研究目的
This study compares the posterior corneal elevation and corneal biomechanics after small incision lenticule extraction (SMILE) and laser-assisted subepithelial keratomileusis (LASEK) for myopia correction in a short- and long-term observation.
研究成果
Both SMILE and LASEK procedures safely alter corneal posterior elevation and biomechanics, with SMILE showing less biomechanical impact per unit tissue removed in the short term, but effects become comparable long-term. No ectasia occurred, indicating safety. Future research should explore underlying mechanisms through methods like microscopy.
研究不足
The study is non-randomized, which may introduce selection bias. The sample size is relatively small (32 per group), and the follow-up period of 3 years may not capture very long-term effects. Measurements have inherent errors, e.g., Pentacam's error range of ±5.0 μm. The mechanisms behind observed changes are not fully elucidated and require further investigation.
1：Experimental Design and Method Selection:
A prospective, non-randomized study design was used to compare SMILE and LASEK procedures. Corneal tomography and biomechanical assessments were performed using Pentacam and ORA devices.
2：Sample Selection and Data Sources:
64 patients (32 per group) aged 18-40 years with stable myopia were recruited from the Eye and ENT Hospital of Fudan University. Inclusion criteria included stable refractive error and sufficient residual bed thickness; exclusion criteria included poor visual acuity or ocular diseases.
3：List of Experimental Equipment and Materials:
Pentacam (Oculus, Inc.), Ocular Response Analyzer (ORA, Reichert, Inc.), VisuMax femtosecond laser system (Carl Zeiss Meditec), Mel 80 excimer laser (Carl Zeiss Meditec), crescent blade (Model 52424A, 66vision Tech Co., Ltd.), bandage contact lens (ACUVE OASYS, Johnson & Johnson, Inc.), topical medications (Fluorometholone
4：1%, Tobramycin 003%, Tears Naturale). Experimental Procedures and Operational Workflow:
Pre-operative examinations included Pentacam and ORA measurements. Surgical procedures: SMILE used VisuMax laser for lenticule extraction; LASEK involved epithelial flap creation with ethanol, ablation with Mel 80 laser, and flap repositioning. Post-operative care included medications and follow-up examinations at 3 months and 3 years.
5：Data Analysis Methods:
Statistical analysis used SPSS 20.0 software. Normality tests, t-tests, Mann-Whitney tests, and repeated measures ANOVA with Bonferroni correction were applied. Significance was set at p < 0.05.
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Tobramycin
0.003%
Alcon Laboratories, Inc.
Topical antibiotic medication used post-operatively to prevent infection.
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Pentacam
Oculus, Inc.
Used for corneal tomography to evaluate corneal posterior central elevation (PCE), posterior mean elevation (PME), corneal back power (Kb), anterior chamber depth (ACD), and corneal volume (CV).
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Ocular Response Analyzer
ORA
Reichert, Inc.
Used to measure intraocular pressure (IOP), corneal hysteresis (CH), corneal resistance factor (CRF), corneal compensated IOP (IOPcc), and Goldmann-correlated IOP (IOPg).
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VisuMax femtosecond laser system
Carl Zeiss Meditec
Used for SMILE treatments to create and extract lenticule from corneal tissue.
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Mel 80 excimer laser
Carl Zeiss Meditec
Used for LASEK treatments to ablate corneal stromal tissue.
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Crescent blade
52424A
66vision Tech Co., Ltd.
Used to peel back the corneal epithelial flap in LASEK surgery.
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Bandage contact lens
ACUVE OASYS
Johnson & Johnson, Inc.
Inserted after LASEK surgery to protect the eye during healing.
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Fluorometholone
0.1%
Santen Pharmaceutical Co., Ltd.
Topical steroid medication used post-operatively to reduce inflammation.
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Tears Naturale
Alcon Laboratories, Inc.
Eye drops containing hypromellose 2910, dextran 70, glycerol, used for lubrication post-operatively.
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SPSS
20.0
SPSS, Inc.
Software used for statistical analysis of the data.
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