Longitudinal changes in corneal epithelial thickness after FS-LASIK, keratorefractive lenticule extraction, and transepithelial PRK: systematic review and meta-analysis.
Tsung-Hsien Tsai, Jui-Hung Hsu, Ling-Shuo Chang, Jen-Hung Wang, Chi-Chin Sun
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引用次数: 0
Abstract
Purpose: To evaluate the longitudinal changes in corneal epithelial thickness after FS-LASIK, keratorefractive lenticule extraction (KLEx), and transepithelial photorefractive keratectomy (tPRK).
Setting: Multicenter, international.
Design: Systematic review and meta-analysis.
Methods: This study was registered with International Platform of Registered Systematic Review and Meta-Analysis Protocols (INPLASY202510085). A systematic search of electronic databases was conducted through January 2025 in accordance with PRISMA guidelines. Studies reporting both baseline and postoperative corneal epithelial thickness in myopic eyes treated with FS-LASIK, KLEx, or tPRK were included. Data from 33 studies (n = 2579 eyes) were extracted, with 23 studies incorporated into the meta-analysis. Meta-regressions were performed to identify predictors of epithelial thickness changes.
Results: FS-LASIK-treated eyes exhibited a central epithelial thickness increase of 3.31 ± 0.75 μm at 1 month, further increasing to 4.58 ± 0.72 μm at 6 months. KLEx resulted in central thickening of 2.51 ± 0.28 μm at 1 month and 3.82 ± 0.35 μm at 6 months. By contrast, tPRK eyes initially demonstrated epithelial thinning, followed by central thickening reaching 3.89 ± 0.38 μm at 6 months. Meta-regression analyses indicated that each additional diopter of myopic correction was associated with 1.05 μm greater central epithelial thickening in FS-LASIK and 1.04 μm in KLEx at 3 months postoperatively. In addition, an increase in the programmed optical zone (OZ) corresponded to a reduction in postoperative epithelial thickness.
Conclusions: Distinct epithelial remodeling patterns were observed: rapid, early thickening and stabilization with FS-LASIK and KLEx vs delayed regeneration with tPRK. Baseline spherical equivalent and programmed OZ were predictors of corneal epithelial thickness changes, suggesting procedure-specific remodeling profiles that may support future refinement of refractive planning.
期刊介绍：
The Journal of Cataract & Refractive Surgery (JCRS), a preeminent peer-reviewed monthly ophthalmology publication, is the official journal of the American Society of Cataract and Refractive Surgery (ASCRS) and the European Society of Cataract and Refractive Surgeons (ESCRS).
JCRS publishes high quality articles on all aspects of anterior segment surgery. In addition to original clinical studies, the journal features a consultation section, practical techniques, important cases, and reviews as well as basic science articles.
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