 0.001). Corneal epithelial thickness was a significant factor for the success of treatment and ROC curve showed that corneal epithelial thickness > 60.50 μm had 81.5% sensitivity and 84.2% specificity for the success of medical treatment.
Corneal epithelial thickness decreases proportionally with the magnitude of improvement of myopic regression during treatment with steroid and anti-glaucoma drugs in post-LASIK eyes with myopic regression.
评估飞秒激光辅助原位角膜磨镶术（FS-LASIK）后近视回退患者接受药物治疗期间角膜上皮厚度的变化。
本研究纳入了 54 例 84 只眼，这些患者在 FS-LASIK 术后诊断为近视回退，并使用局部皮质类固醇和抗青光眼药物进行治疗。使用傅里叶域光学相干断层扫描（OCT）在治疗前后测量角膜上皮厚度。根据近视回退时的角膜上皮厚度，将患者分为三组，并进行回归分析，以探讨角膜上皮厚度与视力和屈光度之间的关系。采用逻辑回归和受试者工作特征（ROC）曲线分析，以确定角膜上皮厚度是否可以预测治疗效果、未矫正远视力提高≥2 行和屈光度改善≥0.5 屈光度或 K。
随着药物治疗期间近视回退的缓解，角膜上皮厚度在中心变薄，变化越大。上皮最厚（≥62μm）的亚组显示出更高的成功率和更大的屈光度和视力变化。角膜上皮厚度的减小幅度与 K 和屈光不正的变化显著相关（均 P<0.001）。角膜上皮厚度是治疗成功的重要因素，ROC 曲线显示角膜上皮厚度>60.50μm 时，药物治疗成功率为 81.5%，特异性为 84.2%。
在接受皮质类固醇和抗青光眼药物治疗的 FS-LASIK 后近视回退眼，随着近视回退改善的程度，角膜上皮厚度呈比例下降。
