FS-LASIK与SMILE对近视患者术后早期角膜生物力学影响的差异OA

·AIM:To evaluate corneal biomechanical changes before surgery and different postoperative time in patients with varying degrees of myopia undergoing either femtosecond laser in situ keratomileusis(FS-LASIK)or small incision lenticule extraction(SMILE)procedures by ocular response analyzer(ORA),and to investigate potential differences in how these two surgical techniques and varying degrees of myopia affect corneal biomechanical properties. ·METHODS:Case series study.A total of 132 eyes that underwent FS-LASIK or SMILE surgery at Lanzhou Huaxia Eye Hospital between December 2023 and June 2024 were enrolled.Based on the surgical procedure,they were categorized into FS-LASIK and SMILE groups and further stratified into a high myopia group(-10.00 D<SE≤-6.00 D)and a moderate-to-low myopia group(-6.00 D<SE≤-0.50 D)according to spherical equivalent(SE).Changes in parameters including uncorrected visual acuity(UCVA),best-corrected visual acuity(BCVA),SE,central corneal thickness(CCT),cornea-compensated intraocular pressure(IOPcc),corneal hysteresis(CH),and corneal resistance factor(CRF)were compared among groups at different postoperative time. ·RESULTS:The corneal biomechanical status in the FS-LASIK group and the SMILE group was well comparable.At 3 mo postoperatively,both the FS-LASIK and SMILE groups showed a significant increase in SE compared with preoperative values,whereas UCVA,CCT,and IOPcc were significantly decreased(all P<0.05).No statistically significant differences were observed in these parameters between the two groups(all P>0.05).At 1 d after surgery,both CH and CRF decreased significantly in the FS-LASIK and SMILE groups(all P<0.05).The reduction was more pronounced in the FS-LASIK group than in the SMILE group(P<0.05).By 1 and 3 mo postoperatively,CH and CRF in both groups exhibited recovery relative to early postoperative levels and tended to stabilize,though they remained lower than preoperative values(all P<0.05).Furthermore,the FS-LASIK group had lower CH and CRF than the SMILE group at these time points(all P<0.05).Within the SMILE group,the high myopia subgroup demonstrated more pronounced decreases in CH and CRF at 1 d and 1 wk after surgery compared with the moderate-to-low myopia subgroup(all P<0.05). ·CONCLUSION:Both FS-LASIK and SMILE procedures demonstrated good safety,predictability,and effectiveness postoperatively.However,both techniques resulted in reduced corneal biomechanical parameters,with FS-LASIK causing a more significant decrease.In the early postoperative period,patients in the high myopia group showed a more pronounced reduction in corneal biomechanics.By 3 mo after surgery,no statistically significant difference was observed in the effect of myopia degree on corneal biomechanical properties.