Jia Yuan, He Rui, Li Xiaona, Song Yaowen, Wei Junchao, Qin Hongwei, Yang Xin, Chen Weiyi
College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan 030024, P. R. China.
Department of Excimer Laser, Shanxi Eye Hospital, Taiyuan 030002, P. R. China.
Sheng Wu Yi Xue Gong Cheng Xue Za Zhi. 2022 Aug 25;39(4):679-684. doi: 10.7507/1001-5515.202203069.
Femtosecond laser small incision lenticule extraction (SMILE) with different residual stromal thicknesses (RST) is set to investigate its effect on corneal biomechanical properties of rabbits . In this study, 24 healthy adult Japanese rabbits were randomly divided into group A and B. The RST of group A was set 30% of the corneal central thickness (CCT), and the RST of group B was 50% of the CCT. The thickness of the corneal cap in both groups was set one third of CCT. Corneal visualization Scheimpflug technology (Corvis ST) and Pentacam three-dimensional anterior segment analyzer were used to determine corneal biomechanical and morphological parameters before surgery, and 1 week, 1 month and 3 months after surgery. Pearson correlation analysis was used to analyze factors affecting corneal biomechanical parameters after SMILE. The results showed that the corneal stiffness of group A was significantly higher than that of group B at 1 week and 1 month after surgery, and most biomechanical parameters returned to preoperative levels at 3 months postoperatively. The results of correlation analysis showed that postoperative CCT and RST were the main factors affecting corneal biomechanical parameters after SMILE. There was no significant difference in corneal posterior surface height (PE) between 3 months after surgery and before surgery in both two groups. It indicates that although the ability to resist deformation of cornea decreases in SMILE with thicker corneal cap and less RST, there is no tendency to keratoconus, which may be related to the preservation of more anterior stromal layer.
采用不同剩余基质厚度(RST)的飞秒激光小切口基质透镜切除术(SMILE)来研究其对兔角膜生物力学特性的影响。在本研究中,24只健康成年日本兔被随机分为A组和B组。A组的RST设定为角膜中央厚度(CCT)的30%,B组的RST为CCT的50%。两组角膜瓣的厚度均设定为CCT的三分之一。使用角膜可视化Scheimpflug技术(Corvis ST)和Pentacam三维眼前节分析仪在手术前、术后1周、1个月和3个月测定角膜生物力学和形态学参数。采用Pearson相关性分析来分析SMILE术后影响角膜生物力学参数的因素。结果显示,术后1周和1个月时,A组的角膜硬度显著高于B组,术后3个月时大多数生物力学参数恢复到术前水平。相关性分析结果表明,术后CCT和RST是影响SMILE术后角膜生物力学参数的主要因素。两组术后3个月时角膜后表面高度(PE)与术前相比均无显著差异。这表明,尽管在角膜瓣较厚且RST较小的SMILE手术中角膜抗变形能力下降,但没有圆锥角膜的倾向,这可能与保留了更多的前基质层有关。