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Postoperative corneal biomechanics and influencing factors during femtosecond-assisted laser in situ keratomileusis (FS-LASIK) and laser-assisted subepithelial keratomileusis (LASEK) for high myopia

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Abstract

The purpose of this study is to compare the postoperative corneal biomechanics and assess the influence factors after femtosecond-assisted laser in situ keratomileusis (FS-LASIK) and laser-assisted subepithelial keratomileusis (LASEK) for high myopia. In this retrospective study, patients who completed 1-year follow-up were included. The corneal biomechanical parameters, including deformation amplitude ratio 2.0 mm (DA ratio 2.0 mm), integrated inverse radius (IntInv Rad), stiffness parameter at first applanation (SP-A1), and Ambrosio relational thickness through the horizontal meridian (ARTh), were measured with Corvis STII. We also investigated the relationship between these biomechanics and preoperative or intraoperative variables. Thirty eyes had FS-LASIK and 30 eyes had LASEK. The changes in DA ratio 2.0 mm, IntInv Rad, and SP-A1 after surgery were significantly smaller in the LASEK group than in the FS-LASIK group, while the change in the ARTh was not significantly different between groups. No significant differences were detected in the mean values of postoperative DA ratio 2.0 mm, IntInv Rad, and SP-A1 between LASEK and FS-LASIK, while significant difference was detected in the mean value of postoperative ARTh. There was a significant correlation between the resident stromal bed thickness and the postoperative DA ratio 2.0 mm, IntInv Rad, or SP-A1. The postoperative ARTh has shown significant correlation with postoperative central corneal thickness and the amount of myopic correction. The effect of LASEK on corneal biomechanics was smaller than FS-LASIK when the same central corneal thickness was consumed. LASEK may be performed with a lower risk of postoperative corneal ectasia than FS-LASIK.

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Abbreviations

FS-LASIK:

femtosecond-assisted laser in situ keratomileusis

LASEK:

laser-assisted subepithelial keratomileusis

DA ratio 2.0 mm:

deformation amplitude ratio 2.0 mm

IntInv Rad:

integrated inverse radius

SP-A1:

stiffness parameter at first applanation

ARTh:

Ambrosio relational thickness through the horizontal meridian

PRK:

photorefractive keratectomy

LASIK:

laser-assisted in situ keratomileusis

FS:

femtosecond

SMILE:

small incision lenticule extraction

CCT:

central corneal thickness

MSE :

manifest spherical equivalent

LSD:

least significant difference

RSB:

residual stromal bed

Km:

average of the steepest and flattest meridians

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Acknowledgements

The authors thank Ping Lin for her linguistic and editorial assistance.

Availability of data and material

The data used to support the findings of this study are available from the corresponding author or the first author upon request.

Code availability

Not applicable for this section.

Funding

This work was supported by the National Natural Science Foundation of China (81870639, 81530027), the Taishan Scholar Program (20150215, 201812150), and the Innovation Project of Shandong Academy of Medical Sciences.

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Authors and Affiliations

  1. Eye Hospital of Shandong First Medical University, 372 Jingsi Road, Jinan, 250021, China

    Mingna Liu, Weiyun Shi, Xin Liu, Na Li, Tong Chen & Hua Gao

  2. State Key Laboratory Cultivation Base Eye Institute, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China

    Mingna Liu, Weiyun Shi, Xin Liu, Na Li, Tong Chen & Hua Gao

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  1. Mingna Liu
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  2. Weiyun Shi
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  3. Xin Liu
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  4. Na Li
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  5. Tong Chen
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  6. Hua Gao
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Xin Liu, Na Li, and Tong Chen. The first draft of the manuscript was written by Mingna Liu and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Hua Gao.

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Ethics approval

The study was approved by the Institutional Review Board of the Eye Hospital of Shandong First Medical University.

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The authors declared that all patients provided written informed consent in the study.

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The authors declared that all patients provided written informed consent for their medical information to be included in the study. All the authors listed have approved the publication of the paper.

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The authors declare no competing interests.

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Liu, M., Shi, W., Liu, X. et al. Postoperative corneal biomechanics and influencing factors during femtosecond-assisted laser in situ keratomileusis (FS-LASIK) and laser-assisted subepithelial keratomileusis (LASEK) for high myopia. Lasers Med Sci 36, 1709–1717 (2021). https://doi.org/10.1007/s10103-021-03320-2

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