飞秒激光辅助LASIK联合快速角膜交联巩固术治疗中高度近视的2年期疗效观察

季红; 熊洁; 张辰星; 罗启惠; 王科; 周青青; 周友惠

doi:10.16016/j.1000-5404.202005022

您当前的位置：

首页 >

文章列表页 >

飞秒激光辅助LASIK联合快速角膜交联巩固术治疗中高度近视的2年期疗效观察

临床医学 | 更新时间：2026-01-09

- 飞秒激光辅助LASIK联合快速角膜交联巩固术治疗中高度近视的2年期疗效观察
- Two-year outcome of Fs-LASIK combined accelerated corneal cross-linking for moderate and high myopia
- 第三军医大学学报 2020年42卷第19期页码：1957-1964
- 作者机构：
- 作者简介：
- 基金信息：
- DOI：10.16016/j.1000-5404.202005022
  中图分类号：
- 收稿：2020-05-06，
  
  纸质出版：2020-10-15
- 稿件说明：
移动端阅览
季红, 熊洁, 张辰星, 等. 飞秒激光辅助LASIK联合快速角膜交联巩固术治疗中高度近视的2年期疗效观察[J]. 第三军医大学学报, 2020,42(19):1957-1964.

Hong JI, Jie XIONG, Chenxing ZHANG, et al. Two-year outcome of Fs-LASIK combined accelerated corneal cross-linking for moderate and high myopia[J]. Journal of Third Military Medical University, 2020, 42(19): 1957-1964.
季红, 熊洁, 张辰星, 等. 飞秒激光辅助LASIK联合快速角膜交联巩固术治疗中高度近视的2年期疗效观察[J]. 第三军医大学学报, 2020,42(19):1957-1964. DOI： 10.16016/j.1000-5404.202005022.

Hong JI, Jie XIONG, Chenxing ZHANG, et al. Two-year outcome of Fs-LASIK combined accelerated corneal cross-linking for moderate and high myopia[J]. Journal of Third Military Medical University, 2020, 42(19): 1957-1964. DOI： 10.16016/j.1000-5404.202005022.

摘要

Abstract

Objective

To evaluate the safety

effectiveness and predictability of femtosecond laser assisted excimer laser

in-situ

keratomileusis combined with accelerated cross-linking (F

s-LASIK Xtra) in moderate and high myopia with thin cornea.

Methods

A retrospective case-control study was carried out after the whole clinical data of 2 years' follow-up from the patients undergoing Fs-LASIK Xtra or single Fs-LASIK in our hospital during March 2016 and March 2017 were collected. Forty-four patients (88 eyes) undergoing Fs-LASIK Xtra surgeries were included in the study group

and 50 patients (100 eyes) Fs-LASIK surgeries in the control group. Changes in uncorrected distance visual acuity (UCVA)

correction of best distant vision (BCVA)

equivalent spherical mirror (SEQ)

corneal curvature

intraocular pressure

endothelium

depth of demarcation line in anterior segmental optical coherence tomography (OCT)

and the incidences of postoperative complications

such as interlaminar inflammation reaction and corneal haze in 1 week

and 1

12 and 24 months after surgery were measured and observed.

Results

The pre-operative BCVA and post-operative UCVA at 3

12 and 24 months were all significant improved (

0.05). The pre-operative corneal curvature and SEQ were also greatly decreased in 3

12 and 24 months after surgery. The SEQ reached the predicted value in both groups in 24 months

but there was no obvious difference between them (

0.05). The distribution of positive SEQ was notably higher

while that of negative SEQ was lower in the study group when compared to the control group (

0.05). Significant differences in the percentages of regression and overcorrection at 24 months were seen between the 2 groups (

0.05)

with the study group having higher percentage of overcorrection

but lower the percentage of regression than the control group. In the study group

the depth of demarcation line of 32 eyes was 224.57±62.01 μm. Six eyes (6.8%) with grade 0.5 haze and 2 eyes (2.3%) with grade 1 haze occurred in 1 to 3 months after surgery

the symptoms wer

e disappeared after topical steroid treatment which had no negative influence in the final visual acuity.

Conclusion

Fs-LASIK Xtra can treat moderate and high myopia with thin cornea with good safety

effectiveness and predictability. Sufficient glucocorticosteroid eye drop should be used regularly to prevent post-operative inflammation reaction and haze.

关键词

Keywords

references

DOU R WANG Y XU L Comparison of corneal biomechanical characteristics after surface ablation refractive surgery and novel lamellar refractive surgery Cornea 2015 34 11 1441 1446 10.1097/ICO.0000000000000556 DOU R, WANG Y, XU L, et al . Comparison of corneal biomechanical characteristics after surface ablation refractive surgery and novel lamellar refractiv e surgery[J ] . Cornea, 2015, 34(11): 1441-1446.

REINSTEIN D Z ARCHER T J RANDLEMAN J B Mathematical model to compare the relative tensile strength of the cornea after PRK, LASIK, and small incision lenticule extraction J Refract Surg Thorofare N J 2013 29 7 454 460 10.3928/1081597X-20130617-03 REINSTEIN D Z, ARCHER T J, RANDLEMAN J B. Mathematical model to compare the relative tensile strength of the cornea after PRK, LASIK, and small incision lenticule extraction[J]. J Refract Surg Thorofare N J, 2013, 29(7): 454-460. DOI:10.3928/1081597X-20130617-03.

SINHA ROY A DUPPS W J ROBERTS C J Comparison of biomechanical effects of small-incision lenticule extraction and laser in situ keratomileusis: finite-element analysis J Cataract Refract Surg 2014 40 6 971 980 10.1016/j.jcrs.2013.08.065 SINHA ROY A, DUPPS W J, ROBERTS C J. 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. DOI:10.1016/j.jcrs.2013.08.065.

WU D WANG Y ZHANG L Corneal biomechanical effects: small-incision lenticule extraction versus femtosecond laser-assisted laser in situ keratomileusis J Cataract Refract Surg 2014 40 6 954 962 10.1016/j.jcrs.2013.07.056 WU D, WANG Y, ZHANG L, et al . Corneal biomechanical effects: small-incision lenticule extraction versus femtosecond laser-assisted laser in situ keratomileusis[J ] . J Cataract Refract Surg, 2014, 40(6): 954-962. DOI:10.1016/j.jcrs.2013.07.056.

ALI J L SORIA F ABBOUDA A Laser in situ keratomileusis for–6.00 to–18.00 diopters of myopia and up to–5.00 diopters of astigmatism: 15-year follow-up J Cataract Refract Surg 2015 41 1 33 40 10.1016/j.jcrs.2014.08.029 ALI J L, SORIA F, ABBOUDA A, et al . Laser in situ keratomileusis for–6.00 to–18.00 diopters of myopia and up to–5.00 diopters of astigmatism: 15-year follow-up[J ] . J Cataract Refract Surg, 2015, 41(1): 33-40. DOI:10.1016/j.jcrs.2014.08.029.

SUGAR A RAPUANO C J CULBERTSON W W Laser in situ keratomileusis for myopia and astigmatism: safety and efficacy: a report by the American Academy of Ophthalmology Ophthalmology 2002 109 1 175 187 10.1016/S0161-6420(01)00966-6 SUGAR A, RAPUANO C J, CULBERTSON W W, et al . Laser in situ keratomileusis for myopia and astigmatism: safety and efficacy: a report by the American Academy of Ophthalmology[J ] . Ophthalmology, 2002, 109(1): 175-187.

DAMGAARD I B REFFAT M HJORTDAL J Review of corneal biomechanical properties following LASIK and SMILE for myopia and myopic astigmatism Open Ophthalmol J 2018 12 164 174 10.2174/1874364101812010164 DAMGAARD I B, REFFAT M, HJORTDAL J. Review of corneal biomechanical properties following LASIK and SMILE for myopia and myopic astigmatism[J]. Open Ophthalmol J, 2018, 12: 164-174. DOI:10.2174/1874364101812010164.

KOBASHI H RONG S S Corneal collagen cross-linking for keratoconus: systematic review Biomed Res Int 2017 2017 8145651 10.1155/2017/8145651 KOBASHI H, RONG S S. Corneal collagen cross-linking for keratoconus: systematic review[J]. Biomed Res Int, 2017, 2017: 8145651. DOI:10.1155/2017/8145651.

TOMITA M Combined laser in situ keratomileusis and accelerated corneal cross-linking: an update Curr Opin Ophthalmol 2016 27 4 304 310 10.1097/ICU.0000000000000281 TOMITA M. Combined laser in situ keratomileusis and accelerated corneal cross-linking: an update[J]. Curr Opin Ophthalmol, 2016, 27(4):304-310.DOI:10.1097/ICU.0000000000000281.

SAKLA H ALTROUDI W MU OZ G Simultaneous topography-guided partial photorefractive keratectomy and corneal collagen crosslinking for keratoconus J Cataract Refract Surg 2014 40 9 1430 1438 10.1016/j.jcrs.2013.12.017 SAKLA H, ALTROUDI W, MU OZ G, et al . Simultaneous topography-guided partial photorefractive keratectomy and corneal collagen crosslinking for keratoconus[J ] . J Cataract Refract Surg, 2014, 40(9): 1430-1438. DOI:10.1016/j.jcrs.2013.12.017.

ALI J L MUFTUOGLU O ORTIZ D Ten-year follow-up of laser in situ keratomileusis for myopia of up to-10 diopters Am J Ophthalmol 2008 145 1 46 54 10.1016/j.ajo.2007.09.010 ALI J L, MUFTUOGLU O, ORTIZ D, et al . Ten-year follow-up of laser in situ keratomileusis for myopia of up to-10 diopters[J ] . Am J Ophthalmol, 2008, 145(1): 46-54. DOI:10.1016/j.ajo.2007.09.010.

WOLLENSAK G SPORL E SEILER T Treatment of keratoconus by collagen cross linking Ophthalmologe 2003 100 1 44 49 10.1007/s00347-002-0700-3 WOLLENSAK G, SPORL E, SEILER T. Treatment of keratoconus by collagen cross linking[J]. Ophthalmologe, 2003, 100(1): 44-49.

WOLLENSAK G SPOERL E SEILER T Riboflavin/ultraviolet-a-induced collagen crosslinking for the treatment of keratoconus Am J Ophthalmol 2003 135 5 620 627 10.1016/S0002-9394(02)02220-1 WOLLENSAK G, SPOERL E, SEILER T. Riboflavin/ultraviolet-a-induced collagen crosslinking for the treatment of keratoconus[J]. Am J Ophthalmol, 2003, 135(5): 620-627.

KOHLHAAS M SPOERL E SPECK A A new treatment of keratectasia after LASIK by using collagen with riboflavin/UVA light cross-linking Klinische Monatsblatter Fur Augenheilkunde 2005 222 5 430 436 10.1055/s-2005-857950 KOHLHAAS M, SPOERL E, SPECK A, et al . A new treatment of keratectasia after LASIK by using collagen with riboflavin/UVA light cross-linking[J ] . Klinische Monatsblatter Fur Augenheilkunde, 2005, 222(5): 430-436. DOI:10.1055/s-2005-857950.

TAMAYO G E Predictable visual outcomes with accelerated corneal cross-linking concurrent with laser in situ keratomileusis J Cataract Refract Surg 2012 38 12 2206 10.1016/j.jcrs.2012.10.023 TAMAYO G E. Predictable visual outcomes with accelerated corneal cross-linking concurrent with laser in situ keratomileusis[J]. J Cataract Refract Surg, 2012, 38(12): 2206. DOI:10.1016/j.jcrs.2012.10.023.

KANELLOPOULOS A J PAMEL G J Review of current indications for combined very high fluence collagen cross-linking and laser in situ keratomileusis surgery Indian J Ophthalmol 2013 61 8 430 432 10.4103/0301-4738.116074 KANELLOPOULOS A J, PAMEL G J. Review of current indications for combined very high fluence collagen cross-linking and laser in situ keratomileusis surgery[J]. Indian J Ophthalmol, 2013, 61(8): 430-432. DOI:10.4103/0301-4738.116074.

KANELLOPOULOS A J ASIMELLIS G Combined laser in situ keratomileusis and prophylactic high-fluence corneal collagen crosslinking for high myopia: two-year safety and efficacy J Cataract Refract Surg 2015 41 7 1426 1433 10.1016/j.jcrs.2014.10.045 KANELLOPOULOS A J, ASIMELLIS G. Combined laser in situ keratomileusis and prophylactic high-fluence corneal collagen crosslinking for high myopia: two-year safety and efficacy[J]. J Cataract Refract Surg, 2015, 41(7): 1426-1433. DOI:10.1016/j.jcrs.2014.10.045.

ZOTTA P G DIAKONIS V F KYMIONIS G D Long-term outcomes of corneal cross-linking for keratoconus in pediatric patients J AAPOS 2017 21 5 397 401 10.1016/j.jaapos.2017.07.205 ZOTTA P G, DIAKONIS V F, KYMIONIS G D, et al . Long-term outcomes of corneal cross-linking for keratoconus in pediatric patients[J ] . J AAPOS, 2017, 21(5): 397-401. DOI:10.1016/j.jaapos.2017.07.205.

TOMITA M YOSHIDA Y YAMAMOTO Y In vivo confocal laser microscopy of morphologic changes after simultaneous LASIK and accelerated collagen crosslinking for myopia: one-year results J Cataract Refract Surg 2014 40 6 981 990 10.1016/j.jcrs.2013.10.044 TOMITA M, YOSHIDA Y, YAMAMOTO Y, et al . In vivo confocal laser microscopy of morphologic changes after simultaneous LASIK and accelerated collagen crosslinking for myopia: one-year results[J ] . J Cataract Refract Surg, 2014, 40(6): 981-990. DOI:10.1016/j.jcrs.2013.10.044.

SEILER T G FISCHINGER I KOLLER T Superficial corneal crosslinking during laser in situ keratomileusis J Cataract Refract Surg 2015 41 10 2165 2170 10.1016/j.jcrs.2015.03.020 SEILER T G, FISCHINGER I, KOLLER T, et al . Superficial corneal crosslinking during laser in situ keratomileusis[J ] . J Cataract Refract Surg, 2015, 41(10): 2165-2170. DOI:10.101 6/j.jcrs.2015.03.020.

CELIK U H ALAG Z N YILDIRIM Y Accelerated corneal crosslinking concurrent with laser in situ keratomileusis J Cataract Refract Surg 2012 38 8 1424 1431 10.1016/j.jcrs.2012.03.034 CELIK U H, ALAG Z N, YILDIRIM Y, et al . Accelerated corneal crosslinking concurrent with laser in situ keratomileusis[J ] . J Cataract Refract Surg, 2012, 38(8): 1424-1431. DOI:10.1016/j.jcrs.2012.03.034.

ASLANIDES I M MUKHERJEE A N Adjuvant corneal crosslinking to prevent hyperopic LASIK regression Clin Ophthalmol Auckl N Z 2013 7 637 641 10.2147/OPTH.S39796 ASLANIDES I M, MUKHERJEE A N. Adjuvant corneal crosslinking to prevent hyperopic LASIK regression[J]. Clin Ophthalmol Auckl N Z, 2013, 7: 637-641. DOI:10.2147/OPTH.S39796.

NG A L K KWOK P S K WU R T K Comparison of the demarcation line on ASOCT after simultaneous LASIK and different protocols of accelerated collagen crosslinking: a bilateral eye randomized study Cornea 2017 36 1 74 77 10.1097/ICO.0000000000001012 NG A L K, KWOK P S K, WU R T K, et al . Comparison of the demarcation line on ASOCT after simultaneous LASIK and different protocols of accelerated collagen crosslinking: a bilateral eye randomized study[J ] . Cornea, 2017, 36(1): 74-77. DOI:10.1097/ICO.0000000000001012.

浏览量

下载量

CSCD

文章被引用时，请邮件提醒。

提交

工具集

关联资源

全飞秒小切口角膜基质透镜取出术联合快速角膜交联治疗薄角膜中高度近视的临床观察

应用智能眼镜监测学龄儿童用眼行为的效果分析

青少年配戴角膜塑形镜偏心量对眼轴影响的临床研究

应用CorVis ST评估不同屈光状态儿童的角膜生物力学特性