Department of Ophthalmology, The Second People's Hospital of Jinan, Jinan, China.
Indian J Ophthalmol. 2020 Dec;68(12):2945-2949. doi: 10.4103/ijo.IJO_1106_20.
We aimed to compare transepithelial photorefractive keratectomy (TPRK) and femtosecond laser-assisted in situ keratomileusis (FS-LASIK) for myopia treatment by analyzing corneal curvature, asphericity (Q-value), and corneal aberration.
Corneal topography was measured before and 6 months after the TPRK or FS-LASIK surgery. We measured and compared corneal curvature (sagittal curvature in the 1- to 7-mm zones), change in keratometric measurements (Kmpost - Kmpre, ΔK), Q-values (from the vertex of the 6-, 7-, 8-, and 9-mm zones), higher-order aberration (HOA), vertical and horizontal trefoil (Z3 and Z3), vertical and horizontal coma (Z3 and Z3), and spherical aberration (Z4) between the two surgery groups.
The sagittal curvature Δ K in the 1-mm zone after TPRK was significantly higher than after FS-LASIK. The Δ K/ΔSE (ΔSE [spherical equivalent] = SEpre - SEpost) ratio in the 1- to 4-mm diameter zones was significantly higher after TPRK than after FS-LASIK. The preoperative Q-values of the 6- and 7-mm zones did not differ between the treatment groups, but postoperative values were significantly higher following FS-LASIK than following TPRK. HOA, Z4, and Z3 were all significantly higher after surgery in both groups. Postoperative Z3 was significantly higher following TPRK but not following FS-LASIK. There were no postoperative differences in aberrations in either group; however, the change in HOA and Z3 was significantly greater following FS-LASIK.
TPRK changes the corneal curvature to a greater extent and the visual quality (Q-value, aberrations) to a lesser extent than FS-LASIK.
通过分析角膜曲率、非球面性(Q 值)和角膜像差,比较经上皮准分子激光角膜切削术(TPRK)和飞秒激光辅助原位角膜磨镶术(FS-LASIK)治疗近视的效果。
在 TPRK 或 FS-LASIK 手术后 6 个月,测量角膜地形图。测量并比较角膜曲率(1-7mm 区矢状曲率)、角膜屈光度测量值的变化(Kmpost-Kmpre,ΔK)、Q 值(6、7、8 和 9mm 区顶点)、高阶像差(HOA)、垂直彗差(Z3 和 Z3)、水平彗差(Z3 和 Z3)和球差(Z4),比较两组手术之间的差异。
TPRK 术后 1mm 区矢状曲率ΔK 明显高于 FS-LASIK,1-4mm 直径区ΔK/ΔSE(ΔSE [等效球镜] = SEpre-SEpost)比值明显高于 FS-LASIK。两组术前 6-7mm 区 Q 值无差异,但 FS-LASIK 术后 Q 值明显高于 TPRK。两组术后 HOA、Z4 和 Z3 均明显升高。TPRK 术后 Z3 明显升高,但 FS-LASIK 术后 Z3 无明显升高。两组术后各像差均无差异,但 FS-LASIK 术后 HOA 和 Z3 变化明显更大。
与 FS-LASIK 相比,TPRK 能更大程度地改变角膜曲率,但对视觉质量(Q 值、像差)的影响较小。