SPT辅助的TPRK术后角膜上皮厚度和光密度的变化及两者的相关性  

Changes in corneal epithelial thickness and optical density and their correlation after smart pulse technology-assisted transepithelial photorefractive keratectomy

作　　者：牛世阳 杨华[1] 李彦 代志强[1] 李新民[1] 周予兰[1] 张欧阳 王保君[1] Niu Shiyang;Yang Hua;Li Yan;Dai Zhiqiang;Li Xinmin;Zhou Yulan;Zhang Ouyang;Wang Baojun(Department of Ophthalmology,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453000,Henan Province,China)

机构地区：[1]新乡医学院第一附属医院眼科,河南省卫辉市453000

出　　处：《国际眼科杂志》2024年第8期1308-1313,共6页International Eye Science

基　　金：新乡市科技攻关计划项目(No.GG2021030)。

摘　　要：目的:观察智能脉冲技术(SPT)辅助的经上皮准分子激光角膜切削术(TPRK)术后角膜上皮厚度(CET)和光密度(CD)变化,并分析两者的相关性。方法:前瞻性研究。选取2023-02/08在新乡医学院第一附属医院眼科行SPT-TPRK手术治疗的近视及近视散光患者60例120眼,评估术前、术后1 wk,1、3 mo CET与CD的变化。结果:纳入患者失访14例28眼,术后出现haze 3例6眼,均剔除本研究,最终纳入患者43例86眼。术后1 wk,CET高于术前(P<0.05),角膜中央0-2 mm区域CET明显增厚(P<0.05);术后1 mo,角膜中央0-2 mm区域CET明显变薄(P<0.05);术后3 mo,角膜中央0-2 mm区域CET基本达术前水平。术后CD值升高,术后3 mo,0-2 mm区域CET与0-2 mm区域全层CD值呈正相关(r=0.256,P<0.05),2-5 mm区域CET与2-6 mm区域前层CD值呈正相关(r=0.319,P<0.05)。结论:角膜中央2 mm以内区域角膜上皮重塑需要3 mo时间;CET较薄的区域,术后角膜上皮重塑更快,术后早期增厚更多;术后早期CD值较术前均增加,且部分区域CET与CD值呈正相关。AIM:To evaluate the changes in corneal epithelial thickness(CET)and corneal optical density(CD)after smart pulse technology(SPT)-assisted transepithelial photorefractive keratectomy(TPRK)and analyze their correlation.METHODS:The prospective study included 60 patients(120 eyes)with myopia and myopic astigmatism who underwent SPT-TPRK in the ophthalmology department at the First Affiliated Hospital of Xinxiang Medical University between February and August 2023.Changes in CET and CD were evaluated preoperatively and at 1 wk,1 and 3 mo postoperatively.RESULTS:A total of 14 cases(28 eyes)were lost to follow-up,and 3 patients(6 eyes)with postoperative haze were excluded from this study,resulting in a final inclusion of 43 patients(86 eyes).At 1 wk after SPT-TPRK,CET had statistically significantly thickened compared to preoperative levels(P<0.05),particularly in the CET at 0-2 mm central corneal area(P<0.05).At 1 mo after SPT-TPRK,the CET at 0-2 mm area had statistically significantly decreased(P<0.05).At 3 mo after SPT-TPRK,the CET at 0-2 mm had essentially reached preoperative levels.Postoperative CD values increased,with a positive correlation between CET in the 0-2 mm area and CD in the whole 0-2 mm area(r=0.256,P<0.05),and a positive correlation between CET in the 2-5 mm area and CD in the anterior 2-6 mm area(r=0.319,P<0.05).CONCLUSION:Corneal epithelial remodeling takes 3 mo in areas within 2 mm of the central cornea;areas with thinner CET have faster postoperative corneal epithelial remodeling and greater thickening in the early postoperative period;CD increases in the early postoperative period compared to the preoperative value,and in some areas,there is a positive correlation between CET and CD value.

关 键 词：经上皮准分子激光角膜切削术(TPRK) 智能脉冲技术(SPT) 角膜上皮厚度 角膜上皮愈合 角膜光密度 屈光不正 

分 类 号：R779.63[医药卫生—眼科]