温州医科大学附属眼视光医院温州院区激光角膜屈光手术方式十年变化趋势

doi:10.3760/cma.j.cn115909-20201209-00473

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摘要目的：分析2010─2019年温州医科大学附属眼视光医院温州院区激光角膜屈光手术方式的变化趋势。方法：回顾性系列病例研究。收集温州医科大学附属眼视光医院温州院区2010年1月1日至2019年 12月31日接受激光角膜屈光手术的屈光不正患者35 902例（70 766眼）的资料，其中男22 372例（43 973眼），女13 530例（26 793眼），年龄为16～62岁（中位数为22岁）。采用SPSS 21.0统计软件对手术对象的年龄和性别分布、手术数量、术式分布的历年变化进行分析，采用R4.0.3统计软件对手术数量的季节性变化趋势进行分析。结果：激光角膜屈光手术数量除了2012和2014年较前一年有所下降外，其余年份呈现上升趋势。2010─2012年，准分子激光屈光性角膜切削术（PRK）占当年手术总量的比例波动于0.10%～0.19%。机械法-准分子激光角膜上皮瓣下磨镶术（Epi-LASIK）由 2010年的7.68%增至2011年的8.71%，随后开始下降至2016年的0.03%（χ2 =1367.475，P<0.001）。经上皮准分子激光角膜切削术（TPRK）所占比例2012年（3.20%）至2019年（36.87%）呈持续上升趋势（χ2 =4388.776，P<0.001）。准分子激光原位角膜磨镶术（LASIK）在2010年占当年手术总量的92.21%，之后逐年下降，2018年降至0.22%（χ2 =23052.398，P<0.001）。飞秒激光辅助准分子激光原位角膜磨镶术（FS-LASIK）由2011年的29.35%增至2016年的72.90%（χ2 =3635.744，P<0.001），随后开始下降，到2019年降至31.41%（χ2 =1107.074，P<0.001）。飞秒激光小切口角膜基质透镜取出术（SMILE）由2016年的4.11%增至2019年的31.72%（χ2 =2021.33，P<0.001）。另外，每年6─8月是手术大高峰， 2月是小高峰。结论：2010年至2019年温州医科大学附属眼视光医院温州院区激光角膜屈光手术数量除前期有所下降外，之后呈现逐年上升趋势。板层手术仍为主流术式，表层手术的回归趋势逐渐突显，近年来TPRK、FS-LASIK、SMILE这3种术式为主要术式。每年6─8月及2月是手术较为集中的月份。

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关键词 ：激光角膜屈光手术, 准分子激光, 飞秒激光, 长期变化趋势

Abstract： Objective: To investigate the changing trends in the types of corneal laser refractive surgury in the Eye Hospital (Wenzhou Branch), Wenzhou Medical University, from 2010 to 2019. Methods: This was a retrospective case series study. Data for 35 902 patients (70 766 eyes), 22 372 men (43 973 eyes), 13 530 women (26 793 eyes); age range (median), 16-62 (22) years, who underwent corneal laser refractive surgery from January 1, 2010 to December 31, 2019 in the Eye Hospital (Wenzhou Branch), Wenzhou Medical University, were collected. Data for age and gender distribution of corneal laser refractive surgical cases and the changing trends in surgical quantity and type, and the seasonal trends were analyzed by SPSS 21.0 and R4.0.3. Results: The number of corneal laser refractive surgical cases increased compared with the previous years except for 2012 and 2014. The proportion of photorefractive keratectomy fluctuated between 0.10% and 0.19% from 2010 to 2012. The ratio of epipolis-laser in situ keratomileusis increased from 7.68% in 2010 to 8.71% in 2011, and then decreased to 0.03% (χ2 =1367.475, P<0.001) in 2016. The proportion of transepithelial photorefractive keratectomy increased from 3.20% in 2012 to 36.87% in 2019 (χ2 =4388.776, P<0.001). The rate of laser in situ keratomileusis was accounted for 92.21% in 2010, and then decreased to 0.22% in 2018 (χ2 =23052.398, P<0.001). The ratio of femtosecond laser-assisted laser in situ keratomileusis increased from 29.35% in 2011 to 72.90% in 2016 (χ2 =3635.744, P<0.001), but decreased to 31.41% in 2019 (χ2 =1107.074, P<0.001). The ratio of femtosecond laser small incision lenticule extraction increased between 2016 and 2019 from 4.11% to 31.72% (χ2 =2021.33, P<0.001). The big seasonal peak was from June to August every year, and the small peak was February. Conclusions: The quantity of corneal laser refractive surgery in the Eye Hospital (Wenzhou Branch), Wenzhou Medical University, showed a gradually increasing trend compared with the previous year except for the decrease in the early stage. Lamellar laser surgery was still the main stream surgical procedure, and the trend of surface laser surgery to regress was becoming more and more prominent. There were three main kinds of corneal laser refractive surgery in recent years: Transepithelial photo refractive keratectomy, femtosecond laser-assisted laser in situ keratomileusis and femtosecond laser small incision lenticule extraction. June to August and February were the months in which operations were concentrated every year.

Key words： corneal laser refractive surgery excimer laser femtosecond laser long-term change trend

收稿日期: 2020-12-09

PACS:

基金资助: 浙江省医药卫生科研项目（2017KY113、2018KY543）

通讯作者: 王勤美（ORCID：0000-0003-0629-0734），Email：wqm3@mail.eye.ac.cn

引用本文:

崔乐乐1，2 周韦禾1，2 朱晓旋1，2 杨凯1，2 肖云凡1，2 陈世豪1，2 余野1，2 许琛琛1，2 胡亮1，2 王勤美1，2. 温州医科大学附属眼视光医院温州院区激光角膜屈光手术方式十年变化趋势[J]. 中华眼视光学与视觉科学杂志, 2021, 23(4): 254-259. Lele Cui1, 2, Weihe Zhou1, 2, Xiaoxuan Zhu1, 2, Kai Yang1, 2, Yunfan Xiao1, 2, Shihao Chen1, 2, Ye Yu1, 2, Chenchen Xu1, 2, Liang Hu1, 2, Qinmei Wang1, 2. Changing Trends during the Past Decade in the Types of Corneal Laser Refractive Surgery in the Eye Hospital (Wenzhou Branch), Wenzhou Medical University. Chinese Journal of Optometry Ophthalmology and Visual science, 2021, 23(4): 254-259. DOI: 10.3760/cma.j.cn115909-20201209-00473

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https://www.cjoovs.com/CN/10.3760/cma.j.cn115909-20201209-00473 或 https://www.cjoovs.com/CN/Y2021/V23/I4/254

[1]	Trokel SL, Srinivasan R, Braren B. Excimer laser surgery of the cornea. Am J Ophthalmol, 1983, 96(6): 710-715. DOI: 10.1016/ s0002-9394(14)71911-7.
[2]	McDonald MB, Kaufman HE, Frantz JM, et al. Excimer laser ablation in a human eye. Arch Ophthalmol, 1989, 107(5): 641- 642. DOI: 10.1001/archopht.1989.01070010659013.
[3]	Pallikaris IG, Papatzanaki ME, Stathi EZ, et al. Laser in situ keratomileusis. Lasers Surg Med, 1990, 10(5): 463-468. DOI: 10.1002/lsm.1900100511.
[4]	Camellin M. LASEK may offer advantages of both LASIK and PRK. Ocu Surg N Int, 1999, 10(3): 14-15.
[5]	Pallikaris IG, Katsanevaki VJ, Kalyvianaki MI, et al. Advances in subepithelialexcimer refractive surgery techniques: EpiLASIK. Curr Opin Ophthalmol, 2003, 14(4): 207-212. DOI: 10.1097/00055735-200308000-00007.
[6]	Stonecipher K, Ignacio TS, Stonecipher M. Advances in refractive surgery: microkeratome and femtosecond laser flap creation in relation to safety, efficacy, predictability, and biomechanical stability. Curr Opin Ophthalmol, 2006, 17(4): 368-372. DOI: 10.1097/01.icu.0000233957.88509.2d.
[7]	Fadlallah A,Fahed D,Khalil K, et al. Transepithelial photo refractive keratectomy: Clinical results. J Cataract Refract Surg, 2011, 37(10): 1852-1857. DOI: 10.1016/j.jcrs.2011.04.029.
[8]	Shah R, Shah S, Sengupta S. Results of small incision lenticule extraction: All-in-one femtosecond laser refractive surgery. J Cataract Refract Surg, 2011, 37(4): 127-137. DOI: 10.1016/ j.jcrs.2010.07.033.
[9]	胡亮, 王勤美. 三种全激光角膜屈光手术技术要点与前景. 中华眼视光学与视觉科学杂志, 2016, 18(4): 193-198. DOI: 10.3760/cma.j.issn.1674-845X.2016.04.001.
[10]	Xu T, Wang B, Liu H, et al. Prevalence and causes of vision loss in China from 1990 to 2019: findings from the Global Burden of Disease Study 2019. Lancet Public Health, 2020, 5(12): e682-e691. DOI: 10.1016/S2468-2667(20)30254-1.
[11]	Holden BA, Fricke TR, Wilson DA, et al. Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050. Ophthalmology, 2016, 123(5): 1036-1042. DOI: 10.1016/ j.ophtha.2016.01.006.
[12]	萧郁雯, 周激波. 个性化角膜屈光手术的研究进展. 中华眼视光学与视觉科学杂志, 2020, 22(5): 392-396. DOI: 10.3760/ cma.j.cn115909-20190313-00075.
[13]	Kim TI, Alió Del Barrio JL, Wilkins M, et al. Refractive surgery. The Lancet, 2019, 393(10185): 2085-2098. DOI: 10.1016/ S0140-6736(18)33209-4.
[14]	王雁, 史伟云, 李莹. 我国角膜屈光手术的快速发展和变迁. 中华眼科杂志, 2020, 56(2): 81-85. DOI: 10.3760/cma.j.issn. 0412-4081.2020.02.001.
[15]	Arranz-Marquez E, Katsanos A, Kozobolis VP, et al. A Critical Overview of the Biological Effects of Mitomycin C Application on the Cornea Following Refractive Surgery. Adv Ther, 2019, 36(4): 786-797. DOI: 10.1007/s12325-019-00905-w.
[16]	Majmudar PA, Schallhorn SC, Cason JB, et al. Mitomycin-C in corneal surface excimer laser ablation techniques: A report by the American Academy of Ophthalmology. Ophthalmology, 2015, 122(6): 1085-1095. DOI: 10.1016/j.ophtha.2015.01.019.
[17]	Hashmani S, Hashmani N, Rajani H, et al. Comparison of visual acuity, refractive outcomes, and satisfaction between LASIK performed with a microkeratome and a femtolaser. Clin Ophthalmol, 2017, 11: 1009-1014. DOI: 10.2147/OPTH. S137451.
[18]	中国科学报. 谢立信院士: 激光近视矫正术风险可控[EB/ OL]. (2012-02-23)[2019-10-10]. http://news.sciencenet.cn/ htmlnews/2012/2/260139. shtm.
[19]	Golan O, Randleman JB. Pain management after photo refractive keratectomy. Curr Opin Ophthalmol, 2018, 29(4): 306-312. DOI: 10.1097/ICU.0000000000000486.
[20]	Spadea L, Giovannetti F. Main Complications of Photo refractive Keratectomy and their Management. Clin Ophthalmol, 2019, 13: 2305-2315. DOI: 10.2147/OPTH.S233125.
[21]	Sandoval HP, Donnenfeld ED, Kohnen T, et al. Modern laser in situ keratomileusis outcomes. J Cataract Refract Surg, 2016, 42(8): 1224-1234. DOI: 10.1016/j.jcrs.2016.07.012.
[22]	Kezirian GM, Stonecipher KG. Comparison of the Intra Lase femtosecond laser and mechanical keratomes for laser in situ keratomileusis. J Cataract Refract Surg, 2004, 30(4): 804-811. DOI: 10.1016/j.jcrs.2003.10.026.
[23]	Wen D, McAlinden C, Flitcroft I, et al. Postoperative Efficacy, Predictability, Safety, and Visual Quality of Laser Corneal Refractive Surgery: A Network Meta-analysis. Am J Ophthalmol, 2017, 178: 65-78. DOI: 10.1016/j.ajo.2017.03.013.
[24]	Seiler T, Koufala K, Richter G. Iatrogenic keratectasia after laser in situ keratomileusis. J Refract Surg, 1998, 14(3): 312-317.
[25]	王勤美, 许琛琛. 激光表层角膜屈光手术的回归. 中华眼视光学与视觉科学杂志, 2015, 17(12): 708-711. DOI: 10.3760/cma. j.issn.1674-845X.2015.12.002.