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飞秒激光原位角膜磨镶术(FS-LASIK)和小切口基质透镜切除术(SMILE)后6个月随访期内眼部生物测量参数的意外变化。

Unintended changes in ocular biometric parameters during a 6-month follow-up period after FS-LASIK and SMILE.

作者信息

Wang Junjie, Lopes Bernardo T, Li Hechen, Vinciguerra Riccardo, Cao Si, Wu Songan, Zhu Rong, Wang Qinmei, Zheng Xiaobo, Bao Fangjun, Elsheikh Ahmed

机构信息

Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, Zhejiang, China.

The Institution of Ocular Biomechanics, Wenzhou Medical University, Wenzhou, 325027, Zhejiang, China.

出版信息

Eye Vis (Lond). 2021 Mar 19;8(1):9. doi: 10.1186/s40662-021-00232-8.

Abstract

BACKGROUND

Corneal refractive surgery has become reliable for correcting refractive errors, but it can induce unintended ocular changes that alter refractive outcomes. This study is to evaluate the unintended changes in ocular biometric parameters over a 6-month follow-up period after femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) and small incision lenticule extraction (SMILE).

METHODS

156 consecutive myopic patients scheduled for FS-LASIK and SMILE were included in this study. Central corneal thickness (CCT), mean curvature of the corneal posterior surface (K), internal anterior chamber depth (IACD) and the length from corneal endothelium to retina (ER) were evaluated before and after surgery over a 6-month period.

RESULTS

Both the FS-LASIK and SMILE groups (closely matched at the pre-surgery stage) experienced flatter K, shallower IACD and decreased ER 1 week post-surgery (P < 0.01), and these changes were larger in FS-LASIK than in SMILE group. During the 1 week to 6 months follow up period, K, IACD and ER remained stable unlike CCT which increased significantly (P < 0.05), more in the FS-LASIK group.

CONCLUSIONS

During the follow up, the posterior corneal surface became flatter and shifted posteriorly, the anterior chamber depth and the length from the corneal endothelium to retina decreased significantly compared with the pre-surgery stage. These unintended changes in ocular biometric parameters were greater in patients undergoing FS-LASIK than SMILE. The changes present clear challenges for IOL power calculations and should be considered to avoid affecting the outcome of cataract surgery.

摘要

背景

角膜屈光手术已成为矫正屈光不正的可靠方法,但它可能会引起意外的眼部变化,从而改变屈光结果。本研究旨在评估飞秒激光制瓣准分子原位角膜磨镶术(FS-LASIK)和小切口基质透镜切除术(SMILE)后6个月随访期内眼部生物测量参数的意外变化。

方法

本研究纳入了156例计划接受FS-LASIK和SMILE手术的连续近视患者。在手术前和术后6个月期间评估中央角膜厚度(CCT)、角膜后表面平均曲率(K)、前房深度(IACD)以及从角膜内皮到视网膜的长度(ER)。

结果

FS-LASIK组和SMILE组(术前阶段密切匹配)在术后1周均出现K变平、IACD变浅和ER缩短(P<0.01),且FS-LASIK组的这些变化比SMILE组更大。在术后1周至6个月的随访期内,K、IACD和ER保持稳定,而CCT则显著增加(P<0.05),FS-LASIK组增加得更多。

结论

在随访期间,角膜后表面变平并向后移位,与术前阶段相比,前房深度和从角膜内皮到视网膜的长度显著减少。接受FS-LASIK手术的患者眼部生物测量参数的这些意外变化比SMILE手术的患者更大。这些变化给人工晶状体屈光度计算带来了明显挑战,应予以考虑以避免影响白内障手术的结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4789/7977186/742f8f07aef1/40662_2021_232_Fig1_HTML.jpg

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