He Shengyu, Luo Yiqi, Ye Yiming, Chen Pei, Liu Chang, Lei Lei, Zhuang Jing, Yu Keming
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.
Ann Transl Med. 2022 Jul;10(13):730. doi: 10.21037/atm-22-330.
To compare the corneal biomechanical changes after small incision lenticule extraction (SMILE) and femtosecond laser-assisted in situ keratomileusis (FS-LASIK) with the same programmed optical zone (POZ) and similar refractive correction in patients with high myopia.
In this prospective comparative study of the contralateral eye, 50 patients with high myopia with the same POZ and similar refractive correction who underwent SMILE in one eye and FS-LASIK in the other eye. Corneal biomechanical parameters and central corneal thickness (CCT) were measured using a Corvis ST II. All the patients were evaluated during follow-up visits beyond one year. Additionally, the corneal volume (CV) of the 10-mm diameter region was measured using a Pentacam.
Ambrosio relational thickness to the horizontal profile (ARTh) and stiffness parameter A1 (SP-A1) decreased significantly after SMILE and FS-LASIK, whereas deformation amplitude ratio 2.0 mm (DA ratio 2.0 mm) and integrated radius (IR) increased significantly in both groups. The ARTh and SP-A1 were greater after SMILE than those after FS-LASIK at all the follow-up visits. In addition, there were greater amounts of CCT and CV after SMILE compared with that after FS-LASIK. Moreover, a positive correlation was found between ARTh and SP-A1 and postoperative CCT, while a negative correlation was found between IR and DA ratio 2.0 mm and postoperative CCT. A moderate correlation was observed between SP-A1 and CV after both SMILE and FS-LASIK, whereas there were no relationships between CV and ARTh, IR, or DA ratio 2.0 mm.
SMILE had greater CCT, CV, ARTh, and SP-A1 than FS-LASIK in high myopia with the same POZ and similar refractive correction. Our results demonstrated that SMILE had lesser effect on corneal biomechanics than FS-LASIK in high myopia.
Corneal biomechanics; Corvis ST II; small incision lenticule extraction (SMILE); femtosecond laser-assisted in situ keratomileusis (FS-LASIK); high myopia.
比较高度近视患者在相同程控光学区（POZ）和相似屈光矫正情况下，小切口透镜切除术（SMILE）和飞秒激光原位角膜磨镶术（FS-LASIK）术后的角膜生物力学变化。
在这项对侧眼的前瞻性对照研究中，50例高度近视患者，其一眼接受SMILE手术，另一眼接受FS-LASIK手术，两组患者的POZ相同且屈光矫正相似。使用Corvis ST II测量角膜生物力学参数和中央角膜厚度（CCT）。所有患者均在术后一年以上的随访中接受评估。此外，使用Pentacam测量直径10 mm区域的角膜体积（CV）。
SMILE和FS-LASIK术后，安布罗西奥水平轮廓相关厚度（ARTh）和刚度参数A1（SP-A1）均显著降低，而两组的变形幅度比2.0 mm（DA比2.0 mm）和综合半径（IR）均显著增加。在所有随访中，SMILE术后的ARTh和SP-A1均高于FS-LASIK术后。此外，与FS-LASIK术后相比，SMILE术后的CCT和CV更大。而且，ARTh和SP-A1与术后CCT呈正相关，而IR和DA比2.0 mm与术后CCT呈负相关。SMILE和FS-LASIK术后，SP-A1与CV之间均观察到中度相关性，而CV与ARTh、IR或DA比2.0 mm之间均无相关性。
在相同POZ和相似屈光矫正的高度近视患者中，SMILE术后的CCT、CV、ARTh和SP-A1均高于FS-LASIK术后。我们的结果表明，在高度近视患者中，SMILE对角膜生物力学的影响小于FS-LASIK。
角膜生物力学；Corvis ST II；小切口透镜切除术（SMILE）；飞秒激光原位角膜磨镶术（FS-LASIK）；高度近视
