Zarei-Ghanavati Siamak, Sadeghi Javad, Hassanzadeh Samira, Shayan Far Mahdieh, Heravian Shandiz Javad, Jamali Jamshid, Abbasi Mehrabadi Ali, Irandoost Niloofar, Aryanmanesh Sina, Gharouni Ahmad, Varshovi-Jaghargh Iman
Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Optometry, School of Paramedical and Rehabilitation Sciences, Mashhad University of Medical Sciences, Azadi Avenue, Mashhad, Iran.
Int Ophthalmol. 2025 Jun 20;45(1):251. doi: 10.1007/s10792-025-03626-y.
To compare dry eye disease (DED) following PRK and T-PRK surgeries using a combined approach of subjective and objective measures, focusing on clinically meaningful outcomes and adjusted statistical modeling.
In this prospective observational study, 89 eyes of patients aged over 20 years were enrolled and grouped into PRK (43 eyes) and T-PRK (46 eyes). The primary outcome was change in ocular surface diseases index (OSDI) score at 6 months. Secondary outcomes included non-invasive tear breakup time (NITBUT) and meibomian gland expressibility. Exploratory parameters such as tear meniscus height (TMH), redness score, strip meniscometry (SM Tube), meibomian gland dropout, and meibum quality were also assessed. Statistical models were adjusted for baseline age differences, and corrections for multiple comparisons were applied.
The mean age of the patients was 34.16 ± 7.23 in the PRK and 28.72 ± 6.26 in the T-PRK group (P < 0.001). The two groups were not significantly different for gender (P = 0.367). After statistical adjustment, only the change in OSDI and NITBUT at 1-month remained significant between groups (adjusted P = 0.038 and P < 0.05, respectively). Effect sizes were small to moderate, and none of the differences exceeded minimal clinically important thresholds. Exploratory analyses revealed no significant between-groups differences. Age was identified as an independent predictor of OSDI change.
In short-term follow-up, both procedures induced some degree of DED. However, T-PRK was associated with slightly fewer signs and symptoms of dry eye disease, but the differences were not clinically significant.
采用主观和客观测量相结合的方法，比较准分子原位角膜磨镶术（PRK）和经上皮准分子原位角膜磨镶术（T-PRK）术后的干眼疾病（DED）情况，重点关注具有临床意义的结果和调整后的统计模型。
在这项前瞻性观察研究中，纳入了89例年龄超过20岁患者的眼睛，并分为PRK组（43只眼）和T-PRK组（46只眼）。主要结局是6个月时眼表疾病指数（OSDI）评分的变化。次要结局包括非侵入性泪膜破裂时间（NITBUT）和睑板腺可挤压性。还评估了诸如泪河高度（TMH）、眼红评分、泪河测量条（SM管）、睑板腺缺失和睑脂质量等探索性参数。对统计模型进行了基线年龄差异调整，并应用了多重比较校正。
PRK组患者的平均年龄为34.16±7.23岁，T-PRK组为28.72±6.26岁（P<0.001）。两组性别差异无统计学意义（P=0.367）。经过统计调整后，仅1个月时OSDI和NITBUT的变化在组间仍具有显著性（调整后P分别为0.038和P<0.05）。效应大小为小到中度，且所有差异均未超过最小临床重要阈值。探索性分析显示组间无显著差异。年龄被确定为OSDI变化的独立预测因素。
在短期随访中，两种手术均会引起一定程度的干眼疾病。然而，T-PRK相关的干眼疾病体征和症状略少，但差异无临床意义。
