| Objective:Femtosecond laser-assisted excimer laser in situ keratomileusis?femtosecond laser-assisted in situ keratomileusis,FS-LASIK?is the current mainstream surgical procedure for corneal refractive surgery[1].The range of corneal flaps that can be set by femtosecond laser is wider than that of corneal lamellar flaps[2],but there is no unified standard for how to set the thickness of the corneal flap according to the patient's original refractive state and corneal structure.In this study,FS-LASIK was used to treat refractive error by setting corneal flaps of different thicknesses on the same patient's eyes,and the clinical efficacy and visual quality of the postoperative observation were observed.The clinical effect and surgical safety of FS-LASIK in correcting refractive error were investigated.The effect of corneal flaps of different thickness on the surgical effect,and further analysis of the possible causes and mechanism of these changes,in order to provide a clinical basis for the choice of corneal flap thickness in FS-LASIK surgery.Methods:A prospective randomized controlled study design was used.A total of 27patients?54 eyes?with refractive errors who planned to receive FS-LASIK in the outpatient excimer laser treatment center of our hospital from September 2018 to August 2019 were collected.The average age of the patients was 21.15±4.588 years old;5 women?18.5%?,22 males?81.5%?,preoperative equivalent spherical degree1.5D?6.0D.Each patient's eyes were divided into a thick corneal flap group and a thin corneal flap group with a difference of 15?m by a random number table method,each with 27 eyes.The corneal flap was made using the German Eagle Vision FS200femtosecond laser system,and the preoperative gender,age,refractive status,best corrected visual acuity?BVCA?,intraocular pressure?IOP?,corneal curvature,Eye parameters such as corneal thickness,follow-up records of naked eye vision,corneal curvature,intraocular pressure,and equivalent spherical degree at 1 day,1 week,1month,3 months,and half a year after operation.Compare thick corneal flap groups The changes of the results before and after the operation in the thin corneal flap group and the changes between the two groups.For the naked eye vision and eye in the same group before and after operation 1 day,1 week,1 month,3 months,half a year The changes in pressure and corneal curvature were compared,and the changes in naked eye vision,intraocular pressure,and corneal curvature at the same time node between the two groups of operations were compared.Postoperative complications and clinical complications of FS-LASIK with different thickness corneal flaps made by the same patient were discussed.Efficacy,analysis of the long-term clinical efficacy stability of FS-LASIK.SPSS20.0 software was used for statistical analysis of the data,P<0.05 was statistically significant.Results:There was no statistically significant difference between the two groups of patients in terms of age,gender,pre-operative refractive status,best corrected visual acuity,intraocular pressure,corneal curvature,and corneal thickness?P>0.05?.Thin and thick corneal flaps before and after operation,1 day,1 week,1 month,3 months,half a year,equivalent spherical degree?0.70±0.37,0.74±0.54,0.56±0.40,0.65±0.55,0.61±0.38,0.57±0.34,0.56±0.34,0.47±0.30,0.57±0.26,0.54±0.34?,intraocular pressure?11.11±3.51mmHg,9.674±2.99mm Hg,11.285±2.61mmHg,9.674±2.99mmHg,11.29±2.61mmHg,10.19±2.28mmHg,9.59±1.56mm Hg,9.52±1.66mmHg?,corneal curvature?39.19±1.88,39.27±1.89,39.24±1.86,39.06±1.65,39.18±1.76,39.13±1.65,39.21±1.61 39.30±1.57,39.19±1.77,39.35±1.66?The difference is significant.Repeated analysis of variance analysis results showed that the equivalent spherometry,intraocular pressure,and corneal curvature at different times were higher than those before surgery?3.85±1.20,3.78±1.01?,intraocular pressure?14.48±2.50mmHg,14.48±2.10mmHg?,corneal curvature?42.56±1.37,42.56±1.19?have decreased,the best postoperative corrected visual acuity?-0.004±0.043,-0.011±0.051,-0.038±0.056,-0.033±0.055,-0.063±0.069,-0.056±0.070,-0.041±0.058,-0.041±0.064,-0.052±0.051,-0.044±0.051?the thinner and thicker valve group had the best corrected visual acuity?0.004±0.192,0.004±0.019?before surgery.The difference was statistically significant?P<0.05?.In half a year,the naked eye vision reached or exceeded 100%of the best corrected visual acuity before surgery.In repeated-measures analysis of variance,the interaction between groups,time,and groups had no statistically significant effect?P<0.05?.In the experiment,one case?95?m,thin-valve group?had subconjunctival hemorrhage on the first postoperative day.1.After symptomatic treatment,hemorrhagic absorption during one week postoperative follow-up.Conclusion:Femtosecond laser-assisted excimer laser in situ keratomileusis has satisfactory visual recovery effect.The clinical effect of FS-LASIK with different thickness corneal flaps made by both eyes of the same patient is stable,and the safety of corneal flaps as thin as 90?m can also be guaranteed.There is an effect,but the difference is not statistically significant,suggesting that the corneal laser response of patients with thin corneal flaps may be more obvious and more likely to have biomechanical benefits. |
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