不同角膜屈光手术对基底膜下神经的影响

Infection of different corneal surgeries on subbasal nerves

目的:观察角膜屈光不同术式后基底膜下神经恢复情况。方法:角膜激光共焦显微镜观察术后1mo的LASEK 12眼、LASIK 12眼、FLEx 12眼、SMILE 12眼,并对部分其它术后时段进行了对比观察。结果:术后1mo SMILE组基底膜下神经均未见明显破坏,走行规律,完整,切口处被切断神经对合良好;LASEK,LASIK和FLEx基底膜下神经仍现不同程度损害,其它时段眼显示随着时间推移,逐渐形成交通支。结论:SMILE手术对基底膜下神经影响小,相对于其他几种角膜屈光手术,在术后神经恢复方面可能有一定优势。

AIM：To observe the recovery of corneal subbasal nerves after laser- assisted subepithelial keratomileusis（LASEK）,laser in situ keratomileusis（LASIK）,femto-second lenticule extraction（FLEx） and small incision lenticule extraction（SMILE）.METHODS：Confocal microscopy was used to observe subbasal nerves 1mo after surgery in 12 eyes of 12 LASEK patients,12 eyes of 12 LASIK patients,12 eyes of 12 FLEx patients and 12 eyes of 12 SMILE patients as well as some other follow-up times.RESULTS：Subbasal nerves 1mo after SMILE were almost complete and regular,showing no significant differences from those 2wk after surgery or even unoperated eyes.The nerves cut off at the incision were well involuted 1mo after surgery.Subbasal nerves were damaged in different degrees and got repaired to form communicating branches with time lapse after LASEK,LASIK and FLEx.CONCLUSION：SMILE exerted small infections on subbasal nerves.It may be superior to other corneal refractive surgeries in terms of postoperative nerve recovery.