Mei Bo, Li Yu, Zhao Dian, Su Dan, Zhou Chun-Yang, Zhou Yue-Hua
Eye School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, 510100, China.
Ineye Hospital of Chengdu University of TCM, Chengdu, Sichuan Province, China.
BMC Ophthalmol. 2025 Aug 19;25(1):478. doi: 10.1186/s12886-025-04313-3.
Given improved survival, HIV + patients are now more likely to pursue common elective procedures, such as refractive surgery. We sought to assess the safety, efficacy, predictability, and stability of lamellar keratomileusis in patients with HIV.
A study was conducted with 14 patients (28 eyes) HIV-positive patients at Ineye Hospital of Chengdu University of Traditional Chinese Medicine, who underwent lamellar keratomileusis. They were observed for at least one year. 8 patients (16 eyes) had femtosecond laser-assisted in situ keratomileusis (FS-LASIK) and 6 patients (12 eyes) received small incision lenticule extraction (SMILE). Measurements taken before and after surgery included uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), refraction, spherical equivalent (SE), intraocular pressure, and any complications.
At one year postoperatively, all groups showed significant UDVA improvement ( < 0.001): overall from 1.36 ± 0.18 LogMAR to -0.07 ± 0.07 LogMAR, SMILE from 1.37 ± 0.18 LogMAR to -0.09 ± 0.07 LogMAR, and FS-LASIK from 1.35 ± 0.19 LogMAR to -0.11 ± 0.06 LogMAR, with all patients achieving a UDVA of 20/20 or better. Only 2 eyes (7.14%, both SMILE cases) experienced a 1-line decrease in CDVA. The mean SE improved from − 6.42 ± 1.46 D preoperatively to -0.06 ± 0.04D; with procedure-specific improvements observed: SMILE eyes improved from − 6.00 ± 0.92 D to -0.01 ± 0.26 D, while FS-LASIK eyes improved from − 6.74 ± 1.72 D to -0.09 ± 0.49 D, postoperatively (all < 0.001). Refractive predictability outcomes revealed 89.29% of eyes within ± 0.50 D (SMILE 100% vs. FS-LASIK 87.50%), 96.43% within ± 1.00 D (SMILE 100% vs. FS-LASIK 93.75%), and 96.00% with astigmatism ≤ 0.50 D (SMILE 100% vs. FS-LASIK 93.75%). During the follow-up, dry eye syndrome occurred in 4 of 14 patients (28.57%, 2 SMILE and 2 FS-LASIK cases), but there were no serious complications, and no healthcare staff contracted HIV.
Laser lamellar corneal refractive surgery in HIV-positive patients demonstrated promising clinical outcomes. It was found to be safe for both healthcare professionals and patients.
鉴于生存率的提高，HIV阳性患者现在更有可能接受常见的择期手术，如屈光手术。我们试图评估HIV患者中板层角膜磨镶术的安全性、有效性、可预测性和稳定性。
在成都中医药大学附属银海眼科医院对14例（28只眼）HIV阳性患者进行了一项研究，这些患者接受了板层角膜磨镶术。对他们进行了至少一年的观察。8例（16只眼）患者接受了飞秒激光原位角膜磨镶术（FS-LASIK），6例（12只眼）患者接受了小切口基质透镜切除术（SMILE）。手术前后的测量指标包括未矫正远视力（UDVA）、矫正远视力（CDVA）、屈光不正、等效球镜度（SE）、眼压以及任何并发症。
术后一年，所有组的UDVA均有显著改善（<0.001）：总体上从1.36±0.18 LogMAR提高到-0.07±0.07 LogMAR，SMILE组从1.37±0.18 LogMAR提高到-0.09±0.07 LogMAR，FS-LASIK组从1.35±0.19 LogMAR提高到-0.11±0.06 LogMAR，所有患者的UDVA均达到20/20或更好。只有2只眼（7.14%，均为SMILE病例）的CDVA下降了1行。平均SE从术前的-6.42±1.46 D改善到-0.06±0.04 D；观察到特定手术的改善情况：SMILE组的眼睛从-6.00±0.92 D改善到-0.01±,0.26 D，而FS-LASIK组的眼睛从-6.74±1.72 D改善到-0.09±0.49 D，术后（均 <0.001）。屈光预测性结果显示，89.29%的眼睛在±0.50 D范围内（SMILE组为100%，FS-LASIK组为87.50%），96.43%在±1.00 D范围内（SMILE组为100%，FS-LASIK组为9,3.75%），96.00%的散光≤0.50 D（SMILE组为100%，FS-LASIK组为93.75%）。在随访期间，14例患者中有4例（28.57%，2例SMILE和2例FS-LASIK病例）出现了干眼综合征，但没有严重并发症，也没有医护人员感染HIV。
HIV阳性患者的激光板层角膜屈光手术显示出有前景的临床结果。发现该手术对医护人员和患者都是安全的。
