关键词: 中高度远视, 透镜植入, 透镜取出, 角膜上皮重塑

Abstract: Objective To investigate corneal epithelial remodeling after small incision lenticule extraction (SMILE) for moderate-high myopia and femtosecond laser-assisted microincision lenticule implantation for moderate-high hyperopia. Design retrospective comparative case series. Participants  15 patients (20 eyes) with moderate-high hyperopia who underwent femtosecond laser-assisted micro-incision lenticule implantation (lenticule implantation group), and 61 patients (115 eyes) with moderate-high myopia who underwent femtosecond laser-assisted micro-incision lenticule extraction (lenticule extraction group) were enrolled in Jinan Mingshui Eye Hospital from February 2021 to September 2022. Methods The Pachymetry mode of OCT (RTVue) was used to scan the corneal epithelial thickness values in each quadrant of the cornea before and 3~12 months after the surgery. Main Outcome Measures Corneal epithelial thickness in each quadrant. Results At the last follow-up, the epithelial thinning is more obvious in the lenticule implantation group within 5mm diameter, and the epithelial thickness is more significant in the lenticule extraction group within 7 mm diameter. Within the diameter of 5mm, the changes of corneal epithelial thickness were statistically significant (all P<0.05), and there was no significant difference between the two groups. Conclusions The epithelium of the lenticule implantation group was thinner than that before surgery, and the overall “concave lens” change was observed. The epithelium of the SMILE group was thicker than that before surgery, showing a “convex lens” change. The degree of epithelial remodeling was similar in the two groups. (Ophthalmol CHN, 2024, 33: 212-217)

Key words:  moderate-high hyperopia, lenticule implantation, lenticule extraction, remodeling of the corneal epithelium