Lee Chia-Yi, Yang Shun-Fa, Chen Hung-Chi, Lian Ie-Bin, Huang Chin-Te, Huang Jing-Yang, Chang Chao-Kai
Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan.
Nobel Eye Institute, Taipei 10041, Taiwan.
Diagnostics (Basel). 2024 Aug 12;14(16):1752. doi: 10.3390/diagnostics14161752.
In this study, we aim to evaluate the risk factors of myopia undercorrection in recipients of second-generation keratorefractive lenticule extraction (KLEx) surgery. A retrospective case-control study was performed, and patients who received second-generation KLEx surgery were enrolled. The cases with myopia undercorrection were matched to non-myopia undercorrection cases with a 1:4 ratio according to age, and a total of 22 and 88 eyes were categorized into the undercorrection and control groups, respectively. Demographic, refractive, topographic, and surgical data were collected preoperatively. A generalized linear model was operated to evaluate the potential risk factors for myopia undercorrection. The uncorrected distance visual acuity (UDVA) at three months postoperation was significantly better in the control group ( = 0.006), and residual myopia and SE were significantly higher in the undercorrection group during the whole follow-up period (all < 0.001). The UDVA value showed a trend of improvement in the control group ( < 0.001), and the changes to SE and residual myopia were significantly lower in the control group (both < 0.001). Regarding the risk factors for myopia undercorrection in the whole population and the high-myopia population, a higher manifest sphere power, higher steep keratometry (K), higher topographic cylinder, lower central corneal thickness (CCT) at apex, higher CCT difference and lower residual stromal thickness (RST) correlated to myopia undercorrection (all < 0.05). In the low-myopia population, only higher myopia and lower RST correlated to myopia undercorrection (both < 0.05). In conclusion, a high-sphere power and irregular topographic pattern correlated to myopia undercorrection after the second KLEx surgery, especially for individuals with high myopia.
在本研究中，我们旨在评估接受第二代角膜屈光透镜切除术（KLEx）的患者近视欠矫的危险因素。进行了一项回顾性病例对照研究，纳入接受第二代KLEx手术的患者。近视欠矫病例与非近视欠矫病例按年龄以1:4的比例匹配，分别有22只眼和88只眼被归入欠矫组和对照组。术前收集人口统计学、屈光、地形图和手术数据。采用广义线性模型评估近视欠矫的潜在危险因素。术后三个月时，对照组的未矫正远视力（UDVA）显著更好（=0.006），在整个随访期间，欠矫组的残余近视和球镜等效度（SE）显著更高（均<0.001）。对照组的UDVA值呈改善趋势（<0.001），对照组SE和残余近视的变化显著更小（均<0.001）。对于整个人群和高度近视人群中近视欠矫的危险因素，更高的显形球镜度、更高的陡峭角膜曲率（K）、更高的地形图柱镜度、顶点处更低的中央角膜厚度（CCT）、更高的CCT差值和更低的残余基质厚度（RST）与近视欠矫相关（均<0.05）。在低度近视人群中，只有更高的近视度数和更低的RST与近视欠矫相关（均<0.05）。总之，高球镜度和不规则的地形图模式与第二次KLEx手术后的近视欠矫相关，尤其是对于高度近视个体。
