经角膜上皮的激光角膜切削术矫治SMILE术后屈光回退
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摘要
目的观察飞秒激光小切口角膜基质透镜取出术(SMILE)后屈光回退患者行经角膜上皮的激光角膜切削术(T-PRK)的临床疗效,评价其安全性和有效性。方法选择2016年3月至2017年3月在我院行SMILE术的近视患者450例(878眼),其中出现屈光回退的7例(12眼),应用T-PRK术进行矫正,观察术后1周、1个月、3个月及6个月的视力、屈光状态及术后并发症。结果术后1周及6个月时裸眼视力均可达到1.0及以上,1眼出现角膜haze 0.5级,未发现其他并发症。结论对于矫正SMILE术后屈光回退,T-PRK手术是安全有效的。
Objective To evaluate the safety and efficacy of transepithelial photorefractive keratectomy (T-PRK) for the correction of refractive regression after small incision lenticule extraction (SMILE) surgery.Methods 450 myopic patients (878 eyes) underwent SMILE surgery were selected in our hospital between March 2016 and March 2017. Among them,7 cases (12 eyes) were observed refraction regression and TPRK was used for correction. The visual acuity, refractive state and postoperative complications were observed at 1 week,1 month,3 month and 6 month after operation. Results One week to six month after operation,uncorrected visual acuity (UCVA) was 1.0 or more,haze grade 0.5 happened on 1 eye,but no other complications happened. Conclusion T-PRK surgery is safe and effective for correcting the refraction regression after SMILE surgery.
Objective To evaluate the safety and efficacy of transepithelial photorefractive keratectomy (T-PRK) for the correction of refractive regression after small incision lenticule extraction (SMILE) surgery.Methods 450 myopic patients (878 eyes) underwent SMILE surgery were selected in our hospital between March 2016 and March 2017. Among them,7 cases (12 eyes) were observed refraction regression and TPRK was used for correction. The visual acuity, refractive state and postoperative complications were observed at 1 week,1 month,3 month and 6 month after operation. Results One week to six month after operation,uncorrected visual acuity (UCVA) was 1.0 or more,haze grade 0.5 happened on 1 eye,but no other complications happened. Conclusion T-PRK surgery is safe and effective for correcting the refraction regression after SMILE surgery.
引文
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[5]Wilson SE,Medeiros CS,Santhiago MR.Pathophysiology of corneal scarring in persistent epithelial defects after PRK and other corneal injuries[J].J Refract Surg,2018,34(1):59-64.
[6]Xeroudaki M,Peebo B,Germundsson J,et al.RGTA in corneal wound healing after transepithelial laser ablation in a rabbit model:a randomized,blinded,placebo-controlled study[J].Acta Ophthalmol,2016,94(7):685-691.
[7]Moshirfar M,D Desautels J,D Walker B,et al.Mechanisms of optical regression following corneal laser refractive surgery:epithelial and stromal responses[J].Med Hypothesis Discov Innov Ophthalmol,2018,7(1):1-9.
[8]Ganesh S,Brar S,Relekar KJ.Epithelial thickness profile changes following small incision refractive lenticule extraction(SMILE)for myopia and myopic astigmatism[J].J Refract Surg,2016,32(7):473-482.
[9]Luft N,Ring MH,Dirisamer M,et a1.Corneal epithelial remodeling induced by small incision lenticule extraction(SMILE)[J].Invest Ophthalmol Vis Sci,2016,57(9):176-183.
[10]李华,王雁,窦瑞,等.飞秒激光小切口角膜基质透镜取出术后眼压测量及其影响因素分析[J].中华眼科杂志,2016,52(1):22-29.
[11]张钰,陈跃国.当代准分子激光角膜表层消融术[J].中华眼视光学与视觉科学杂志,2016,18(2):65-68.
[12]Sinha Roy A,Dupps WJ Jr,Robeas CJ.Comparison of biomechanical effects of small-incision lenticule extraction and laser in situ keratomileusis:finite-element analysis[J].J Cataract Refract Surg,2014,40(6):971-980.
[13]窦瑞,王雁,吴文静,等.飞秒激光小切口角膜基质透镜取出术术后角膜生物力学的影响因素分析[J].中华实验眼科杂志,2016,34(5):448-455.
[2]Shah R,Shah S,Sengupta S.Results of small incision lenticule extraction:all-in-one femtosecond laser refractive surgery[J].JCataract Refract Surg,2011,37(1):127-137.
[3]Pedersen IB,Ivarsen A,Hjortdal J.Three-year results of small incision lenticule extraction for high myopia:refractive outcomes and aberrations[J].J Refract Surg,2015,31(11):719-724.
[4]lum M,Taubig K,Gruhn C,et a1.Five-year results of small incision lenticule extraction(ReLEx SMILE)[J].Br JOphthalmol,2016,100(9):1192-1195.
[5]Wilson SE,Medeiros CS,Santhiago MR.Pathophysiology of corneal scarring in persistent epithelial defects after PRK and other corneal injuries[J].J Refract Surg,2018,34(1):59-64.
[6]Xeroudaki M,Peebo B,Germundsson J,et al.RGTA in corneal wound healing after transepithelial laser ablation in a rabbit model:a randomized,blinded,placebo-controlled study[J].Acta Ophthalmol,2016,94(7):685-691.
[7]Moshirfar M,D Desautels J,D Walker B,et al.Mechanisms of optical regression following corneal laser refractive surgery:epithelial and stromal responses[J].Med Hypothesis Discov Innov Ophthalmol,2018,7(1):1-9.
[8]Ganesh S,Brar S,Relekar KJ.Epithelial thickness profile changes following small incision refractive lenticule extraction(SMILE)for myopia and myopic astigmatism[J].J Refract Surg,2016,32(7):473-482.
[9]Luft N,Ring MH,Dirisamer M,et a1.Corneal epithelial remodeling induced by small incision lenticule extraction(SMILE)[J].Invest Ophthalmol Vis Sci,2016,57(9):176-183.
[10]李华,王雁,窦瑞,等.飞秒激光小切口角膜基质透镜取出术后眼压测量及其影响因素分析[J].中华眼科杂志,2016,52(1):22-29.
[11]张钰,陈跃国.当代准分子激光角膜表层消融术[J].中华眼视光学与视觉科学杂志,2016,18(2):65-68.
[12]Sinha Roy A,Dupps WJ Jr,Robeas CJ.Comparison of biomechanical effects of small-incision lenticule extraction and laser in situ keratomileusis:finite-element analysis[J].J Cataract Refract Surg,2014,40(6):971-980.
[13]窦瑞,王雁,吴文静,等.飞秒激光小切口角膜基质透镜取出术术后角膜生物力学的影响因素分析[J].中华实验眼科杂志,2016,34(5):448-455.