Huang Yanming, Zhao Yuancheng, Chen Xiaofan, Zou Huan, Yuan Rongdi
Xinqiao Hospital, Army Medical University, 183th, Xinqiao Street, Shapingba District, Chongqing, China.
General Hospital of Western Theater Command, Chengdu, China.
Sci Rep. 2025 Jan 15;15(1):2045. doi: 10.1038/s41598-025-85740-6.
The purpose of this study was to evaluate the stability of small-incision lenticule extraction (SMILE) and laser in situ keratomileusis (LASIK) when ascending from near sea level to an altitude of 3874 m. The visual acuity (VA), intraocular pressure (IOP), spherical equivalent refraction (SER) and biometric parameters of 20 normal subjects (40 eyes, controls) and 36 subjects who underwent corneal refractive surgery (35 eyes with SMILE and 36 eyes with LASIK) were examined in Chongqing (C, 500 m above sea level) and 7-10 days after a collective travel to Shigatse (S, 3874 m above sea level). SER and corneal thickness (CT) were choosed as main indicators of the stability of corneal refractive surgery at high altitude. The IOP decreased and CT increased from C to S, while VA and SER did not significantly change in the control subjects. The VA and IOP of both the SMILE and LASIK subjects did not significantly change at an altitude of 3874 m. At high altitudes, no significant difference in the SER was found among the SMILE subjects, while a significant myopic shift was found among the LASIK subjects. With an increase in the altitude of 3874 m in S, an obvious increase in CT was observed in subjects who underwent corneal refraction surgery. The increase in CT in the SMILE group was significantly less than the increase in CT in the LASIK group. In addition, the biometric parameters of the SMILE and LASIK subjects showed the same minor changes as those of the control subjects when exposed to high altitude. The VA, IOP and biometric parameters of the subjects who underwent SMILE and LASIK remained stable at an altitude of 3874 m. SMILE shows better stability than LASIK in the refractive state and CT when exposed to high altitude.Trial registration: This study was approved by the Ethics Committee of The Second Affiliated Hospital of Army Medical University (ID: 2022-No.084-1) and adhered to the principles of the Declaration of Helsinki. The study was registered at http://www.chictr.org.cn (Study NO. ChiCTR2200059833) on 12/5/2022.
本研究的目的是评估小切口飞秒透镜切除术（SMILE）和准分子原位角膜磨镶术（LASIK）从近海平面上升至海拔3874米时的稳定性。对20名正常受试者（40只眼，对照组）以及36名接受角膜屈光手术的受试者（35只眼行SMILE，36只眼行LASIK）的视力（VA）、眼压（IOP）、等效球镜度（SER）和生物测量参数在重庆（C，海拔500米）以及集体前往日喀则（S，海拔3874米）7 - 10天后进行了检查。选择SER和角膜厚度（CT）作为高海拔地区角膜屈光手术稳定性的主要指标。从C到S，对照组的IOP降低而CT增加，而VA和SER没有显著变化。在海拔3874米时，SMILE组和LASIK组受试者的VA和IOP均无显著变化。在高海拔地区，SMILE组受试者的SER无显著差异，而LASIK组受试者出现了显著的近视性偏移。随着海拔升至S的3874米，接受角膜屈光手术的受试者CT明显增加。SMILE组CT的增加显著小于LASIK组CT的增加。此外，SMILE组和LASIK组受试者的生物测量参数在暴露于高海拔时与对照组受试者表现出相同的微小变化。接受SMILE和LASIK手术的受试者在海拔3874米时，其VA、IOP和生物测量参数保持稳定。在暴露于高海拔时，SMILE在屈光状态和CT方面比LASIK表现出更好的稳定性。试验注册：本研究经陆军军医大学第二附属医院伦理委员会批准（编号：2022 - No.084 - 1），并遵循赫尔辛基宣言的原则。该研究于2022年5月12日在http://www.chictr.org.cn注册（研究编号：ChiCTR2200059833）。
