SPT辅助的TPRK术后角膜上皮厚度和光密度的变化及两者的相关性

Changes in corneal epithelial thickness and optical density and their correlation after smart pulse technology-assisted transepithelial photorefractive keratectomy

摘要:

目的：观察智能脉冲技术(SPT)辅助的经上皮准分子激光角膜切削术(TPRK)术后角膜上皮厚度(CET)和光密度(CD)变化，并分析两者的相关性。

方法：前瞻性研究。选取2023-02/08在新乡医学院第一附属医院眼科行SPT-TPRK手术治疗的近视及近视散光患者60例120眼，评估术前、术后1 wk，1、3 mo CET与CD的变化。

结果：纳入患者失访14例28眼，术后出现haze 3例6眼，均剔除本研究，最终纳入患者43例86眼。术后1 wk，CET高于术前(P<0.05)，角膜中央0-2 mm区域CET明显增厚(P<0.05)； 术后1 mo，角膜中央0-2 mm区域CET明显变薄(P<0.05)； 术后3 mo，角膜中央0-2 mm区域CET基本达术前水平。术后CD值升高，术后3 mo，0-2 mm区域CET与0-2 mm区域全层CD值呈正相关(r=0.256，P<0.05)，2-5 mm区域CET与2-6 mm区域前层CD值呈正相关(r=0.319，P<0.05)。

结论：角膜中央2 mm以内区域角膜上皮重塑需要3 mo时间； CET较薄的区域，术后角膜上皮重塑更快，术后早期增厚更多； 术后早期CD值较术前均增加，且部分区域CET与CD值呈正相关。

Abstract:

AIM: To evaluate the changes in corneal epithelial thickness(CET)and corneal optical density(CD)after smart pulse technology(SPT)-assisted transepithelial photorefractive keratectomy(TPRK)and analyze their correlation.

METHODS: The prospective study included 60 patients(120 eyes)with myopia and myopic astigmatism who underwent SPT-TPRK in the ophthalmology department at the First Affiliated Hospital of Xinxiang Medical University between February and August 2023. Changes in CET and CD were evaluated preoperatively and at 1 wk, 1 and 3 mo postoperatively.

RESULTS: A total of 14 cases(28 eyes)were lost to follow-up, and 3 patients(6 eyes)with postoperative haze were excluded from this study, resulting in a final inclusion of 43 patients(86 eyes). At 1 wk after SPT-TPRK, CET had statistically significantly thickened compared to preoperative levels(P<0.05), particularly in the CET at 0-2 mm central corneal area(P<0.05). At 1 mo after SPT-TPRK, the CET at 0-2 mm area had statistically significantly decreased(P<0.05). At 3 mo after SPT-TPRK, the CET at 0-2 mm had essentially reached preoperative levels. Postoperative CD values increased, with a positive correlation between CET in the 0-2 mm area and CD in the whole 0-2 mm area(r=0.256, P<0.05), and a positive correlation between CET in the 2-5 mm area and CD in the anterior 2-6 mm area(r=0.319, P<0.05).

CONCLUSION: Corneal epithelial remodeling takes 3 mo in areas within 2 mm of the central cornea; areas with thinner CET have faster postoperative corneal epithelial remodeling and greater thickening in the early postoperative period; CD increases in the early postoperative period compared to the preoperative value, and in some areas, there is a positive correlation between CET and CD value.