飞秒激光小切口角膜基质透镜取出术联合角膜胶原交联术矫正近视的角膜生物力学

doi:10.19739/j.cnki.issn1001-9510.2020.06.009

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Abstract Objective To study the changes of corneal biomechanical parameters of small incision lenticule extraction (SMILE) combined with corneal collagen cross-lingking (CXL) to correct myopia.Methods Prospective studies were carried out on thirty-two patients (64 eyes) who underwent SMILE surgery. They were divided into two groups according to eye exam results, including 18 petients (36 eyes ) in the SMILE group and 14 patients (28 eyes) in the SMILE combined with corneal collagen crossing-linking group (SMILE+CXL).The SMILE group received routine SMILE surgery. The SMILE+CXL group first received SMILE surgery, after the separation and removal of the corneal stroma lens, they were given Vibex Xtra riboflavin solution uniformly repeated drops in the corneal capsular bag, with 45 s, Avedro accelerate cross-linking system was used for line across epithelial rapid cross- linking, the wavelength of 365 nm was chosen, with 30 mW/cm² ultraviolet irradiation illumination for 45 s of the cornea with the continuous illumination model, and the total energy was 1.35 J/cm². The patients were followed up for 1 month and 3 months after the operation, and the basic preoperative data and postoperative ophthalmic examination parameters, corneal biomechanical parameters before and after operation, and corneal endothelial cell count were compared between the two groups.Results All the operations were completed successfully. All patients achieved or exceeded the best corrected visualacuity after the operation. The patients in SMILE+CXL group had more obvious irritation symptoms such as eye pain and tears than SMILE group. LogMAR 1 day, 1 month and 3 months after the operation were compared between the SMILE group and the SMILE+CXL group, and the difference was statistically significant (P<0.05). Comparison of spherical equivalent (SE) between the SMILE group and the SMILE+CXL group 1 day, 1 month and 3 months after surgery showed statistically significant differences (P<0.05). Intraocular pressure (IOP) was compared between the SMILE group and the SMILE+CXL group 1 month and 3 months after surgery, and the difference was statistically significant (P<0.05). Compared with 1 day after surgery, LogMAR of 1 month and 3 months after surgery was statistically significant between the two groups (P<0.05). Compared with 1 day after surgery, there was a statistically significant difference in SE between the two groups at 1 month and 3 months after surgery (P<0.05). Compared with 1 month after surgery, LogMAR difference was statistically significant in SMILE+CXL group 3 months after surgery, P<0.05. Compared with 1 month after surgery, IOP increased 3 months after surgery in both groups (P<0.05). All patients had statistically significant differences in AT1, AT2, AL1, AL2, V1, V2, HCR and DA before and after the surgery (P<0.05). Compared with the SMILE+CXL group, AT1, HCT, AL1, AL2, V1, V2 and PD showed statistically significant differences 3 months after surgery, P<0.05.Conclusion The corneal biomechanics decreased after SMILE. SMILE combined with corneal collagen cross-linking was safe and effective in early myopia correction. The corneal hardness increased and the corneal deformation rate decreased after corneal collagen cross-linking.

Key words： corneal stroma laser femtosecond collagen cross-linking corneal biomechanics

Received: 05 June 2020

PACS:

R779.63

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	MA Gang
	FU Mengjun
	ZHANG Haorun

Cite this article:

MA Gang,FU Mengjun,ZHANG Haorun. Corneal biomechanics of small incision lenticule extraction combined with corneal
collagen cross-linking in the treatment of myopia[J]. 滨州医学院学报, 2020, 43(6): 430-434.

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http://manu58.magtech.com.cn/Jwk_bzyxy/EN/10.19739/j.cnki.issn1001-9510.2020.06.009 OR http://manu58.magtech.com.cn/Jwk_bzyxy/EN/Y2020/V43/I6/430

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