光线追踪引导的FS-LASIK治疗近视后与角膜能量和角膜高阶像差相关的上皮重塑

IF 2.6 3区医学 Q2 ONCOLOGY

Photodiagnosis and Photodynamic Therapy Pub Date : 2025-09-22 DOI:10.1016/j.pdpdt.2025.105230

Jiayu Li , Yuyan Huang , Yanzheng Song , Yushan Xu , Yixin Zhang , Jie Wen , Zecheng Wang , Fengju Zhang

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引用次数: 0

摘要

目的：评价射线追踪引导飞秒激光辅助原位角膜磨除术（RG FS-LASIK）后角膜上皮重塑、角膜能量分布和角膜高阶像差（HOAs）的变化。方法：对33例患者的66只眼睛进行了为期6个月的观察性研究。评估上皮厚度（ET）、角膜总屈光度（TCRP）、角膜HOAs、角膜体积（CV）和视力质量问卷。计算TCRP同心梯度（△Kmn = Kmn+1 - Kmn）。结果：0 ~ 2 mm的ET仅增加2.97±4.57 μm，近视矫正量为- 6.24±1.78 d，陡经与平经无显著差异（P < 0.050）。Km保持了1-3毫米的下降速度，并缓慢上升了4-6毫米。2 ~ 5 mm ET增厚与TCRP梯度呈正相关（△Km3、△Km4、△Km5的r分别为0.304、0.399、0.357，P均< 0.050）。该环的平均重构和下重构程度的增加与球差和6 mm垂直彗差的增加有关（r = 0.414和-0.505，P均< 0.001），相应的发生严重的聚焦困难和较轻的复视（系数 = 8.665和3.612，P均< 0.050）。CV3消耗与△Km1、△Km2呈负相关（r = -0.522、-0.475，P均< 0.001）。结论：RG - FS-LASIK术后中央区上皮增厚最小，散光轴间可比较。虽然视觉症状不明显，但与新型消融特征和角膜hoa术后发展相关的明显中心旁重构仍需要持续监测。

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Epithelial remodeling associated with corneal power and corneal higher-order aberrations after ray-tracing guided FS-LASIK for myopia

Purpose

To evaluate epithelial remodeling, corneal power distribution and corneal higher-order aberrations (HOAs) after ray tracing-guided femtosecond laser-assisted in situ keratomileusis (RG FS-LASIK) for myopia.

Methods

66 eyes from 33 patients were included in this 6-month observational case series. Epithelial thickness (ET), total corneal refractive power (TCRP), corneal HOAs, corneal volume (CV), and Quality of Vision questionnaire were assessed. Concentrical TCRP gradient was calculated (△Km_n = Km_n+1 - Km_n).

Results

ET in 0–2 mm only increased by 2.97 ± 4.57 μm with the myopic correction of - 6.24±1.78 D. No difference between steep and flat meridians was identified (P > 0.050). Km maintained a rate of decline in 1–3 mm and gently raised across 4–6 mm. ET thickening in 2–5 mm showed positive associations with TCRP gradient (r of △Km₃, △Km₄, and △Km₅ were 0.304, 0.399, and 0.357; all P < 0.050). And greater mean and inferior remodeling in this annulus were related to increased spherical aberration and vertical coma at 6 mm (r = 0.414 and −0.505; both P < 0.001), correspondingly severer focusing difficulties and milder double vision occurred (coef = 8.665 and 3.612, both P < 0.050). CV₃ consumption correlated negatively with △Km₁ and △Km₂ (r = −0.522 and −0.475, both P < 0.001).

Conclusions

Epithelial thickening was minimal in central zone and comparable between astigmatism axes after RG FS-LASIK. Though the visual symptoms were subtle, pronounced paracentral remodeling associated with novel ablation profile and postoperative development of corneal HOAs still requires continuous monitoring.

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来源期刊

Photodiagnosis and Photodynamic Therapy ONCOLOGY-

CiteScore

5.80

自引率

24.20%

发文量

509

审稿时长

50 days

期刊介绍： Photodiagnosis and Photodynamic Therapy is an international journal for the dissemination of scientific knowledge and clinical developments of Photodiagnosis and Photodynamic Therapy in all medical specialties. The journal publishes original articles, review articles, case presentations, "how-to-do-it" articles, Letters to the Editor, short communications and relevant images with short descriptions. All submitted material is subject to a strict peer-review process.