TransPRK与Epi-LASIK术后角膜上皮重塑的对比研究
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Comparison study of corneal epithelial remodeling after TransPRK and Epi-LASIK for myopia
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    摘要:

    目的:对比观察TransPRK与Epi-LASIK手术治疗近视术后角膜不同区域上皮厚度的变化。

    方法:前瞻性对照研究。选择行表层切削手术的近视及近视散光患者76例76眼,其中纳入TransPRK组43例43眼,Epi-LASIK组33例33眼,术前等效球镜度-1.25~-6.00D。分别于术前及术后1、3、6mo应用傅立叶域眼前节OCT对患者角膜0~2、2~5、5~6mm的角膜上皮厚度进行测量,研究两组患者术后不同时间角膜上皮厚度的变化规律。

    结果:两组患者术后3mo与6mo角膜各区域上皮厚度均较术前增厚,且差异有统计学意义(P<0.05)。TransPRK组上皮厚度的增厚表现为越接近光学区周边增厚越显著的特点(F3mo=-2.687,P=0.027; F6mo=-2.908,P=0.000),Epi-LASIK组各区域之间增厚的差异比较无统计学意义(F=1.365,P=0.237)。两组患者仅在光学区周边5~6mm上皮厚度变化的差异比较有统计学意义(P<0.05)。

    结论:TransPRK与Epi-LASIK两种表层手术后角膜上皮均发生重塑效应,表现为上皮厚度的增厚; TransPRK术后角膜上皮增厚在光学区周边较Epi-LASIK手术显著,且符合越接近周边增厚越显著的特点,可能与其愈合反应有关。

    Abstract:

    AIM: To compare the changes in epithelial thickness profile following TransPRK and Epi-LASIK for myopia.

    METHODS: In this prospective non-randomized controlled study, 76 right eyes of 76 myopic patients with the spherical equivalent refraction -1.25 to -6.00D were included under the informed consent. The eyes were divided into TransPRK group for 43 eyes and Epi-LASIK group for 33 eyes. Epithelial thickness was measured using spectral-domain optical coherence tomography at different corneal zones(central, 2mm; paracentral, 2-5mm; and mid-peripheral, 5-6mm)preoperatively and at 1, 3, and 6mo postoperatively. The results were compared between the two groups.

    RESULTS: The epithelium were thicker at 3 and 6mo after surgery compared to preoperative measurements in the two groups(all P<0.05). In TransPRK group, the epithelial thickness at 3 and 6mo demonstrated a negative meniscus-like lenticular pattern with lesser thickening centrally and progressively great thickening centrifugally(F3mo=-2.687,P=0.027; F6mo=-2.908,P=0.000). No statistically significant change was detected among the three zones in Epi-LASIK group(F=1.365, P=0.237). The epithelial thickness was thicker in the TransPRK group compared to the Epi-LASIK group mid-peripherally(P<0.05).

    CONCLUSION: Significant epithelial thickening was observed after TransPRK and Epi-LASIK. It was showed a lenticular change with more thickening mid-peripherally after TransPRK than Epi-LASIK. Wound healing and inflammation may account for differences in the effect on epithelial thickness change by both surgeries.

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孟繁超,侯杰,雷玉琳,等. TransPRK与Epi-LASIK术后角膜上皮重塑的对比研究.国际眼科杂志, 2016,16(8):1519-1521.

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  • 最后修改日期:2016-07-07
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  • 在线发布日期: 2016-07-26
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