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近视激光原位角膜磨镶术中角膜生物力学变化及组织改变百分比的影响研究

Study on change in corneal biomechanics and effect of percent tissue altered in myopic laser-assisted keratomileusis.

作者信息

Vanathi Murugesan, Azimeera Suresh, Gupta Noopur, Tandon Radhika

机构信息

Cornea, Cataract and Refractive Services, Dr Rajendra Prasad Center for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.

出版信息

Indian J Ophthalmol. 2020 Dec;68(12):2964-2974. doi: 10.4103/ijo.IJO_1453_20.

Abstract

PURPOSE

To evaluate corneal biomechanical changes and their correlation with the percentage of tissue altered (PTA) in myopic femtosecond (FS)-flap LASIK.

METHODS

Prospective longitudinal observational study of 80 eyes of FS LASIK. Demographic details, LASIK parameters, preoperative and postoperative (day 1, month 1, 3, and 6), UCVA, BCVA, refraction, corneal topography, corneal hysteresis (CH), and a corneal resistance factor (CRF) were noted. Change in CH and CRF and its correlation with PTA were analyzed. Data were analyzed in three subgroups [subgroup 1: PTA 23 to <27%; subgroup 2: 27 to <33%; subgroup 3: 33 to <40%].

RESULTS

FS LASIK for MRSE -3.5D ± 1.6D with mean PTA of 31.6 ± 4.4% (range 23.8-39.8%), showed statistically significant decrease in CH and CRF. Mean CH decreased from a preoperative value of 10.4 ± 1.9 to 8.1 ± 1.1; mean CRF from 10.5 ± 1.6 to 7.5 ± 1.3 at 6-months postoperative period, respectively. Mean preoperative CH decreased by 25%, 24%, 23%, and 21% and mean preoperative CRF decreased by 34%, 28%, 28%, and 28% at postoperative day 1, month 1, 3, and 6 follow-ups. Mean CH and CRF showed a significant negative correlation with PTA (CH: r = - 0.33 [P = <0.0001], CRF: r = -0.34 [P = <0.001]. Subgroup analysis noted greater decrease in CRF and CH in eyes with higher PTA (subgroup 3).

CONCLUSION

Myopic FS LASIK causes a decrease in corneal biomechanics with a significant negative correlation with PTA indicating a greater decrease in corneal biomechanics with higher PTA.

摘要

目的

评估近视飞秒(FS)瓣下准分子原位角膜磨镶术(LASIK)中角膜生物力学变化及其与组织改变百分比(PTA)的相关性。

方法

对80只接受FS LASIK手术的眼睛进行前瞻性纵向观察研究。记录人口统计学细节、LASIK参数、术前及术后(第1天、第1个月、第3个月和第6个月)的最佳矫正视力(UCVA)、最佳矫正视力(BCVA)、屈光、角膜地形图、角膜滞后(CH)和角膜阻力因子(CRF)。分析CH和CRF的变化及其与PTA的相关性。数据在三个亚组中进行分析[亚组1:PTA 23%至<27%;亚组2:27%至<33%;亚组3:33%至<40%]。

结果

对于平均球镜等效屈光度(MRSE)为-3.5D±1.6D且平均PTA为31.6±4.4%(范围23.8 - 39.8%)的近视FS LASIK,CH和CRF有统计学意义的下降。术后6个月时,平均CH从术前的10.4±1.9降至8.1±1.1;平均CRF从10.5±1.6降至7.5±1.3。术后第1天、第1个月、第3个月和第6个月随访时,平均术前CH分别下降25%、24%、23%和21%,平均术前CRF分别下降34%、28%、28%和28%。平均CH和CRF与PTA呈显著负相关(CH:r = -0.33[P = <0.0001],CRF:r = -0.34[P = <0.001])。亚组分析表明,PTA较高的眼睛(亚组3)中CRF和CH下降幅度更大。

结论

近视FS LASIK导致角膜生物力学下降,且与PTA呈显著负相关,表明PTA越高,角膜生物力学下降越大。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b7a/7856945/da5ce6b6eb1a/IJO-68-2964-g001.jpg

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