摘要
目的探讨飞秒激光小切口透镜提取术(SMILE)和准分子激光角膜切削术(PRK)对角膜生物力学的影响。方法选取广州视献眼科屈光手术中心2019年10月至2020年1月收治的中低度近视(等效球镜小于-6.00 D)患者20例(40眼),根据患者意愿分为SMILE组(10例,20眼)和PRK组(10例,20眼)。使用角膜生物力学分析仪测量术前及术后1个月角膜在空气脉冲作用下的形变参数。结果在等效球镜和角膜厚度等基线条件相近的情况下,SMILE组角膜切削量显著高于PRK组,差异有统计学意义(t=3.502,P=0.02)。术前和术后1个月,2组患者反向曲率半径(Radius)、第一次压平时间(AT1)、第一次压平角膜长度(Length1)、峰值距离(Peak Distance)和变形幅度比(DA Ratio)组内分别比较,差异有统计学意义(P<0.05)。SMILE组和PRK组ΔDA Ratio、ΔLength2、ΔAT2和ΔPeak Distance比较,差异均有统计学意义(P<0.05)。结论角膜屈光手术改变了角膜的生物力学性能,角膜对变形的阻力变小,角膜硬度降低。SMILE组术后Peak Distance和DA Ratio生物力学参数较PRK组明显增加,说明SMILE术对角膜生物力学影响更大。
Objective To evaluate the influence of small incision lenticule extraction(SMILE)and photorefractive keratectomy(PRK)on corneal biomechanical properties.Methods A total of 40 patients(40 eyes)from October 2019 to January 2020 in Broad Vision with low and moderate myopia(spherical equivalent refraction was below-6 diopters)were divided into SMILE group(10 patients,20 eyes)and PRK group(10 patients,20 eyes)according to the patient′s wishes.Corneal applanation and deformation were registered with Corvis ST during an air-pulse before and 1 month after surgery.Results The cut depth of SMILE group was deeper than that of PRK group,the difference was significant between the two group at the similar baseline conditions such as spherical equivalent and corneal thickness(t=3.502,P=0.02).There were significant differences in Corvis ST biomechanical parameters including radius at highest concavity(HC radius),time until first applanation(A1 time),length1 at the applanation,peak distance and deformation amplitude in each group before and one month after surgery(P<0.05).Furthermore,the differences in deformation amplitude ratio(ΔDA ratio),Δlength2,time until second applanation(ΔA2 time)andΔpeak distance were significant between two groups(P<0.05).Conclusion Keratorefractive procedures alter the corneal biomechanical properties,with the corneal resistance to deformation decreased and the corneal hardness decreased.Biomechanical parameters of peak distance and DA ratio were significantly increased in SMILE group compared with PRK group,indicating that SMILE surgery has a greater impact on corneal biomechanics.
作者
黄志翾
陶梦颖
刘庆明
李玥娇
刘陇黔
HUANG Zhi-xuan;TAO Meng-ying;LIU Qing-ming;LI yue-jiao;LIU Long-qian(Department of Ophthalmology,West China Hospital,Sichuan University,Chengdu Sichuan 610041,China;Department of Ophthalmology,Broad Vision,Guangzhou Guangdong 510000,China)
出处
《局解手术学杂志》
2020年第5期363-367,共5页
Journal of Regional Anatomy and Operative Surgery
