利用眼反应分析仪评估FS-LASIK和LASEK术后角膜生物力学稳定性

目的：利用眼反应分析仪(ORA)评估飞秒激光辅助的准分子激光原位角膜磨镶术(FS-LASIK)和准分子激光上皮下角膜磨镶术(LASEK)术后角膜生物力学稳定性的差异。

方法：选取2016-01/2017-12于我院眼科视光学中心就诊且行LASEK/FS-LASIK手术的近视患者117例200眼(等效球镜-2.00～-5.00D)，其中行FS-LASIK术者64例100眼(FS-LASIK组)； 行LASEK术者53例100眼(LASEK组)。分别于术前和术后1、3mo采用ORA检测两组患者的角膜滞后量(CH)和角膜阻力因子(CRF)值，并进行统计分析。

结果：手术前后，两组患者CH和CRF比较，差异均有统计学意义(P<0.05)。术后1、3mo，两组患者CH和CRF均低于术前，差异均有统计学意义(P<0.05)。术后1mo，FS-LASIK组患者CH和CRF均低于LASEK组，差异均有统计学意义(P<0.05)。

结论：LASEK和FS-LASIK两种术式均会对角膜生物力学稳定性产生一定影响，但LASEK手术比FS-LASIK手术产生的影响更小，更安全，可减少术后屈光回退的可能性。

Comparison on biomechanical stability between femtosecond laser assisted LASIK and LASEK with ocular response analyzer

AIM: To compare the difference of biomechanical stability after a femtosecond laser-assisted in situ keratomileusis(FS-LASIK)and laser-assisted subepithelial keratomileusis(LASEK)by ocular response analyzer(ORA).

METHODS: This prospective study was conducted at the First Affiliated Hospital of Harbin Medical University, and myopic patients with the equivalent sphere between -2.00 and -5.00 diopters from January 2016 and December 2017 were enrolled. All the subjects were divided into FS-LASIK and LASEK group respectively according to different surgical methods. There were 64 patients(100 eyes)participated in the FS-LASIK group while 53 patients(100 eyes)in the LASEK surgery group. Corneal hysteresis value(CH)and corneal resistance factor value(CRF)were measured pre-, 1mo and 3mo postoperation of all the subjects. And the variance analysis of two groups was repeated to compare the overall difference between the two modes of operation from pre-operation to post operation.

RESULTS: The CH and CRF value of the two groups were different before and after operation(P<0.05). The comparison results of repeated measurements showed that the CH value and CRF value of the surgical methods were reduced in 1 and 3mo after operation, respectively, and there was significance(P<0.05). The CH and CRF of FS-LASIK group was lower than LASEK group only in 1mo after the operation(P<0.05).

CONCLUSION: Both surgeries could affect the biomechanical stability of cornea. From the point of view of biomechanical stability, LASEK operation is safer than FS-LASIK operation and reduces the possibility of postoperative refractive regression.