Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany.
Department of Ophthalmology, Goethe University, Frankfurt, Germany.
PLoS One. 2021 May 4;16(5):e0250700. doi: 10.1371/journal.pone.0250700. eCollection 2021.
Myopia is the most common refractive error. Surgical correction with laser is possible. LASIK and SMILE are the techniques currently most used. Aim of the study was to compare changes in corneal volume and thickness after the respective laser treatment. 104 eyes of 52 patients were matched based on refractive error into two equally sized groups, either treated with LASIK or SMILE. Measurements were obtained from the Scheimpflug camera (Pentacam) preoperatively and at 3 and 12 months postoperatively. 3 months postoperatively, the flapless SMILE procedure resulted in a significant overall greater loss of corneal volume (P < 0.01) and corneal thickness (P < 0.01) compared to LASIK. No significant difference was found when comparing the 3 to 12-months values in each group. Within the currently used ranges of refractive error correction, loss in central corneal thickness and corneal volume with SMILE is higher in comparison to LASIK. As greater loss in corneal volume and thickness might contribute to higher level of corneal instability maximum ranges of refractive error correction with SMILE should not supersede those set currently for LASIK until more long-term results on corneal ectasia are available for SMILE.
近视是最常见的屈光不正。激光手术矫正近视是可行的。目前应用最广泛的技术是 LASIK 和 SMILE。本研究旨在比较两种激光治疗方法后角膜体积和厚度的变化。根据近视程度,将 52 名患者的 104 只眼分为两组,每组 52 只眼,分别接受 LASIK 或 SMILE 治疗。术前及术后 3 个月和 12 个月,采用 Scheimpflug 相机(Pentacam)进行测量。术后 3 个月,与 LASIK 相比,无瓣 SMILE 手术导致角膜总体体积(P < 0.01)和角膜厚度(P < 0.01)显著减少。两组在 3 个月和 12 个月的测量值之间无显著差异。在目前应用的屈光不正矫正范围内,SMILE 治疗导致的中央角膜厚度和角膜体积损失高于 LASIK。由于角膜体积和厚度的损失可能会导致角膜稳定性更高,因此 SMILE 的最大矫正近视范围不应超过 LASIK 目前设定的范围,直到 SMILE 治疗角膜扩张的长期结果可供参考。