摘要
目的:观察全飞秒激光小切口角膜基质透镜取出术(SMILE)和飞秒激光辅助制瓣的准分子激光原位角膜磨镶术(FS-LASIK)对角膜密度的影响。方法:回顾性非随机对照研究。收集2016年7月至2017年11月在济南市第二人民医院行SMILE和FS-LASIK矫正近视患者各45例(86眼),分别于术前及术后3个月用Pentacam三维眼前节分析诊断系统进行角膜光密度的测量,以角膜顶点为中心,分别测量0~2mm、2~6mm、6~10mm直径范围的前层(120μm)、中间层、后层(60μm)以及整体的角膜光密度。对角膜光密度组间的对比采用协方差分析,组内的对比采用Wilcoxon秩和检验,手术前后角膜厚度、眼压、曲率、等效球镜度的改变与角膜光密度改变的相关关系采用Spearman相关关系检测。结果:SMILE组中间层0~2mm手术前后角膜光密度差异无统计学意义(Z=-1.956,P=0.051),其余层次和范围差异均有统计学意义(均P<0.05),且术后角膜光密度值低于术前。FS-LASIK组在0~2mm前层和后层手术前后差异有统计学意义(Z=-2.927,P=0.003;Z=-2.261,P=0.024),其余层次和范围差异均无统计学意义,且术后角膜光密度的值低于术前。SMILE组和FS-LASIK组手术前后密度变化量的对比在6~10mm的后层(F=1.808,P=0.181)、总的后层(F=3.281,P=0.072)、总的全层(F=3.666,P=0.057)的差异均无统计学意义,其余均有统计学意义(均P<0.05),且SMILE组的角膜光密度低于FS-LASIK组。结论:SMILE和FSFS-LASIK术后3个月角膜光密度均降低,且FS-LASIK和SMILE对整体角膜光密度具有相似的影响。
Objective:To study the effects of small incision lenticule extraction(SMILE)and femtosecond laser in situ keratomileusis(FS-LASIK)on corneal densitometry(CD)after refractive correction for myopia.Methods:This was a retrospective non-randomized cohort study.Ninety patients(172eyes)underwent refractive surgery from July2016to November2017,in which45patients(86eyes)underwent SMILE and the other45patients(86eyes)underwent FS-LASIK.The CD data was calculated automatically by the Pentacam system before surgery and3months after surgery.For CD analysis,the average CD in the three concentric radial zones centered on the apex of the cornea(0-2mm,2-6mm,6-10mm diameters)were divided into three layers that were defined according to different corneal depths(the anterior120μm as the1st layer,the posterior60μm as the3rd layer,and the center part between them as the2nd layer).The overall CD of the cornea was also measured.A covariance analysis was used to compare the CD between the two groups,and a Wilcoxon test was used to compare the CD within groups.A Spearman test was used to analyze the relationship between the change in CD and CCT,IOP,corneal curvature and SE.Results:In the SMILE group,CD after surgery was lower than before surgery and differences were significant(all P<0.05),except for the2nd layer in the0-2mm range(Z=-1.956,P=0.051).In the FS-LASIK group,CD after surgery was lower than before surgery and differences were significant(all P<0.05).Except for the0-2mm1st and3rd layer(Z=-2.927,P=0.003;Z=-2.261,P=0.024),the diffrences were not significant for other radial zone and layers.When the changes in CD were compared between the two groups,there were no statistically significant differences for the3rd layer in the6-10mm range(F=1.808,P=0.181),the3rd layer(F=3.281,P=0.072),and the total layer(F=3.666,P=0.057).The rest had statistically significant differences(all P<0.05),and the CD of the SMILE group was lower than that in the FS-LASIK group.Conclusions:Both SMILE and FS-LASIK decrease corneal densitometry,and they have
作者
袁倩
刘蕾
张亚丽
李招娜
井秀华
Qian Yuan;Lei Liu;Yali Zhang;Zhaona Li;Xiuhua Jing(School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Jinan250062, China)
出处
《中华眼视光学与视觉科学杂志》
CAS
CSCD
2018年第12期719-724,共6页
Chinese Journal Of Optometry Ophthalmology And Visual Science
