Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei City, Taiwan.
School of Medicine, National Defense Medical Center, Taipei City, Taiwan.
Clin Exp Optom. 2024 Jan;107(1):23-31. doi: 10.1080/08164622.2023.2197107. Epub 2023 Apr 20.
Corneal epithelial healing after refractive surgery is a clinically significant issue, especially for surface ablation procedures, and this can be monitored using optical coherence tomography (OCT).
The aim of this work is to investigate the corneal epithelial thickness and irregularity by OCT after transepithelial photorefractive keratectomy (t-PRK) and analyse its correlation with visual and refractive outcomes.
Patients aged ≥18 years with myopia, with or without astigmatism, who underwent t-PRK between May 2020 and August 2021 were included. All participants were subjected to complete ophthalmic examinations and OCT pachymetry at every follow-up visit. Patients were followed up at 1 week and 1, 3, and 6 months postoperatively.
A total of 67 patients (126 eyes) were enrolled in this study. One month postoperatively, spherical equivalent refraction and visual acuity achieved preliminary stability. However, central corneal epithelial thickness (CCET) and standard deviation of the corneal epithelial thickness (SD) took 3-6 months to progressive recovery. Patients with higher baseline spherical equivalent refraction were associated with slower epithelial recovery. At every follow-up time point, a significant superior-inferior difference in the minimum corneal epithelial thickness area was observed. Higher stromal haze was correlated with higher spherical equivalent refraction (both baseline and residual) but had no relation with visual outcomes. There was a significant correlation between higher CCET with a better uncorrected distance visual acuity and lower corneal epithelial thickness irregularity.
CCET and SD measured by OCT seem to be a good auxiliary indicator for reflecting the status of corneal wound recovery after t-PRK surgery. However, a well-designed randomised control study is needed to confirm the study results.
屈光手术后的角膜上皮愈合是一个具有临床意义的问题，特别是对于表面消融手术，这可以通过光学相干断层扫描（OCT）来监测。
本研究旨在通过 OCT 分析经上皮准分子激光角膜切削术（t-PRK）后角膜上皮厚度和不规则性，并分析其与视觉和屈光结果的相关性。
纳入 2020 年 5 月至 2021 年 8 月期间行 t-PRK 治疗的近视患者（伴或不伴散光），年龄≥18 岁。所有患者均接受全面眼科检查和 OCT 角膜测厚，随访时间为术后 1 周、1、3 和 6 个月。
本研究共纳入 67 例（126 只眼）患者。术后 1 个月，球镜等效屈光度和视力初步稳定，但中央角膜上皮厚度（CCET）和角膜上皮厚度标准差（SD）需要 3-6 个月才能逐渐恢复。术前球镜等效屈光度较高的患者上皮恢复较慢。在每个随访时间点，均观察到最小角膜上皮厚度区域的明显上下差异。较高的基质混浊与较高的球镜等效屈光度（包括术前和术后）相关，但与视觉结果无关。较高的 CCET 与更好的未矫正远视力和较低的角膜上皮厚度不规则性相关。
OCT 测量的 CCET 和 SD 似乎是反映 t-PRK 术后角膜伤口愈合状态的良好辅助指标。然而，需要进行精心设计的随机对照研究来验证研究结果。
