Mishra Sanjay Kumar, Singh Mrinalini, Joshi Amrita, Shukla Sarvadarshi, Sati Alok, Pannu Anju, Kumar Sonali V, Kaushik Jaya
Department of Ophthalmology, Army Hospital (Research and Referral), New Delhi, India.
Department of Hospital Administration, AMC Centre and College, Lucknow, Uttar Pradesh, India.
Indian J Ophthalmol. 2025 Jul 1;73(7):1016-1020. doi: 10.4103/IJO.IJO_1454_24. Epub 2025 Apr 17.
The purpose is to compare the outcomes between microkeratome-assisted superficial anterior lamellar keratoplasty (MK-SALK) and femtosecond laser-assisted superficial anterior lamellar keratoplasty (FL-SALK) for superficial corneal opacities.
Seventy-five eyes with superficial corneal opacities were prospectively randomized into the MK-SALK control arm and an FL-SALK study arm. Follow-up examinations were set at day 1, day 7, day 30, and at the third and sixth month after the surgery. The primary outcome measure was best-corrected visual acuity (BCVA), whereas secondary outcome measures were contrast sensitivity, corneal aberrations, K-readings, corneal thickness, and complications after the surgery.
Seventy-two eyes completed the six-month follow-up interval. An insignificant difference in BCVA was observed at day 30 [control arm ( n = 36); 0.80 ± 0.27 logarithm of the minimum angle of resolution (log MAR), study arm ( n = 36); 0.78 ± 0.12 log MAR, P = 0.63], at third month [control arm; 0.65 ± 0.28 log MAR, study arm; 0.66 ± 0.10 log MAR, P = 0.93], and sixth month [control arm; 0.61 ± 0.28 log MAR, study arm; 0.62 ± 0.10 log MAR, P = 0.84] following surgery. In addition, an insignificant difference was observed between the two groups in terms of contrast sensitivity, corneal aberration, mean keratometric value, mean central corneal thickness, and complications following surgery.
MK-SALK is non-inferior to FL-SALK for the treatment of superficial corneal opacities. By demonstrating comparable outcomes, our study alleviates apprehension and doubts about choosing between the techniques and allows the surgeon to make a choice based on his expertise and resources.
比较微型角膜刀辅助的表层前板层角膜移植术（MK-SALK）和飞秒激光辅助的表层前板层角膜移植术（FL-SALK）治疗浅层角膜混浊的效果。
将75例浅层角膜混浊患者的眼睛前瞻性随机分为MK-SALK对照组和FL-SALK研究组。术后第1天、第7天、第30天以及术后第3个月和第6个月进行随访检查。主要观察指标为最佳矫正视力（BCVA），次要观察指标为对比敏感度、角膜像差、角膜曲率读数、角膜厚度和术后并发症。
72只眼睛完成了6个月的随访期。术后第30天[对照组（n = 36）；最小分辨角对数（log MAR）为0.80±0.27，研究组（n = 36）；log MAR为0.78±0.12，P = 0.63]、第3个月[对照组；log MAR为0.65±0.28，研究组；log MAR为0.66±0.10，P = 0.93]和第6个月[对照组；log MAR为0.61±0.28，研究组；log MAR为0.62±0.10，P = 0.84]时，BCVA无显著差异。此外，两组在对比敏感度、角膜像差、平均角膜曲率值、平均中央角膜厚度和术后并发症方面也无显著差异。
对于治疗浅层角膜混浊，MK-SALK不劣于FL-SALK。通过显示可比的结果，我们的研究减轻了在这两种技术之间做出选择的担忧和疑虑，并允许外科医生根据其专业知识和资源做出选择。
