Kenia Vaishal P, Kenia Raj V, Pirdankar Onkar H
Kenia Eye Hospital, Mumbai, India.
Kenia Foundation, Mumbai, India.
Indian J Ophthalmol. 2021 Oct;69(10):2650-2656. doi: 10.4103/ijo.IJO_3365_20.
To report the short-term changes in a corneal stress-strain index (SSI) and other corneal biomechanical parameters post-laser in situ keratomileusis (LASIK) surgery.
A retrospective study was conducted at a tertiary eye care center wherein patients who had undergone LASIK (microkeratome blade and femtosecond bladeless LASIK) between July and December 2019 were enrolled. Patients of age group 20-40 years, best-corrected visual acuity of 20/20, intraocular pressure (IOP) <22 mmHg, pre-LASIK pachymetry >500 microns, and corneal astigmatism ≤3.00 D were included. Subjects with a prior history of refractive surgery, any other ocular or systemic disease, poor-quality scans, intraoperative complications, and missing data were excluded. Corneal biomechanical properties including SSI were analyzed using Corvis ST and compared using the Paired T-test for each group separately at pre-LASIK, and 1-month post-operatively.
Overall, 202 eyes were reviewed, and 79 eyes fulfilled the inclusion criteria. Forty-three and 36 eyes had undergone Microkeratome Blade LASIK (Group I) and Femto LASIK (Group II), respectively. Overall, 29 and 26 corneal biomechanical parameters out of 33 changed significantly post-Microkeratome Blade LASIK and Femto LASIK, respectively. Statistically significant changes were noted in all the parameters at A1, maximum and Vinciguerra screening parameters (P < 0.001), however, no changes were noted in SSI in both the groups when compared with the pre-surgery data.
Though the reduction in SSI was not statistically significant, other biomechanical parameters showed significant biomechanical changes pre- and post-LASIK surgeries in both the groups. However, a long-term study with a larger sample size would be required to understand the changes and stability in SSI post-refractive surgery.
报告准分子原位角膜磨镶术(LASIK)术后角膜应力应变指数(SSI)及其他角膜生物力学参数的短期变化。
在一家三级眼科护理中心进行了一项回顾性研究,纳入了2019年7月至12月期间接受LASIK手术(微型角膜刀和飞秒无刀LASIK)的患者。纳入年龄在20 - 40岁、最佳矫正视力为20/20、眼压(IOP)<22 mmHg、LASIK术前角膜厚度测量>500微米且角膜散光≤3.00 D的患者。排除有屈光手术史、任何其他眼部或全身疾病、扫描质量差、术中并发症及数据缺失的受试者。使用Corvis ST分析包括SSI在内的角膜生物力学特性,并在LASIK术前和术后1个月分别对每组使用配对t检验进行比较。
总体而言,共检查了202只眼,79只眼符合纳入标准。分别有43只眼和36只眼接受了微型角膜刀LASIK手术(第一组)和飞秒LASIK手术(第二组)。总体而言,33项角膜生物力学参数中,分别有29项和26项在微型角膜刀LASIK和飞秒LASIK术后发生了显著变化。在A1、最大值和Vinciguerra筛查参数处所有参数均有统计学显著变化(P < 0.001),然而,与术前数据相比,两组的SSI均未发生变化。
虽然SSI的降低无统计学显著性,但两组在LASIK手术前后其他生物力学参数均显示出显著的生物力学变化。然而,需要进行一项样本量更大的长期研究来了解屈光手术后SSI的变化和稳定性。