经上皮准分子激光角膜切削术和飞秒激光原位角膜磨镶术后眼压的变化
Changes in Intraocular Pressure after Transepithelial Photorefractive Keratectomy and Femtosecond Laser In Situ Keratomileusis.
作者信息
Chou Chien-Chih, Shih Po-Jen, Lin Hung-Chou, Chen Jun-Peng, Yen Jia-Yush, Wang I-Jong
机构信息
Department of Ophthalmology, Taichung Veterans General Hospital, Taichung, Taiwan.
Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
出版信息
J Ophthalmol. 2021 Mar 10;2021:5592195. doi: 10.1155/2021/5592195. eCollection 2021.
PURPOSE
To investigate the changes in intraocular pressure (IOP) and biomechanically corrected IOP (bIOP) in patients undergoing transepithelial photorefractive keratectomy (TPRK) and femtosecond laser in situ keratomileusis (FS-LASIK) and to determine the effects of preoperative biomechanical factors on IOP and bIOP changes after FS-LASIK and TPRK.
DESIGN
A retrospective comparative study.
METHODS
We retrospectively investigated the IOP and corneal biomechanical changes in 93 eyes undergoing FS-LASIK and 104 eyes undergoing TPRK in a clinical setting. Preoperative and postoperative data on ophthalmic and Corvis ST examinations, in vivo Young's modulus, and noncontact tonometry were analyzed. Marginal linear regression models with generalized estimating equations were used for intragroup and intergroup comparisons of IOP and bIOP changes.
RESULTS
In the univariate model, IOP reduction after FS-LASIK was 2.49 mmHg higher than that after TPRK. In addition, bIOP reduction after FS-LASIK was 1.85 mmHg higher than that after TPRK. In the multiple regression model, we revealed that IOP reduction after FS-LASIK was 1.75 mmHg higher than that after TPRK. Additionally, bIOP reduction after FS-LASIK was 1.64 mmHg higher than that after TPRK. Postoperative changes in bIOP were less than those in IOP. In addition, Young's modulus and CBI had no significant effect on postoperative IOP and bIOP changes. We establish a biomechanically predictive model using the available data to predict postoperative IOP and bIOP changes after TPRK and FS-LASIK.
CONCLUSIONS
Reductions in IOP and bIOP after FS-LASIK were 1.75 mmHg and 1.64 mmHg, respectively, more than those after TPRK, after adjustment for confounders. We revealed that the type of refractive surgery and peak distance (PD) were significant predictors of postoperative IOP and bIOP changes. By contrast, depth of ablation showed a significant effect on only IOP changes.
目的
研究接受经上皮准分子激光角膜切削术（TPRK）和飞秒激光原位角膜磨镶术（FS-LASIK）患者的眼压（IOP）及生物力学校正眼压（bIOP）变化，并确定术前生物力学因素对FS-LASIK和TPRK术后IOP及bIOP变化的影响。
设计
一项回顾性比较研究。
方法
我们回顾性研究了临床环境中93只接受FS-LASIK的眼睛和104只接受TPRK的眼睛的IOP和角膜生物力学变化。分析了眼科和Corvis ST检查、体内杨氏模量和非接触眼压测量的术前和术后数据。采用带有广义估计方程的边际线性回归模型对IOP和bIOP变化进行组内和组间比较。
结果
在单变量模型中，FS-LASIK术后的IOP降低值比TPRK术后高2.49 mmHg。此外，FS-LASIK术后的bIOP降低值比TPRK术后高1.85 mmHg。在多元回归模型中，我们发现FS-LASIK术后的IOP降低值比TPRK术后高1.75 mmHg。此外，FS-LASIK术后的bIOP降低值比TPRK术后高1.64 mmHg。bIOP的术后变化小于IOP的变化。此外，杨氏模量和角膜生物力学指数（CBI）对术后IOP和bIOP变化无显著影响。我们利用现有数据建立了一个生物力学预测模型，以预测TPRK和FS-LASIK术后的IOP和bIOP变化。
结论
在调整混杂因素后，FS-LASIK术后IOP和bIOP的降低值分别比TPRK术后高1.75 mmHg和1.64 mmHg。我们发现屈光手术类型和顶点距离（PD）是术后IOP和bIOP变化的重要预测因素。相比之下，切削深度仅对IOP变化有显著影响。
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