Yu Junjie, Zhou Hao, Chen Minjie, Yu Zhiqiang, Zhou Xingtao, Qian Yishan
Department of Ophthalmology, Eye and ENT Hospital, NHC Key Laboratory of Myopia (Fudan University), Fudan University, 83 Fenyang Rd, Shanghai, 200031, People's Republic of China.
Eye Vis (Lond). 2025 May 28;12(1):21. doi: 10.1186/s40662-025-00437-1.
Transepithelial photorefractive keratectomy (transPRK) can be safely and predictably performed to correct low-to-high astigmatism. This study explored the effects of fixation stability, corneal density (CD), ocular residual astigmatism (ORA), and the surgically-induced change in the epithelial thickness (ΔET) on the efficacy of astigmatism correction by transPRK.
Eighty-three consecutive patients who underwent transPRK to correct myopia and myopic astigmatism were divided into two groups according to refractive astigmatism [high refractive astigmatism (RA) group: ≥ 2.0 D, n = 31; low RA group: < 2.0 D, n = 52]. Fixation stability was evaluated by measuring the lateral movement of the pupil center on the eye tracker images. The CD was measured using a Pentacam Scheimpflug imaging system, epithelial thickness mapping was performed using optical coherence tomography, and the ORA was determined using vector analysis. Multiple linear regression analyses were performed to identify factors associated with the correction index (CI) and angle of error (AOE).
At 6 months postoperatively, the RA was higher in the high RA group (- 0.66 ± 0.44 D) than in the low RA group (- 0.29 ± 0.29 D, P < 0.001), whereas no significant differences were found in CI or AOE between two groups. Multiple linear regression analyses showed that for the low RA group, preoperative anterior CD of the central 2 mm (CD, β = - 0.482, P = 0.011) and ΔET (β = 0.295, P = 0.041), were associated with CI, whereas the vector length of the pupil center shift (PCVL, β = - 0.404, P = 0.005) and ΔET (β = - 0.293, P = 0.036) were associated with AOE. For the high RA group, ΔET (β = 0.519, P = 0.038) was associated with CI, whereas static cyclotorsion (β = - 0.493, P = 0.040) was associated with AOE. No significant associations were found between ORA and CI or AOE.
Postoperative changes in epithelial thickness were associated with the efficacy of transPRK in both the low and high RA groups, whereas the pupil center shift and anterior CD were associated with the efficacy of transPRK in the low RA group.
经上皮光屈光性角膜切削术（transPRK）可安全、可预测地用于矫正低至高度散光。本研究探讨了注视稳定性、角膜密度（CD）、眼残余散光（ORA）以及手术引起的上皮厚度变化（ΔET）对transPRK矫正散光疗效的影响。
83例连续接受transPRK矫正近视和近视性散光的患者，根据屈光性散光分为两组[高度屈光性散光（RA）组：≥2.0 D，n = 31；低度RA组：<2.0 D，n = 52]。通过测量眼动仪图像上瞳孔中心的横向移动来评估注视稳定性。使用Pentacam Scheimpflug成像系统测量CD，使用光学相干断层扫描进行上皮厚度测绘，并使用矢量分析确定ORA。进行多元线性回归分析以确定与矫正指数（CI）和误差角（AOE）相关的因素。
术后6个月，高度RA组的RA（-0.66±0.44 D）高于低度RA组（-0.29±0.29 D，P < 0.001），而两组之间的CI或AOE无显著差异。多元线性回归分析显示，对于低度RA组，中央2 mm的术前前表面CD（CD，β = -0.482，P = 0.011）和ΔET（β = 0.295，P = 0.041）与CI相关，而瞳孔中心移位的矢量长度（PCVL，β = -0.404，P = 0.005）和ΔET（β = -0.293，P = 0.036）与AOE相关。对于高度RA组，ΔET（β = 0.519，P = 0.038）与CI相关，而静态旋转斜视（β = -0.493，P = 0.040）与AOE相关。ORA与CI或AOE之间未发现显著相关性。
上皮厚度的术后变化与低度和高度RA组中transPRK的疗效相关，而瞳孔中心移位和前表面CD与低度RA组中transPRK的疗效相关。
