高度近视SMILE、FS-LASIK及LASEK 术后角膜后表面高度变化的比较

doi:10.3760/cma.j.cn115909-20211019-00416

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Abstract Objective: To compare the change in posterior corneal elevation (PCE) after small incision lenticule extraction (SMILE), femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) and laserassisted subepithelial keratomileusis (LASEK) for high myopia correction. Methods: Retrospective case series study. 144 patients (144 eyes) of high myopia who visited Eye Hospital of Shandong First Medical University (Shandong Eye Hospital) from January 2017 to December 2019 were divided into 3 groups, including SMILE, FS-LASIK and LASEK, with 48 patients (48 eyes) in each group. The PCE at the corneal apex and the average PCE of the 2 mm and 4 mm diameter were analyzed by Pentacam preoperatively, 1 month, 3 months and 6 months postoperatively. The change of PCE (ΔPCE) is the difference between postoperative and preoperative PCE. Repeated measurements analysis of variance was used to compare PCE and ΔPCE within and among the three groups. The impact of central corneal thickness (CCT), lenticule thickness/ablation depth (LT/AD) and residual bed thickness (RBT) to ΔPCE was evaluated in each group at 6 months after surgery. Results: The difference of PCE among the three groups was statistically significant only at the 4 mm diameter (F=7.79, P<0.001). PCE in SMILE and FS-LASIK group was lower than that in LASEK group at 6 months after surgery (F=9.75, P<0.001). There was no significant difference of ΔPCE in each area of the cornea among the three groups. The posterior corneal surface was slightly forward in the 4 mm circle in SMILE and LASEK group at 1 month after surgery (P<0.05), and remained stable 6 months after surgery. The central posterior surface was slightly backward in the LASEK group at 1 month after surgery (P=0.001), and recovered to preoperative level at 6 months after surgery. There was no significant difference of PCE in each corneal area and at each time point before and after FS-LASIK. In the FS-LASIK group, ΔPCE and AD showed a slight positive correlation in the 2 mm (r=0.31, P=0.029) and 4 mm circle (r=0.30, P=0.039). Conclusion: SMILE, FSLASIK and LASEK presented stable PCE in correction of high myopia, and there was no difference in ΔPCE among the three groups.

Key words： small incision lenticule extraction femtosecond laser-assisted laser in situ keratomileusis laser-assisted subepithelial keratomileusis high myopia posterior corneal elevation

Received: 19 October 2021

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Fund:National Natural Science Foundation of China (81870639);
Shandong Natural Science Foundation (ZR2020MH171)

Corresponding Authors: Mingna Liu, Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital),State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Jinan 250021, China. (Email: lmn_2422@126.com)

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Na Li,Mingna Liu,Hua Gao等. Comparison of the Change in Posterior Corneal Elevation after SMILE, FS-LASIK and LASEK for High Myopia Correction[J]. Chinese Journal of Optometry Ophthalmology and Visual science, 2022, 24(5): 343-350.

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https://www.cjoovs.com/EN/10.3760/cma.j.cn115909-20211019-00416 OR https://www.cjoovs.com/EN/Y2022/V24/I5/343

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