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飞秒激光制瓣准分子原位角膜磨镶术和经上皮准分子角膜切削术后角膜上皮重塑对角膜非球面性的影响:一项前瞻性研究。

Effects of corneal epithelial remodeling on corneal asphericity after FS-LASIK and Trans-PRK: A prospective study.

作者信息

Xu Mingyu, Yang Fan, Pazo Emmanuel Eric, Li Qiwei, Yang Zheng, Huang Yue, Zhao Shaozhen

机构信息

Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin, China.

Tianjin Branch of National Clinical Research Center for Ocular Disease, Tianjin, China.

出版信息

Indian J Ophthalmol. 2025 Jan 1;73(1):134-140. doi: 10.4103/IJO.IJO_623_24. Epub 2024 Oct 25.

Abstract

PURPOSE

To observe the changes in corneal epithelial thickness after FS-LASIK and Trans-PRK surgery and to investigate the impact of corneal epithelial remodeling on Q-value and HOA.

METHODS

In this prospective cohort study, 50 patients (100 eyes) underwent FS-LASIK and 45 patients (90 eyes) underwent Trans-PRK. Anterior segment OCT was used to measure the corneal epithelial thickness in different corneal zones (central zone: 0-2 mm; paracentral zone: 2-5 mm; and mid-peripheral zone: 5-6 mm) preoperatively and postoperatively at 1 week, 1 month, 3 months, and 6 months. The correlation between △CET in the superior, nasal, inferior, and temporal region at 6 months postoperatively and △Q and △HOA was analyzed.

RESULTS

At 6 months postoperatively, the epithelial thickness increased in the central, paracentral, and mid-peripheral zones in FS-LASIK and Trans-PRK. Central epithelial thickness and different regions of the paracentral zone and mid-peripheral exhibited significant thickening ( P < 0.001). In the para-central zone and mid-peripheral zone, the △CET in different regions after LASIK and Trans-PRK was positively correlated with △Q ( P < 0.05) and △HOA ( P < 0.05).

CONCLUSION

After FS-LASIK and Trans-PRK, significant epithelial thickening was observed. Epithelial changes in different regions lead to different Q-values in different regions and have different effects on HOA. This has a certain guiding significance for the design of refractive surgery, and minimizing the increase of Q-value may improve the postoperative visual quality.

摘要

目的

观察飞秒激光制瓣准分子原位角膜磨镶术(FS-LASIK)和经上皮准分子激光角膜切削术(Trans-PRK)术后角膜上皮厚度的变化,并探讨角膜上皮重塑对Q值和高阶像差(HOA)的影响。

方法

在这项前瞻性队列研究中,50例患者(100只眼)接受了FS-LASIK手术,45例患者(90只眼)接受了Trans-PRK手术。使用眼前节光学相干断层扫描(OCT)在术前以及术后1周、1个月、3个月和6个月测量不同角膜区域(中央区:0-2mm;旁中央区:2-5mm;中周边区:5-6mm)的角膜上皮厚度。分析术后6个月时上方、鼻侧、下方和颞侧区域的角膜上皮厚度变化量(△CET)与△Q和△HOA之间的相关性。

结果

术后6个月时,FS-LASIK和Trans-PRK手术的中央、旁中央和中周边区的上皮厚度均增加。中央上皮厚度以及旁中央区和中周边区的不同区域均出现显著增厚(P<0.001)。在旁中央区和中周边区,LASIK和Trans-PRK术后不同区域的△CET与△Q(P<0.05)和△HOA(P<0.05)呈正相关。

结论

FS-LASIK和Trans-PRK术后观察到明显的上皮增厚。不同区域的上皮变化导致不同区域产生不同的Q值,并对HOA产生不同影响。这对屈光手术的设计具有一定的指导意义,尽量减少Q值的增加可能会改善术后视觉质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/83d8/11831929/ec26d6e15f75/IJO-73-134-g001.jpg

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