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[ReLEx SMILE和飞秒激光原位角膜磨镶术(FemtoLASIK)术后角膜生物力学特性变化的直接评估]

[Direct assessment of changes in biomechanical properties of the cornea after ReLEx SMILE and FemtoLASIK surgeries].

作者信息

Boiko E V, Togo E S, Suetov A A, Kachanov A B, Litvin I B

机构信息

Saint Petersburg branch of S.N. Fedorov National Medical Research Center "MNTK "Eye Microsurgery", St. Petersburg, Russia.

North-Western State Medical University named after I.I. Mechnikov, St. Petersburg, Russia.

出版信息

Vestn Oftalmol. 2023;139(3):41-48. doi: 10.17116/oftalma202313903141.

Abstract

UNLABELLED

The aim of this study was to evaluate corneal biomechanical properties in myopic patients after ReLEx SMILE and FemtoLASIK surgeries using the Corvis ST analyzer.

MATERIAL AND METHODS

The SMILE group comprised 23 patients (46 eyes) with spherical refraction -3.8±1.8 diopters (D), the FemtoLASIK group included 18 patients (36 eyes) with spherical refraction -3.5±1.3 D. Analysis of the biomechanical properties of the cornea was carried out using the CORVIS ST device (Oculus, Germany) before and seven days after corneal refractive surgery.

RESULTS

In the SMILE group, with intraoperative decrease in corneal thickness of 91.43±19.43 µm, a significant increase in the following parameters was observed: deformation coefficient (DA ratio; =0.0001), peak distance (PD; =0.02) and inverse concave radius (ICR; =0.003); a decrease in the stiffness parameter at first applanation (SP-A1; =0.0001), Corvis biomechanical index (CBI; =0.0001), intraocular pressure (IOP; =0.001). In the FemtoLASIK group, with intraoperative decrease in corneal thickness of 75.33±32.3 µm, we observed a significant increase in DA ratio (=0.0002), PD (=0.04), ICR (=0.0002), a decrease in SP-A1 (<0.0001), IOP values (=0.0003). In comparison with the FemtoLASIK group, the deformation amplitude DA changed significantly less in the SMILE group (=0.04). In the FemtoLASIK group, in comparison with the SMILE group, the DA ratio (=0.0009) and SP-A1 (=0.0003) significantly increased. Intraoperative corneal thickness change correlates with ICR both in SMILE (=0.52) and in FemtoLASIK (=0.65).

CONCLUSION

Corneal biomechanical properties determined with CORVIS ST in eyes with mild to moderate myopia change to a lesser extent after ReLEx SMILE compared to FemtoLASIK.

摘要

未标注

本研究旨在使用Corvis ST分析仪评估ReLEx SMILE和飞秒激光原位角膜磨镶术(FemtoLASIK)术后近视患者的角膜生物力学特性。

材料与方法

SMILE组包括23例患者(46只眼),球镜度数为-3.8±1.8屈光度(D);FemtoLASIK组包括18例患者(36只眼),球镜度数为-3.5±1.3 D。在角膜屈光手术前及术后7天,使用CORVIS ST设备(德国Oculus公司)对角膜生物力学特性进行分析。

结果

在SMILE组,术中角膜厚度下降91.43±19.43 µm,观察到以下参数显著增加:变形系数(DA比值;=0.0001)、峰值距离(PD;=0.02)和反凹半径(ICR;=0.003);首次压平刚度参数(SP-A1;=0.0001)、Corvis生物力学指数(CBI;=0.0001)、眼压(IOP;=0.001)下降。在FemtoLASIK组,术中角膜厚度下降75.33±32.3 µm,观察到DA比值(=0.0002)、PD(=0.04)、ICR(=0.0002)显著增加,SP-A1(<0.0001)、IOP值(=0.0003)下降。与FemtoLASIK组相比,SMILE组的变形幅度DA变化显著更小(=0.04)。在FemtoLASIK组中,与SMILE组相比,DA比值(=0.0009)和SP-A1(=0.0003)显著增加。术中角膜厚度变化在SMILE组(=0.52)和FemtoLASIK组(=0.65)中均与ICR相关。

结论

与FemtoLASIK相比,使用CORVIS ST测定的轻至中度近视眼中的角膜生物力学特性在ReLEx SMILE术后变化较小。

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