Tear meniscus evaluation after microkeratome laser in situ keratomileusis, femtosecond laser and femtosmile laser techniques using anterior segment optical coherence tomography.
Tear meniscus evaluation after microkeratome laser in situ keratomileusis, femtosecond laser and femtosmile laser techniques using anterior segment optical coherence tomography.
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DOI：
10.2147/opth.s169091
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发表时间：
2018
期刊：
影响因子：
--
通讯作者：
Badran TAF
中科院分区：
文献类型：
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作者：
Shaaban YM;Badran TAF
本研究的目的是比较三种角膜屈光手术：微角膜瓣激光原位角膜磨磨术（LASIK）、飞秒激光原位角膜磨磨术（FS-LASIK）和飞秒小切口晶状体提取术（FS-SMILE）对术后6个月泪膜稳定性的影响，为手术方式的选择提供依据。这是一项前瞻性的、随机的、比较的研究，包括三组相等的患者的90只眼睛。每组接受不同的激光技术：LASIK， FS-LASIK和FS-SMILE。术前及术后1周、1个月、3个月、6个月采用前段光谱域光学相干断层扫描（AS-SD-OCT）测量下撕裂半月板参数。对变化进行研究和比较。FS-SMILE与FS-LASIK术后1周、1个月撕裂半月板高度（TMH）差异有统计学意义（P = 0.003），术后3、6个月撕裂半月板高度（TMH）差异无统计学意义（P = 0.002）。FS-SMILE组1个月后TMH恢复到术前水平的95%。FS-LASIK与microkeratome LASIK术后1周、1个月TMH差异无统计学意义，3个月、6个月TMH差异有统计学意义（P = 0.019）。FS-SMILE与FS-LASIK的撕裂半月板面积（Tear半月板area， TMA）在随访各时间点差异均无统计学意义，但两者与微角膜瓣LASIK的差异均有统计学意义（P < 0.05）。微角膜瓣LASIK参数直到6个月才达到术前水平。与FS-LASIK和microkeratome LASIK技术相比，FS-SMILE技术早在术后1个月即可实现下颞下颌关节的早期恢复。
The purpose of this study was to compare the effects of three different corneal refractive surgeries: microkeratome laser in situ keratomileusis (LASIK), femtosecond laser in situ keratomileusis (FS-LASIK) and femtosecond small incision lenticule extraction (FS-SMILE) on 6-month postoperative stability of tear film to provide a basis for selection of operative procedures. This is a prospective, randomized, comparative study that included 90 eyes of three equal groups of patients. Each group was subjected to a different laser technique: LASIK, FS-LASIK and FS-SMILE. Using anterior segment spectral domain optical coherence tomography (AS-SD-OCT), the lower tear meniscus parameters were measured preoperatively and 1 week, 1 month, 3 months and 6 months postoperatively. Changes were studied and compared. There was a statistically significant difference in tear meniscus height (TMH) between FS-SMILE and FS-LASIK in the first week (P = 0.003) and first month (P = 0.002) with no statistically significant difference between both techniques at 3 and 6 months postoperatively. In FS-SMILE, TMH returned to 95% of its preoperative level after 1 month. There was no statistically significant difference in TMH between FS-LASIK and microkeratome LASIK techniques after 1 week and 1 month, but there was a statistically significant difference between both techniques in 3 months (P = 0.019) and 6 months (P = 0.032). Tear meniscus area (TMA) showed no statistically significant difference between FS-SMILE and FS-LASIK at all points of follow-up, but there was a statistically significant difference between both techniques and microkeratome LASIK (all P < 0.05). Microkeratome LASIK parameters failed to reach the preoperative level till 6 months. Early recovery of the lower TMH can be achieved as early as 1 month post-operatively with the FS-SMILE technique compared to FS-LASIK and microkeratome LASIK techniques.