Hainan Eye Hospital and Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Sun Yat-sen University, Guangzhou, China.
Yichang Maternal and Child Health Hospital, School of Clinical Medicine for Women and Children, China Three Gorges University, Hubei, China.
Eur J Ophthalmol. 2024 Mar;34(2):384-393. doi: 10.1177/11206721231187669. Epub 2023 Jul 12.
To evaluate the corneal biological parameters stability between the different corneal residual bed thickness (RBT) after Small Incision Lenticule Extraction (SMILE).
In this prospective clinical trial, 127 eyes of 64 patients underwent SMILE. According to the corneal RBT, the patients were divided into the 250-270 µm, 270-290 µm and 290-310 µm groups. Corvis ST (Oculus Optikgeräte GmbH, Wetzlar, Germany) and Scheimpflug camera (Pentacam; Oculus Optikgeräte GmbH, Wetzlar, Germany) measurements were performed preoperatively, 1 day, 1week, 1month and 3 months after surgery.
The keratometer values among the three groups were no significant differences in postoperative periods (each P > 0.05), except the corneal thickness values (each P < 0.05). In the 250-270 µm and 270-290 µm groups, the keratometer and corneal thickness values were decreased at postoperative 1 week and increased at 1 and 3 months. The 290-310 µm group significantly higher posterior maximum elevation (PME) than the 250-270 µm group at 1 and 3 months (P = 0.022, 0.022, respectively), and higher preoperative thinnest point (PTE) at 1 week and 1 month (P = 0.013, 0.035, respectively). The PME of the 290-310 µm group was higher than the 270-290 µm group at 3 months (P = 0.045), and higher PTE at 1 week and 3 months (P = 0.022, 0.02, respectively). In all three groups, the maximal deformation amplitude (DA) was significantly higher at 1 and 3 months compared to postoperative 1 day and 1 week, and the IOP was decreased at 1 month then recovered at 3 months (each P < 0.05).The DA of the 250-270 µm group was significantly higher than the 290-310 µm group at postoperative 1 week, 1 and 3 months (P = 0.001, 0.01, 0.02, respectively). The change of the posterior corneal elevation and biomechanical parameters values were no significant differences among the three groups in postoperative periods (each P > 0.05).
The range of 250-310 µm RBT was safe and stable at the early postoperative of SMILE. The RBT may be positively correlated with the posterior corneal elevation.
评估 SMILE 术后不同角膜剩余床厚度（RBT）之间的角膜生物学参数稳定性。
在这项前瞻性临床试验中，64 名患者的 127 只眼接受了 SMILE 手术。根据角膜 RBT，将患者分为 250-270μm、270-290μm 和 290-310μm 组。在术前、术后 1 天、1 周、1 个月和 3 个月，使用 Corvis ST（Oculus Optikgeräte GmbH，德国威茨拉尔）和 Scheimpflug 相机（Pentacam；Oculus Optikgeräte GmbH，德国威茨拉尔）进行测量。
在术后期间，三组的角膜曲率计值没有显著差异（P 值均>0.05），但角膜厚度值有显著差异（P 值均<0.05）。在 250-270μm 和 270-290μm 组中，角膜曲率计和角膜厚度值在术后 1 周时下降，在 1 个月和 3 个月时增加。290-310μm 组在术后 1 个月和 3 个月时的最大后表面隆起（PME）显著高于 250-270μm 组（P 值分别为 0.022、0.022），在术后 1 周和 1 个月时的最薄点（PTE）也显著高于 250-270μm 组（P 值分别为 0.013、0.035）。290-310μm 组的 PME 在术后 3 个月时高于 270-290μm 组（P 值为 0.045），在术后 1 周和 3 个月时的 PTE 也高于 270-290μm 组（P 值分别为 0.022、0.02）。在所有三组中，最大变形幅度（DA）在术后 1 个月和 3 个月时明显高于术后 1 天和 1 周时，而眼压在术后 1 个月时降低，3 个月时恢复（P 值均<0.05）。在术后 1 周、1 个月和 3 个月时，250-270μm 组的 DA 显著高于 290-310μm 组（P 值分别为 0.001、0.01、0.02）。在术后期间，三组间角膜后表面隆起和生物力学参数值的变化没有显著差异（P 值均>0.05）。
SMILE 术后 250-310μm 的 RBT 在早期是安全且稳定的。RBT 可能与角膜后表面隆起呈正相关。
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