Femtosecond Lenticule Extraction (FLEx): Clinical Results, Interface Evaluation, and Intraocular Pressure Variation
Femtosecond Lenticule Extraction (FLEx): Clinical Results, Interface Evaluation, and Intraocular Pressure Variation
复制标题
DOI：
10.1167/iovs.11-8808
复制
发表时间：
2012-03-01
影响因子：
4.4
通讯作者：
Mehta, Jodhbir S.
中科院分区：
文献类型：
--
作者：
Ang, Marcus;Chaurasia, Shyam S.;Mehta, Jodhbir S.
目的。目的探讨飞秒晶状体摘除（FLEx）与角膜界面超微结构分析和活体实时眼压（IOP）的相关性。前瞻性临床病例系列及实验研究；连续患者在单一三级中心接受FLEx治疗超过10个月，术后随访3个月。根据球体等效度（SE）将患者分为3组（A, < -5.0屈光度[D]； B, >= -5.00 D和< -9.00 D； C, >= -9.0 D）。用扫描电镜分析了接受FLEx治疗后的12只人体尸体眼睛；40只兔眼接受FLEx治疗并进行体内IOP测量。主要观察指标为研究对象的屈光结果；角膜界面对IOP的影响。33名受试者（22名女性，占66.7%）双眼行FLEx手术（66只眼）。平均年龄32岁（范围21 ~ 46岁）。术前平均SE为-5.77 +/- 2.04 D，散光为-1.03 +/- 0.72 D，有轻微远视移位（平均SE为0.14 +/- 0.53 D）；术后3个月未矫正视力>= 20/25,94%。屈光稳定性在1个月内达到（P < 0.001）。超微结构上，角膜界面平滑度与消融深度无关（平均不规则度评分A、B、C分别为8.8 +/- 0.6、10.3 +/- 0.4、8.7 +/- 0.6,P = 0.88）。FLEx期间IOP的增加与飞秒(FS)-LASIK相似，尽管FLEx期间IOP升高的持续时间是飞秒(FS)-LASIK的两倍（P < 0.001）。这些结果表明FLEx治疗近视和近视散光是可预测和有效的。实验研究支持该手术的早期临床结果和安全性。（Invest Ophthalmol Vis Sci. 2012;53:14 -1421） DOI:10.1167/iovs.11-8808
PURPOSE. To characterize the clinical profile of femtosecond lenticule extraction (FLEx) correlated with ultrastructural analysis of the corneal interface and in vivo real-time intraocular pressure (IOP).METHODS. Prospective clinical case series with experimental studies; consecutive patients underwent FLEx at a single tertiary center over 10 months with postsurgical follow-up of 3 months. The patients were divided into three groups according to spherical equivalence (SE) (A, < -5.0 diopters [ D]; B, >= -5.00 D and < -9.00 D; and C, >= -9.0 D). Twelve human cadaveric eyes analyzed using scanning electron microscopy after receiving FLEx; 40 rabbit eyes received FLEx with in vivo IOP measurements. The main outcome measures were refractive outcomes from study subjects; with corneal interface and IOP in experimental studies.RESULTS. Thirty-three subjects (22 females, 66.7%) underwent FLEx in both eyes (66 eyes). Mean age was 32 years (range, 21 to 46 years). Preoperative mean SE was -5.77 +/- 2.04 D with astigmatism of -1.03 +/- 0.72 D. There was a slight hyperopic shift (mean SE 0.14 +/- 0.53 D); 94% achieved uncorrected visual acuity >= 20/25 3 months post-operatively. Refractive stability was achieved within 1 month (P < 0.001). Ultrastructurally, the smoothness of the corneal interface was independent of ablation depth (mean irregularity scores A, B, C: 8.8 +/- 0.6, 10.3 +/- 0.4, 8.7 +/- 0.6, respectively; P = 0.88). The increase in IOP during FLEx was similar to that in femtosecond (FS)-LASIK, albeit a twofold duration of raised IOP in FLEx (P < 0.001).CONCLUSIONS. These results suggest that FLEx is predictable and effective in treating myopia and myopic astigmatism. Experimental studies support the early clinical results and safety of this procedure. (Invest Ophthalmol Vis Sci. 2012;53:1414-1421) DOI:10.1167/iovs.11-8808