Eye Hospital of Shandong First Medical University, 372 Jingsi Road, Jinan, 250021, China.
State Key Laboratory Cultivation Base Eye Institute, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China.
Lasers Med Sci. 2021 Oct;36(8):1709-1717. doi: 10.1007/s10103-021-03320-2. Epub 2021 Apr 23.
The purpose of this study is to compare the postoperative corneal biomechanics and assess the influence factors after femtosecond-assisted laser in situ keratomileusis (FS-LASIK) and laser-assisted subepithelial keratomileusis (LASEK) for high myopia. In this retrospective study, patients who completed 1-year follow-up were included. The corneal biomechanical parameters, including deformation amplitude ratio 2.0 mm (DA ratio 2.0 mm), integrated inverse radius (IntInv Rad), stiffness parameter at first applanation (SP-A1), and Ambrosio relational thickness through the horizontal meridian (ARTh), were measured with Corvis STII. We also investigated the relationship between these biomechanics and preoperative or intraoperative variables. Thirty eyes had FS-LASIK and 30 eyes had LASEK. The changes in DA ratio 2.0 mm, IntInv Rad, and SP-A1 after surgery were significantly smaller in the LASEK group than in the FS-LASIK group, while the change in the ARTh was not significantly different between groups. No significant differences were detected in the mean values of postoperative DA ratio 2.0 mm, IntInv Rad, and SP-A1 between LASEK and FS-LASIK, while significant difference was detected in the mean value of postoperative ARTh. There was a significant correlation between the resident stromal bed thickness and the postoperative DA ratio 2.0 mm, IntInv Rad, or SP-A1. The postoperative ARTh has shown significant correlation with postoperative central corneal thickness and the amount of myopic correction. The effect of LASEK on corneal biomechanics was smaller than FS-LASIK when the same central corneal thickness was consumed. LASEK may be performed with a lower risk of postoperative corneal ectasia than FS-LASIK.
本研究旨在比较飞秒激光辅助 LASIK(FS-LASIK)和准分子激光上皮下角膜磨镶术(LASEK)治疗高度近视术后的角膜生物力学变化,并评估其影响因素。本回顾性研究纳入了完成 1 年随访的患者。采用 Corvis STII 测量角膜生物力学参数,包括 2.0mm 变形幅度比(DA 比 2.0mm)、综合反转半径(IntInv Rad)、首次压平刚度参数(SP-A1)和水平子午线通过的 Ambrosio 相关角膜厚度(ARTh)。我们还研究了这些生物力学参数与术前或术中变量之间的关系。30 只眼行 FS-LASIK,30 只眼行 LASEK。术后 LASEK 组的 DA 比 2.0mm、IntInv Rad 和 SP-A1 变化明显小于 FS-LASIK 组,而两组 ARTh 变化无明显差异。LASEK 和 FS-LASIK 术后 DA 比 2.0mm、IntInv Rad 和 SP-A1 的平均值无显著差异,但 ARTh 的平均值有显著差异。LASEK 组术后中央角膜厚度和近视矫正量与术后 DA 比 2.0mm、IntInv Rad 或 SP-A1 呈显著相关性。术后 ARTh 与术后中央角膜厚度和近视矫正量呈显著相关性。当消耗相同的中央角膜厚度时,LASEK 对角膜生物力学的影响小于 FS-LASIK。与 FS-LASIK 相比,LASEK 术后发生角膜扩张的风险可能较低。