飞秒激光辅助基质内透镜角膜移植术（LIKE）在角膜基质袋内（SMI-LIKE）或角膜瓣下（FS-LIKE）进行后角膜后表面的变化。
Changes in the posterior corneal surface after femtosecond laser-assisted lenticule intrastromal keratoplasty (LIKE) performed into a pocket (SMI-LIKE) or under a flap (FS-LIKE).
作者信息
Liu Shengtao, Yu Lanhui, Zhao Yu, Zhou Xingtao
机构信息
Department of Ophthalmology and Optometry, Eye and ENT Hospital of Fudan University, Shanghai, China.
NHC Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Fudan University, Shanghai, China.
出版信息
Eye Vis (Lond). 2023 May 1;10(1):23. doi: 10.1186/s40662-023-00337-2.
BACKGROUND
To compare the changes in posterior corneal surface after small-incision lenticule intrastromal keratoplasty (SMI-LIKE) and femtosecond laser-assisted lenticule intrastromal keratoplasty (FS-LIKE) for hyperopia correction.
METHODS
In this prospective comparative randomized study, 23 eyes with hyperopia were recruited. Eyes were categorized into two groups-SMI-LIKE group (11 eyes) and FS-LIKE group (12 eyes). Lenticules from myopia small incision lenticule extraction were implanted into a pocket (SMI-LIKE group) or at a depth of 100 µm under a flap (FS-LIKE group). Posterior corneal elevations in the center, mid-periphery, and periphery, as well as mean keratometry of the posterior corneal surface (Kmb) were measured using a Pentacam over a three-month follow-up.
RESULTS
All surgeries were completed successfully and no complications occurred. At one day postoperatively, there was a slight backward change with SMI-LIKE and a forward change with FS-LIKE in the central region of the posterior corneal elevation. Conversely, the peripheral area showed forward displacement in SMI-LIKE and an apparent backward change in FS-LIKE. The mid-peripheral regions manifested a backward change after the procedure throughout the entire follow-up in both groups. Kmb exhibited flattening at one month postoperatively and subsequently returned to its original level at three months after SMI-LIKE while in FS-LIKE, Kmb steepened after lenticule implantation with a significant change noted at one day postoperatively (P = 0.001).
CONCLUSIONS
Posterior corneal surface after SMI-LIKE and FS-LIKE exhibited different change patterns in various corneal regions, with the most prominent change occurring at one day postoperatively during the three-month follow-up.
TRIAL REGISTRATION
Chinese Clinical Trial Registry: ChiCTR-ONC-16008300. Registered on Apr 18th, 2016. http://www.chictr.org.cn/edit.aspx?pid=14090&htm=4.
背景
比较小切口基质透镜植入角膜基质内屈光手术（SMI-LIKE）和飞秒激光辅助基质透镜植入角膜基质内屈光手术（FS-LIKE）矫正远视后角膜后表面的变化。
方法
在这项前瞻性比较随机研究中，招募了23只远视眼。将眼睛分为两组——SMI-LIKE组（11只眼）和FS-LIKE组（12只眼）。将近视小切口透镜取出术中的透镜植入袋内（SMI-LIKE组）或在瓣下100 µm深度处植入（FS-LIKE组）。在三个月的随访期间，使用Pentacam测量角膜中央、中周边和周边的后表面高度，以及角膜后表面平均角膜曲率（Kmb）。
结果
所有手术均成功完成，未发生并发症。术后一天，SMI-LIKE组角膜后表面中央区域有轻微后移变化，FS-LIKE组有前移变化。相反，周边区域在SMI-LIKE组表现为前移，在FS-LIKE组表现为明显后移。两组中周边区域在整个随访过程中术后均表现为后移变化。SMI-LIKE组术后1个月Kmb变平，随后在3个月时恢复到原始水平，而在FS-LIKE组，透镜植入后Kmb变陡，术后1天有显著变化（P = 0.001）。
结论
SMI-LIKE和FS-LIKE术后角膜后表面在不同角膜区域呈现不同的变化模式，在三个月随访期间最显著的变化发生在术后一天。
试验注册
中国临床试验注册中心：ChiCTR-ONC-16008300。于2016年4月18日注册。http://www.chictr.org.cn/edit.aspx?pid=14090&htm=4。
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