FS-LASIK与SMILE矫正近视术后角膜后表面高度的变化

Changes in posterior corneal surface elevation after correction of myopia by FS-LASIK and SMILE

目的观察并比较飞秒激光制瓣准分子激光原位角膜磨镶术(femtosecond laser-assisted laser in situ keratomileusis,FS-LASIK)与飞秒激光小切口基质透镜取出术(small incision lenticule extraction,SMILE)术后角膜后表面高度的变化。方法选取2017年5月至2018年8月在天津市眼科医院接受SMILE手术矫正近视患者31例(50眼)和FS-LASIK手术矫正近视患者36例(59眼)。两组术前及术后1个月、3个月、6个月应用三维眼前节分析仪测量并比较角膜地形图和角膜前后表面高度。结果FS-LASIK组手术前后各区域各时间点,角膜后表面高度差异均有统计学意义(均为P<0.05);SMILE组手术前后4 mm环角膜后表面高度差异有统计学意义(P<0.05)。术后1个月,两组手术后4 mm环角膜后表面高度差值差异有统计学意义(P<0.05);术后3个月,两组术后角膜后表面高度差值差异均无统计学意义(均为P>0.05);术后6个月,两组各区域角膜后表面高度差值差异均有统计学意义(均为P<0.05)。结论FS-LASIK术后早期角膜后表面高度发生了轻微向前膨隆,SMILE术后角膜后表面高度在4 mm环发生了轻微后移。SMILE术后角膜后表面相对更加稳定。

Objective To observe and compare the changes of posterior corneal surface elevation after femtosecond laser-assisted laser in situ keratomileusis(FS-LASIK)and small incision lenticule extraction(SMILE).Methods There were 31 cases(50 eyes)received SMILE and 36 cases(59 eyes)received FS-LASIK for correction of myopia in Tianjin Eye Hospital from May 2017 to August 2018.The corneal topography,anterior and posterior corneal surface elevations were detected for patients in both two groups by three-dimensional anterior segment analyzer before operation,1 month,3 months and 6 months after operation.Results Statistical differences were found in posterior corneal surface elevation at different time points in all regions between before and after operation in FS-LASIK group(all P<0.05).Statistical difference was found in posterior corneal surface elevation at 4 mm ring between before and after operation in SMILE group(P<0.05).The difference in posterior corneal surface elevation at 4 mm ring was statistically significant at postoperative 1 month between the two groups(P<0.05);no differences were found in posterior corneal surface elevation at postoperative 3 months between the two groups(all P>0.05);statistical differences were found in posterior corneal surface elevation at postoperative 6 months between the two groups(all P<0.05).Conclusion Posterior corneal surface elevation has slight ectasia forwardly at early stage after FS-LASIK,but has slight ectasia backwardly at 4 mm ring after SMILE.Posterior corneal surface becomes more stable after SMILE.