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To compare the early change of posterior corneal elevation with femtosecond laser assisted laser in situ keratomileusis (FS-LASIK) and sub-Bowman keratomileusis (SBK) by Oculyzer and analyze the related factors after FS-LASIK.
A longitudinal observational study was designed.Ninety-one eyes of 46 patients with myopia or myopic astigmatism in the First Affiliated Hospital of Anhui Medical University from January to April in 2016 were divided into FS-LASIK group (53 eyes of 27 patients), SBK group (38 eyes of 19 patients) according to the patients’ wishes and each part of corneal elevation change values were explored after FS-LASIK and SBK surgeries.The posterior corneal elevation was measured at twenty-seven measuring points along the central, paracentral, midperipheral and peripheral zone (vertex and 1, 2 and 3 mm radius) using Oculyzer preoperatively, l day, 7 days and 1 month postoperatively, respectively.Written informed consent was obtained from each patient before the surgery.
In the FS-LASIK group, the posterior corneal elevation difference values in the central zone were (-0.924±1.859), (-1.151±1.586) and (-0.940±1.994)μm 1 day, 7 days and 1 month postoperatively, respectively.In the periphery zone, the elevation difference values were (1.046±1.667), (1.172±1.566) and (1.023±1.622)μm.In the paracentral and midperipheral zone, the cornea displayed slightly backward or forward shift.In SBK group, the posterior corneal elevation difference values of the vertex were (-0.684±1.454), (-1.053±1.723) and (-0.553±1.572)μm 1 day, 7 days and 1 month after operation, respectively.In the paracentral and midperipheral zone displayed the same trend with FS-LASIK group, and in the periphery, the values were (1.207±1.317), (1.327±1.529) and (1.208±1.415)μm.There were no statistically significant differences in posterior corneal elevation between the two surgery modes among the three time points (all at P>0.05). At 1 month postoperatively, only two independent variables, which were spherical equivalent (SE) and ablation depth (AD) entered the regression in the central and paracentral zones.Independent variables, such as central thinnest corneal thickness (TCT), SE, AD, residual bed thickness (RBT) and the ratio of AD and TCT (AD/TCT) did not enter the regression in other two areas.
The posterior corneal elevation in the central 6 mm area shows tiny change in the early stage and the variation is larger 7 days after operation in the two groups, but it does not result in keratectasia.With the increase of SE and AD, the posterior corneal elevation is more likely to be affected.