SPT-TPRK与FS-LASIK角膜基质切削深度可预测性的研究  

Predictability of the corneal stromal reduction with smart pulse technology-assisted transperitoneal photorefractive keratomileusis and femtosecond laser-assisted in situ keratomileusis

作　　者：张欧阳 李彦 杨华[1] 闫海波 严泽宇 王保君[1] ZHANG Ouyang;LI Yan;YANG Hua;YAN Haibo;YAN Zeyu;WANG Baojun(Department of Ophthalmology,the First Affiliated Hospital of Xinxiang Medical University,Xinxiang 453003,Henan Province,China)

机构地区：[1]新乡医学院第一附属医院眼科,河南省新乡市453003

出　　处：《眼科新进展》2025年第4期304-309,共6页Recent Advances in Ophthalmology

基　　金：新乡市科技攻关计划项目(编号:GG2021030);新乡医学院博士科研基金资助(编号:11359)。

摘　　要：目的观察智能脉冲技术辅助的经上皮准分子激光角膜切削术(SPT-TPRK)与飞秒激光制瓣的准分子激光原位角膜磨镶术(FS-LASIK)角膜基质切削深度的可预测性。方法选取2023年2月至9月在新乡医学院第一附属医院眼科行激光手术患者,按照术式不同分为SPT-TPRK组(21例37眼)和FS-LASIK组(18例32眼),测量术前、术后1周、术后1个月、术后3个月的裸眼远视力(UCVA)、眼压、角膜厚度和角膜上皮厚度并计算切削偏差值,同时观察基质厚度变化,分析预测基质切削量与切削偏差值的相关性。结果SPT-TPRK组与FS-LASIK组患者各组内各时间点UCVA总体比较差异均有统计学意义(均为P<0.001)。与SPT-TPRK组相比,FS-LASIK组患者术后1周UCVA提高更明显,差异有统计学意义(P<0.001),术后1、3个月两组患者UCVA差异均无统计学意义(均为P>0.05)。SPT-TPRK组与FS-LASIK组患者各组内各时间点眼压总体比较差异均有统计学意义(均为P<0.001)。与SPT-TPRK组相比,术后1周FS-LASIK组患者眼压降低,差异有统计学意义(P<0.05),术后1、3个月两组患者眼压差异均无统计学意义(均为P>0.05)。SPT-TPRK组与FS-LASIK组患者各组内预测基质切削量与术后各时间点实际基质切削量总体比较差异均有统计学意义(均为P<0.001)。与预测基质切削量相比,术后各时间点SPT-TPRK组患者角膜实际基质切削量均更大,差异均有统计学意义(P<0.05),而术后1周、1个月FS-LASIK组患者预测基质切削量与实际基质切削量均更大,差异均有统计学意义(均为P<0.05),术后3个月FS-LASIK组患者预测基质切削量与实际基质切削量差异无统计学意义(P>0.05)。与SPT-TPRK组相比,术后1个月FS-LASIK组切削偏差值差异无统计学意义(P>0.05),而术后1周、3个月FS-LASIK组患者切削偏差值差异均有统计学意义(均为P<0.05)。SPT-TPRK组与FS-LASIK组患者各组内各时间点基质厚度变化值整体比较差异均有统计学意义(�Objective To observe the predictability of the corneal stromal reduction with smart pulse technology-assisted transperitoneal photorefractive keratomileusis(SPT-TPRK)and femtosecond laser-assisted in situ keratomileusis(FS-LASIK).Methods Patients undergoing laser surgery in the Department of Ophthalmology of the First Affiliated Hospital of Xinxiang Medical College from February to September 2023 were selected and divided by surgical modalities into an SPT-TPRK group(21 cases,37 eyes)and an FS-LASIK group(18 cases,32 eyes).The uncorrected visual acuity(UCVA),intraocular pressure,corneal thickness,and corneal epithelial thickness were measured before surgery,1 week,1 month and 3 months after surgery.The cutting deviation was calculated,and the change of corneal stromal thickness was observed.The correlation between the predicted corneal stromal reduction and the cutting deviation was analyzed.Results There were significant differences in UCVA among different time points in both SPT-TPRK and FS-LASIK groups(all P<0.001).The UCVA of patients in the FS-LASIK group was significantly higher than that in the SPT-TPRK group 1 week after surgery(P<0.001).The difference in UCVA was not statistically significant between the two groups 1 month and 3 months after surgery(all P>0.05).There were significant differences in intraocular pressure among different time points in both SPT-TPRK and FS-LASIK groups(all P<0.001).The FS-LASIK group had a lower intraocular pressure than the SPT-TPRK group 1 week after surgery(P<0.05),but the difference in intraocular pressure was not statistically significant between the two groups 1 month and 3 months after surgery(all P>0.05).There was significant difference between predicted corneal stromal reductions and actual corneal stromal reductions measured at different time points postoperatively in both SPT-TPRK and FS-LASIK groups(all P<0.001).The actual corneal stromal reductions were higher than the predicted ones in the SPT-TPRK group at all postoperative time points(all P<0.05).In the FS-L

关 键 词：智能脉冲技术 经上皮准分子激光角膜切削术 飞秒激光 准分子激光原位角膜磨镶术 角膜基质厚度 可预测性 

分 类 号：R778.1[医药卫生—眼科]