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远视性小切口基质透镜切除术(SMILE)后角膜扩张的同种异体角膜透镜移植的长期效果

Long-term results of allogenic corneal lenticule of hyperopic SMILE for post-LASIK ectasia.

作者信息

Li Meiyan, Wei Ruoyan, Qin Bing, Chang John S M, Zhou Xingtao

机构信息

Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.

NHC Key Laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, China.

出版信息

iScience. 2024 Aug 8;27(9):110689. doi: 10.1016/j.isci.2024.110689. eCollection 2024 Sep 20.

Abstract

Post-laser-assisted keratomileusis (LASIK) corneal ectasia is a severe complication of corneal refractive surgery, and cryopreserved lenticules from hyperopic small incision lenticule extraction (SMILE) may offer a promising treatment though their long-term safety and efficacy are still under investigation. In this prospective case series, six eyes from six patients with post-LASIK ectasia received lenticules (mean cryopreserved time: 63 days). The procedure involved lifting the corneal flap, implanting the lenticule, and repositioning the flap. Over a follow-up period of at least one year, uncorrected distance visual acuity (UDVA) improved from 1.52 ± 0.40 preoperatively to 0.74 ± 0.28 LogMAR. Two eyes gained one line of corrected distance visual acuity (CDVA), three gained two lines, and one gained over three lines. Spherical equivalents decreased from -14.67 ± 2.36 D to -8.75 ± 4.03 D ( = 0.02). Mean anterior K and total corneal refractive power decreased ( < 0.05). Thinnest corneal thickness increased from 359.2 ± 39.3 μm to 401.7 ± 53.4 μm ( = 0.02). These findings support the potential of cryopreserved lenticules for treating post-LASIK ectasia, though further refinement in refractive predictability is needed.

摘要

准分子激光原位角膜磨镶术(LASIK)后角膜扩张是角膜屈光手术的一种严重并发症,尽管超高度近视小切口基质透镜切除术(SMILE)中冷冻保存的透镜的长期安全性和有效性仍在研究中,但它可能提供一种有前景的治疗方法。在这个前瞻性病例系列中,6例LASIK术后角膜扩张患者的6只眼睛接受了透镜植入(平均冷冻保存时间:63天)。手术包括掀起角膜瓣、植入透镜和重新放置角膜瓣。在至少一年的随访期内,未矫正远视力(UDVA)从术前的1.52±0.40提高到0.74±0.28 LogMAR。2只眼睛矫正远视力(CDVA)提高了1行,3只眼睛提高了2行,1只眼睛提高了3行以上。等效球镜度从-14.67±2.36 D降至-8.75±4.03 D(P=0.02)。平均角膜前表面曲率和总角膜屈光力下降(P<0.05)。最薄角膜厚度从359.2±39.3μm增加到401.7±53.4μm(P=0.02)。这些发现支持了冷冻保存的透镜治疗LASIK术后角膜扩张的潜力,尽管屈光预测性还需要进一步改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3146/11399612/35ef0017f554/fx1.jpg

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