Wei Ruoyan, Li Meiyan, Yang Weiming, Shen Yang, Zhao Yu, Fu Dan, Shang Jianmin, Zhang Jing, Choi Joanne, Zhou Xingtao
Department of Ophthalmology and Optometry, Eye and ENT Hospital, Fudan University, Shanghai, China.
NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.
Front Med (Lausanne). 2020 Nov 6;7:521078. doi: 10.3389/fmed.2020.521078. eCollection 2020.
To investigate long-term changes in corneal densitometry (CD) following small incision lenticule extraction (SMILE) vs. femtosecond laser-assisted LASIK (FS-LASIK) in patients with myopia or myopic astigmatism. Prospective analysis was performed in 66 eyes of 38 patients (13 males) who underwent SMILE and 54 eyes of 29 patients (5 males) who underwent FS-LASIK. In all patients, an ocular examination was performed preoperatively, and at 6-12 months and 5 years postoperatively. CD was obtained with the Pentacam Scheimpflug imaging system at the 0-2-mm, 2-6-mm, and 6-10-mm zones of the cornea at depth of anterior 120 μm, midcornea, and posterior 60 μm. Correlation analysis was performed between postoperative change in CD and other variables such as age, type of surgery, central corneal thickness, spherical equivalent, lenticule thickness/ablation depth, and changes in wavefront aberrations. At postoperative 6-12 months, a significant reduction at several corneal zones in the FS-LASIK cohort ( < 0.05) was observed. In the SMILE cohort, no significant change in CD relative to baseline was observed. However, at 5 years postoperatively, in both groups, a significant decrease in CD was observed in three zones of three layers (all < 0.001). The change in CD was similar between groups at postoperative 6-12 months, but at 5 years the magnitude of change was significantly smaller in SMILE than FS-LASIK in the anterior and central layers (all < 0.05). CD with the Scheimpflug imaging system showed a significant decrease at 5 years after SMILE or FS-LASIK, and the change was significantly less pronounced after SMILE.
为研究近视或近视散光患者行小切口透镜切除术（SMILE）与飞秒激光制瓣准分子原位角膜磨镶术（FS-LASIK）后角膜密度测量（CD）的长期变化。对38例患者（13例男性）的66只眼行SMILE手术，以及29例患者（5例男性）的54只眼行FS-LASIK手术进行前瞻性分析。所有患者在术前、术后6 - 12个月及5年进行眼部检查。使用Pentacam Scheimpflug成像系统在角膜前120μm深度、角膜中部和后60μm深度的0 - 2mm、2 - 6mm和6 - 10mm区域获取CD值。对CD术后变化与其他变量进行相关性分析，这些变量包括年龄、手术类型、中央角膜厚度、等效球镜度、透镜厚度/消融深度以及波前像差变化。术后6 - 12个月，FS-LASIK组多个角膜区域出现显著降低（<0.05）。在SMILE组，相对于基线，CD未观察到显著变化。然而，术后5年，两组在三层的三个区域均观察到CD显著降低（均<0.001）。术后6 - 12个月两组间CD变化相似，但术后5年，SMILE组在前层和中央层的变化幅度明显小于FS-LASIK组（均<0.05）。使用Scheimpflug成像系统测量的CD在SMILE或FS-LASIK术后5年显著降低，且SMILE术后变化明显较小。
