摘要
目的比较飞秒激光辅助的准分子激光原位角膜磨镶术(FS-LASIK)与智能脉冲技术(SPT)辅助的经上皮准分子激光角膜切削术(TPRK)术后角膜上皮厚度(CET)和光密度(CD)变化及其相关性分析。方法采用前瞻性研究,选取2023年2月至9月在新乡医学院第一附属医院眼科接受手术治疗的21例(42眼)FS-LASIK患者和25例(50眼)SPT-TPRK患者。比较术前及术后1周、1个月、3个月的视力、屈光度、眼压,CET和CD的变化,组间比较采用独立样本t检验。结果术后1周,FS-LASIK组视力优于SPT-TPRK组[(-0.04±0.08)logMAR比(0.14±0.12)logMAR,t=-8.538,P<0.001],FS-LASIK组屈光度优于SPT-TPRK组[(0.10±0.65)D比(-1.04±1.09)D,t=6.135,P<0.001];术后1个月和3个月,两组间视力差异无统计学意义[(-0.08±0.07)logMAR比(-0.09±0.07)logMAR,(-0.10±0.07)logMAR比(-0.12±0.07)logMAR,t=-0.838、-1.036,P>0.05]。术后1周、1个月和3个月时,两组眼压差异均无统计学意义[(14.34±4.16)mmHg比(14.71±4.40)mmHg,(13.71±6.91)mmHg比(14.26±6.21)mmHg,(12.08±3.68)mmHg比(12.15±3.61)mmHg,t=-0.414、-0.413、-0.098,P>0.05]。术后1个月和3个月,两组的CD变化无统计学差异[(0.02±1.54)比(0.48±1.82),(0.79±1.89)比(0.41±1.99),t=-1.314、0.938,P>0.05]。术后1个月和3个月,FS-LASIK组CET高于SPT-TPRK组[(63.93±10.79)μm比(46.30±3.97)μm,(60.52±5.91)μm比(51.80±4.49)μm,t=10.020、7.847,P<0.001];术后3个月SPT-TPRK组CET接近术前水平[(51.80±4.49)μm比(50.42±3.82)μm,t=-1.170,P>0.05]。结论FS-LASIK术后CET增厚更显著,FS-LASIK和SPT-TPRK术后对CD的影响相似,两种手术方式对术后视力的影响相同。
Objective To compare postoperative changes in corneal epithelial thickness(CET)and corneal density(CD)between femtosecond laser-assisted laser in situ keratomileusis(FS-LASIK)and SmartPulse technology(SPT)-assisted transepithelial photorefractive keratectomy(TPRK),along with their correlation analysis.Methods A prospective study was conducted,enrolling 21 cases(42 eyes)of FS-LASIK and 25 cases(50 eyes)of SPT-TPRK patients who underwent surgery at the Ophthalmology Department of the First Affiliated Hospital of Xinxiang Medical University from February to September 2023.Comparisons were made between preoperative and postoperative(1-week,1-month,3-month)visual acuity,refractive error,intraocular pressure,CET,and CD changes.Intergroup comparisons utilized independent samples t-test,with statistical analysis performed using SPSS software(P<0.05 considered significant).Results At 1 week postoperatively,the FS-LASIK group showed better visual acuity than the SPT-TPRK group[(-0.04±0.08)logMAR vs.(0.14±0.12)logMAR,t=-8.538,P<0.001],with superior refractive outcomes[(0.10±0.65)D vs.(-1.04±1.09)D,t=6.135,P<0.001].No significant differences in visual acuity were observed between groups at 1 month[(-0.08±0.07)logMAR vs.(-0.09±0.07)logMAR,t=-0.838]or 3 months[(-0.10±0.07)logMAR vs.(-0.12±0.07)logMAR,t=-1.036],with P>0.05 for both timepoints.Intraocular pressure showed no significant intergroup differences at 1 week[(14.34±4.16)mmHg vs.(14.71±4.40)mmHg,t=-0.414],1 month[(13.71±6.91)mmHg vs.(14.26±6.21)mmHg,t=-0.413],or 3 months[(12.08±3.68)mmHg vs.(12.15±3.61)mmHg,t=-0.098,all P>0.05].CD changes demonstrated no significant intergroup differences at 1 month[(0.02±1.54)vs.(0.48±1.82),t=-1.314]or 3 months[(0.79±1.89)vs.(0.41±1.99),t=0.938],with P>0.05.The FS-LASIK group exhibited greater CET than the SPT-TPRK group at both 1 month[(63.93±10.79)μm vs.(46.30±3.97)μm,t=10.020]and 3 months[(60.52±5.91)μm vs.(51.80±4.49)μm,t=7.847],with P<0.001.The SPT-TPRK group’s CET at 3 months[(51.80±4.49)μm]approximated preoperative levels[(50.42±3.82)μm,t=-1.170,P>0.05].Conclusion The thickening of CET after FS-LASIK is more obvious.Both procedures caused similar mild increases in CD and the two surgical methods have the same effects on postoperative vision.
作者
李彦
牛世阳
杨华
王保君
Li Yan;Niu Shiyang;Yang Hua;Wang Baojun(Department of Ophthalmology,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453000,China)
出处
《中华实验外科杂志》
2025年第6期1147-1151,共5页
Chinese Journal of Experimental Surgery
