FS-LASIK与FS-LASIK Xtra矫正近视术后角膜上皮重塑状态及角膜像差变化比较  

Comparison of corneal epithelial remodeling and corneal aberration changes after FS-LASIK and FS-LASIK Xtra

作　　者：李辰 周跃华 李福生 陶冶 盖珊珊 于嘉 于黎黎 Li Chen;Zhou Yuehua;Li Fusheng;Tao Ye;Ge Shanshan;Yu Jia;Yu Lili(The Academy of Ophthalmology,Chengdu University of Traditional Chinese Medicine,Yinhai Eye Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu 610075,China;Beijing Ming Vision and Ophthalmology,Beijing 100062,China)

机构地区：[1]成都中医药大学眼科学院,成都中医大银海眼科医院,成都610075 [2]北京茗视光眼科,北京100062

出　　处：《中华实验眼科杂志》2023年第8期782-794,共13页Chinese Journal Of Experimental Ophthalmology

摘　　要：目的探讨飞秒激光辅助准分子激光角膜原位磨镶术(FS-LASIK)与FS-LASIK联合角膜胶原交联(FS-LASIK Xtra)术后角膜上皮重塑状态和角膜像差,分析角膜上皮厚度(CET)与角膜像差的关系。方法采用队列研究方法,纳入2021年6月至2022年2月于成都中医大银海眼科医院接受FS-LASIK的近视患者172例172眼,按手术方式不同分为FS-LASIK组94眼和FS-LASIK Xtra组78眼,共随访6个月。以角膜中央为基点将角膜分为中央2 mm环区和2~5 mm环区,分别于术前及术后1、3和6个月采用眼前节光学相干断层扫描测量角膜中央0~5 mm范围内9个区域的CET,采用iTrace视觉功能分析系统测量角膜高阶像差(HOA),研究主要结局为术后6个月CET增加量(ΔCET)及角膜HOA,分析角膜中央ΔCET与角膜像差的关系。结果FS-LASIK Xtra组术眼术后1、3和6个月角膜中央、上方、鼻上、鼻侧、鼻下、下方、颞下、颞侧、颞上ΔCET均明显低于FS-LASIK组,差异均有统计学意义(均P<0.05)。FS-LASIK Xtra组术眼术后6个月角膜中央、上方、鼻上、下方、颞下ΔCET明显高于术后1个月,术后3个月和6个月颞侧ΔCET均明显高于术后1个月,术后6个月颞上ΔCET均明显高于术后1个月和3个月,差异均有统计学意义(均P<0.05)。FS-LASIK组术眼术后3个月和6个月角膜中央、上方、下方、颞下ΔCET均明显高于术后1个月,术后6个月鼻上ΔCET明显高于术后3个月,术后6个月鼻侧、鼻下、颞侧、颞上ΔCET均明显高于术后1个月和3个月,差异均有统计学意义(均P<0.05)。FS-LASIK Xtra组和FS-LASIK组术眼术后不同时间点垂直三叶草、垂直彗差、水平彗差变化量总体比较差异均无统计学意义(垂直三叶草:χ^(2)_(分组)=4.27,P=0.118;χ^(2)_(时间)=0.01,P>0.05.垂直彗差:χ^(2)_(分组)=5.74,P=0.057;χ^(2)_(时间)=0.08,P=0.957.水平彗差:χ^(2)_(分组)=3.97,P=0.137;χ^(2)_(时间)=0.51,P=0.773)。FS-LASIK Xtra组术眼术后1、3和6个月倾斜三叶草变�Objective To investigate the status of corneal epithelial remodeling and changes in corneal aberration after femtosecond laser-assisted laser in situ keratomileusis(FS-LASIK)and FS-LASIK combined with corneal collagen cross-linking(FS-LASIK Xtra),and to analyze the relationship between corneal epithelial thickness(CET)and corneal aberration.Methods A cohort study was conducted.A total of 172 patients(172 eyes)who underwent FS-LASIK at Yinhai Eye Hospital of Chengdu University of Traditional Chinese Medicine were enrolled from June 2021 to February 2022.The 172 eyes were divided into FS-LASIK group(94 eyes)and FS-LASIK Xtra group(78 eyes)according to the surgical procedure,with a total follow-up of 6 months.The cornea was divided into a central 2-mm ring and a ring of 2-5 mm centered on the central cornea.CET at 9 regions in the central 0-5 mm area was measured by OCT before and at 1,3 and 6 months after surgery,and the corneal higher-order aberration(HOA)was measured by the iTrace visual function analyzer.The main outcomes were the increase in CET(ΔCET),and corneal HOA at 6 months after surgery.The relationship between central cornealΔCET and corneal aberration was analyzed.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Yinhai Eye Hospital of Chengdu University of Traditional Chinese Medicine(No.2021yh-009).Written informed consent was obtained from each subject.Results At 1,3 and 6 months after surgery,the central,superior,superior nasal,nasal,inferior nasal,inferior,inferior temporal,temporal and superior temporalΔCET were significantly smaller in FS-LASIK Xtra group than in FS-LASIK group(all at P<0.05).In FS-LASIK Xtra group,6-month postoperative central,superior,superior nasal,inferior and inferior temporalΔCET were significantly larger than those at 1 month after surgery,and 3-and 6-month postoperative temporalΔCET were significantly larger than that at 1 month after surgery,and 6-month postoperative superior temporalΔCET was significantly

关 键 词：近视 角膜激光手术 角膜波前像差 飞秒激光 角膜胶原交联 光学相干断层扫描 角膜上皮重塑 

分 类 号：R779.6[医药卫生—眼科]