A Comparative Study Of The Effects Of SPT-TransPRK Versus SMILE On Dry Eye Parameters For Moderate Myopia

Purpose To compare and observe the difference of dry eye parameters after the treatment of moderate myopia with the intelligent pulse technology-assisted transepithelial excimer laser keratectomy(SPT-Trans PRK)and femtosecond laser small incision stromal lens extraction(SMILE)in 6 months postoperatively.Methods A prospective non-randomized controlled study.Moderate myopia patients who underwent corneal laser refractive surgery were screened at the Third People’s Hospital of Dalian,affiliated to Dalian Medical University,including 27 patients(54 eyes)who underwent SPT-Trans PRK surgery and 21 patients(42 eyes)who underwent SMILE surgery from December 2021 to April 2022.They were divided into SPT-Trans PRK group and SMILE group according to different surgical procedures.After 6 months of followup,dry eye parameters such as the corneal fluorescence staining scores,non-invasive break-up time(NIBUT),non-invasive average break-up time(NIAvg-BUT),Schirmer I test(SIT),ocular surface disease index(OSDI)questionnaire scores and uncorrected visual acuity,best corrected visual acuity,diopter of the two groups of patients were collected before and 1,3 and 6 months after surgery.The dry eye parameters of the two groups were compared.For the measurement data between the two groups after the operation,the Shapiro-Wilk test was used for the measurement data,the independent sample t test was used for the normal distribution,the rank sum test was used for the skewed distribution.The rank sum test was used for the count data between the two groups after operation,the inspection level α is 0.05.The measurement data in the two groups after operation were tested by generalized estimation equation,the inspection levelα is 0.05,and the count data were tested by rank sum test with recalculated inspection level 、=0.0083.Results There was no significant difference in corneal fluorescence staining score between SPT-Trans PRK group and SMILE group before operation and 1,3,6months postoperatively(P>0.05).There was no significant difference in corneal fluorescence staining score in SPT-Trans PRK group between 1 month postoperatively and before operation(P>0.0083).The corneal fluorescence staining score of SMILE group increased at 1 month postoperatively compared with that before operation,and the difference was statistically significant(P<0.0083).For both groups,there was no significant difference in corneal fluorescence staining at 3 and 6 months postoperatively compared with that before operation(P>0.0083).There was no significant difference in NIBUT,NIAvg-BUT,SIT between SPT-Trans PRK group and SMILE group before and 1,3 and 6 months after operation(P>0.05).The NIBUT,NIAvg-BUT and SIT in both group decreased in different degrees at 1 month after operation compared with those before operation.In SPT-Trans PRK group,NIBUT,NIAvg-BUT and SIT at 1 month after operation were significantly different from those before operation(P<0.05),there was no significant difference in NIBUT,NIAvg-BUT and SIT between 1 month after operation and before operation in SMILE group(P>0.05).There was no significant difference in NIBUT,NIAvg-BUT and SIT in the two groups at 3 and 6 months postoperatively(P>0.05).There was no significant difference in OSDI scores between the two groups before and 1,3 and6 months after operation(P>0.05).There was no significant difference in OSDI scores for SPT-Trans PRK group at 1,3 and 6 months postoperatively compared with that before operation(P>0.0083).There was significant difference in OSDI scores for the SMILE group at 1month postoperatively compared with that before operation(P<0.0083),and there was no significant difference in OSDI scores at 3 and 6 months postoperatively compared with that before operation(P>0.0083).Conclusion Both SPT-Trans PRK and SMILE can lead to dry eye.The degree of dry eye is similar between SPT-Trans PRK and SMILE within 6 months after surgery.At 1 month postoperatively,both groups showed different degrees of corneal epithelial tissue staining,decreased tear film stability,decreased tear secretion and subjective discomfort symptoms.The recovery of objective dry eye parameters within 1 month after SMILE was faster than that after SPT-Trans PRK.The dry eye parameters of the two groups recovered to the preoperative level 3 months postoperatively.