SMILE与FS-LASIK术后眼压和角膜生物力学指标的变化比较

Comparison of IOP and corneal biomechanical changes after SMILE and FS-LASIK

目的:比较飞秒激光小切口角膜基质透镜取出术(small incision lenticule extraction,SMILE)、飞秒辅助LASIK术(FS-LASIK)两种手术方式术后眼压和角膜生物力学指标的变化。方法:选取我院自愿接受SMILE手术101例202眼和FSLASIK手术101例202眼近视患者,分别于术前、术后1mo应用眼反应分析仪(ocular response analyzer,ORA)检测角膜补偿眼压(corneal compensated intraocular pressure,IOPcc)、模拟Goldmann眼压(Goldmann correlated IOP value,IOPg)、角膜阻力因子(corneal resistance factor,CRF)、角膜滞后量(corneal hysteresis,CH)。比较术后1mo与术前测量值的差异,两组CRF、CH降低值的差异。结果:术后1mo SMILE组IOPcc、IOPg分别为13.84±2.22、10.81±2.52mmHg,较术前16.15±2.90、15.95±3.08mmHg显著降低(t=-13.58、-32.91,均P<0.01)。CRF、CH术后测量值7.52±1.41、8.66±1.19mmHg较术前10.72±1.61、10.60±1.43mmHg显著降低(t=-41.21、-24.03,均P<0.01)。CRF、CH分别较术前降低3.19±1.10、1.93±1.14mmHg。FS-LASIK组术后1mo IOPcc、IOPg分别为13.99±2.33、10.10±2.55mmHg,较术前15.88±3.29、14.86±3.34mmHg显著降低(t=-10.09、-23.00,均P<0.01)。CRF、CH术后测量值6.68±1.14、7.90±1.27mmHg较术前9.93±1.85、9.98±1.60mmHg显著降低(t=-24.84、-18.90,均P<0.01)。CRF、CH分别较术前降低3.25±1.86、2.08±1.57mmHg。CRF、CH术后降低值SMILE组显著小于FS-LASIK组(t=-0.351、-1.081,均P<0.01)。结论:两种手术方式术后角膜生物力学和眼压测量值均较术前显著降低。CRF、CH术后降低值,SMILE组显著低于FS-LASIK组。

AIM:To evaluate the influence on corneal biomechanics after small incision lenticule extraction(SMILE)and Femto LDV laser flapping in laser in situ keratomileusis(FS-LASIK).METHODS:Preoperatively,1mo after surgery,101patients(202eyes)with myopia in each group respectively by SMILE and FS-LASIK were examined by ocular response analyzer(ORA).Parameters were compared between postoperative(1mo)and preoperative.Comparisons included the corneal thickness and corneal compensated intraocular pressure(lopcc),Goldmann correlated IOP value(lopg),corneal resistance factor(CRF),corneal hysteresis(CH).RESULTS:SMILE group:lOPcc,lOPg(1mo postoperatively,13.84±2.22,10.81±2.52mmHg)significantly changed comparing with preoperative(16.15±2.90,15.95±3.08mmHg;f=-13.58,-32.91;both P<0.01).CRF and CH(1mo postoperatively,7.52±1.41,8.66±1.19mmHg)significantly changed comparing with preoperative(10.72±1.61,10.60±1.43;f=-41.21,-24.03;both P<0.01).The difference were3.19±1.10,1.93±1.14mmHg respectively.FS-LASIK group:lopcc and lopg(1mo postoperatively,13.99±2.33,10.10±2.55mmHg)significantly changed comparing with preoperative(15.88±3.29,14.86±3.34mmHg;f=-10.09、-23.00;both P<0.01).CRF,CH(1mo postoperaturely,6.68±1.14,7.90±1.27mmHg)significantly changed comparing with preoperative(9.93±1.85,9.98±1.60mmHg;r=-24.84,-18.90;both P<0.01).The difference were3.25±1.86,2.08±1.57mmHg respectively.Changes of CRF and CH were significantly different between two groups(t=-0.351,-1.081;both P<0.01).CONCLUSION:The postoperative corneal biomechanics and IOP measurements are lower than preoperative.SMILE are lower than FS-lasik in changes of CRF,CH.