Shao Y H, Li M, Wang W, Shi Y H, Sun L N, Qian Y Y, Zou J
School of Medicine, Tongji University, Department of Ophthalmology, Tenth People's Hospital Affiliated to Tonji University, Shanghai 200072, China.
Zhonghua Yan Ke Za Zhi. 2025 Feb 14;61(2):104-111. doi: 10.3760/cma.j.cn112142-20240401-00155.
To explore the correlation between the nerve growth factor (NGF) in the corneal stroma and the corneal optical quality in high myopia patients wearing soft contact lenses (SCLs) for a long time before small incision lenticule extraction (SMILE). A retrospective cohort study was conducted. Sixty high myopia patients (120 eyes) who underwent SMILE in Shanghai Tenth People's Hospital from December 2020 to October 2022 were included, with an age of (30.75±4.37) years, including 26 males and 34 females. According to the duration of wearing SCLs before surgery, they were divided into three groups: group A (wearing time>10 years), group B (wearing time≤10 years), and group C (without wearing lenses). General examinations were carried out to collect medical histories and parameters, such as uncorrected visual acuity, intraocular pressure, and axial length of the eye. The Pentacam corneal topography system was used to measure corneal higher-order aberrations, including total higher-order aberrations and various coma aberrations, and to obtain the optical density of different parts and layers of the cornea. A part of the corneal stromal lenticule was used for immunofluorescence detection, and another part was used to detect the NGF level. The expression level of NGF in the corneal stromal lenticules showed an upward trend with the prolongation of the wearing time of SCLs (<0.05). The total higher-order aberration in group A was (0.39±0.10) μm, and the horizontal coma aberration was (0.17±0.12) μm, both higher than those in group C [(0.33±0.07) μm and (0.09±0.08) μm]. The full-thickness optical density of the central 6-mm annular region of the cornea in group A (13.64±2.08) and that of the central 2-mm circular region of the cornea in group B (13.58±1.28) were both higher than that in group C (12.74±0.85) (all 0.05). The NGF level in the corneal stromal lenticules in group A was positively correlated with the optical density of the anterior layer and the full-thickness layer within the central 6-mm circular region of the cornea (both 0.05). In group B, the NGF level in the corneal stromal lenticules was positively correlated with the optical density of the middle layer and the posterior layer within the central 6-mm circular region of the cornea, and also positively correlated with the optical density of the middle layer and the posterior layer of the 2-mm circular region (all 0.05). The NGF level in the corneal stromal lenticules in group C was also positively correlated with the optical density of the middle layer and the posterior layer of the 0-to 6-mm annular region of the cornea (all 0.05). In high myopia patients who have worn SCLs for a long time, the expression of NGF in the corneal stromal lenticules increases, the corneal optical quality decreases, and the NGF level is closely related to the corneal optical density.
探讨高度近视患者在小切口透镜切除术（SMILE）前长期佩戴软性角膜接触镜（SCL）时角膜基质中神经生长因子（NGF）与角膜光学质量的相关性。进行了一项回顾性队列研究。纳入2020年12月至2022年10月在上海第十人民医院接受SMILE的60例高度近视患者（120只眼），年龄为（30.75±4.37）岁，其中男性26例，女性34例。根据术前佩戴SCL的时间，将其分为三组：A组（佩戴时间>10年）、B组（佩戴时间≤10年）和C组（未佩戴镜片）。进行全身检查以收集病史和参数，如未矫正视力、眼压和眼轴长度。使用Pentacam角膜地形图系统测量角膜高阶像差，包括总高阶像差和各种彗差，并获取角膜不同部位和层面的光密度。取部分角膜基质透镜进行免疫荧光检测，另一部分检测NGF水平。角膜基质透镜中NGF的表达水平随SCL佩戴时间的延长呈上升趋势（<0.05）。A组的总高阶像差为（0.39±0.10）μm，水平彗差为（0.17±0.12）μm，均高于C组[（0.33±0.07）μm和（0.09±0.08）μm]。A组角膜中央6mm环形区域的全层光密度（13.64±2.08）和B组角膜中央2mm圆形区域的全层光密度（13.58±1.28）均高于C组（12.74±0.85）（均P<0.05）。A组角膜基质透镜中NGF水平与角膜中央6mm圆形区域前层和全层的光密度呈正相关（均P<0.05）。在B组中，角膜基质透镜中NGF水平与角膜中央6mm圆形区域中层和后层的光密度呈正相关，也与2mm圆形区域中层和后层的光密度呈正相关（均P<0.05）。C组角膜基质透镜中NGF水平也与角膜0至6mm环形区域中层和后层的光密度呈正相关（均P<0.05）。在长期佩戴SCL的高度近视患者中，角膜基质透镜中NGF的表达增加，角膜光学质量下降，且NGF水平与角膜光密度密切相关。
