AbstractRefractive error is becoming a significant public health issue. Photorefractive Keratectomy (PRK) is a corneal surface surgical technique that removes the corneal epithelium before stromal photoablation by ultraviolet radiation from the Excimer laser. We designed a retrospective study to characterize corneal remodeling after myopic Photorefractive Keratectomy and assess the accuracy of laser-predicted ablation depth (AD).

摘要屈光不正成为一个重要的公共卫生问题。屈光性角膜切削术（PRK）是一种角膜表面手术技术，通过准分子激光的紫外线辐射在基质光消融之前去除角膜上皮。我们设计了一项回顾性研究，以表征近视屈光性角膜切削术后的角膜重塑，并评估激光预测消融深度（AD）的准确性。

This study took place in 15–20 National Ophthalmology Hospital, Paris, France. 150 eyes with preoperative manifest spherical equivalent between − 10.00D and − 0.25D and cylinder < 3D, treated with the WaveLight® EX500 laser between 01/2019 and 01/2023, were followed for at least three months. The main outcome measurements were postoperative changes in epithelial (ET) and stromal (ST) thicknesses measured with spectral domain optical coherence tomography and mean simulated keratometry (SimK) assessed with corneal topography.

这项研究发生在法国巴黎15-20国家眼科医院。在2019年1月至2023年1月期间，用WaveLight®EX500激光治疗了150只眼，术前表现为球形当量在-10.00D和-0.25D之间，圆柱体<3D，随访至少三个月。主要结果测量是用光谱域光学相干断层扫描测量的上皮（ET）和基质（ST）厚度的术后变化，以及用角膜地形图评估的平均模拟角膜曲率（SimK）。

The central ET significantly decreased at M1, increased over the preoperative value from M1 to M6, and stabilized after M6. The increase in central ET after M1 was associated with an increase in mean SimK (r = 0.34). The achieved AD was 7.9 ± 8.0 µm greater than the laser-predicted AD. Stromal over-ablation was significantly and independently associated with myopia > 6D preoperative mean SimK > 44D and transepithelial procedures..

中央ET在M1时显着降低，从M1到M6比术前值增加，M6后稳定。M1后中枢ET的增加与平均SimK的增加有关（r=0.34）。达到的AD比激光预测的AD大7.9±8.0µm。基质过度消融与近视>6D术前平均SimK>44D和跨上皮手术显着且独立相关。。

IntroductionRefractive error is a leading cause of reversible visual impairment1. The incidence of myopia is currently increasing worldwide2. It is becoming a significant public health issue, with billions of people (i.e., 49.8% of the world population) estimated to be affected by this condition by 20503.

引言屈光不正是可逆性视力障碍的主要原因1。目前，近视的发病率在全球范围内不断增加2。它正在成为一个重大的公共卫生问题，到20503年，估计有数十亿人（即世界人口的49.8%）受到这种情况的影响。

The effect of refractive surgery on patients extends beyond spectacle independence, with the procedure leading to improved quality of life, better working ability, and improved daily working performance4. Photorefractive Keratectomy (PRK) was developed four decades ago and improved with time5. It is a corneal surface surgical technique that removes the corneal epithelium before stromal photoablation by ultraviolet radiation from the Excimer laser (an acronym for Excited Dimer).

屈光手术对患者的影响超出了眼镜的独立性，手术可以改善生活质量，提高工作能力，改善日常工作表现4。屈光性角膜切除术（PRK）是四十年前开发的，随着时间的推移而改进5。它是一种角膜表面手术技术，通过准分子激光（激发二聚体的缩写）的紫外线辐射在基质光消融之前去除角膜上皮。

It has been established as a reasonably safe procedure producing excellent visual outcomes6,7. The WaveLight® EX500 excimer laser (Alcon Laboratories®, Fort Worth, TX, USA) is a well-known platform for refractive surgery8. This platform proposes an estimation of the residual stroma after treatment9.

它已被确立为一种合理安全的程序，可产生出色的视觉效果6,7。WaveLight®EX500准分子激光器（Alcon Laboratories®，Fort Worth，TX，USA）是一种众所周知的屈光手术平台8。该平台提出了治疗后残留基质的估计9。

Post-treatment residual stromal bed (RSB) thickness is associated with the risk of postoperative corneal ectasia10,11. While wound healing after PRK has been well characterized12, very little data are available concerning its implications on keratometry and spherical equivalents. The WaveLight® EX500 estimation of residual stroma after treatment has never been evaluated after PRK11,13.This study aims to describe the natural corneal remodeling after myopic treatment and its consequences on refraction.

治疗后残留基质床（RSB）厚度与术后角膜扩张的风险相关10,11。虽然PRK后的伤口愈合已得到很好的表征12，但关于其对角膜曲率和球形等效物的影响的数据很少。治疗后残留基质的WaveLight®EX500估计从未在PRK11,13之后进行过评估。本研究旨在描述近视治疗后的自然角膜重塑及其对屈光的影响。

It also compares the OCT measurement of the RSB after myopic treatment with the pre-treatment estimation provided by the WaveLight® EX500 laser.Material and methodsStudy designThis retrospective study wa.

它还将近视治疗后RSB的OCT测量值与WaveLight®EX500激光器提供的治疗前估计值进行了比较。材料和方法研究设计这项回顾性研究。

Data availability

数据可用性

The datasets analysed during the current study are available from the corresponding author on reasonable request.

本研究期间分析的数据集可根据合理要求从通讯作者处获得。

References:Global causes of blindness and distance vision impairment 1990–2020: a systematic review and meta-analysis - The Lancet Global Health. https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(17)30393-5/fulltext.Shinojima, A., Negishi, K., Tsubota, K. & Kurihara, T. Multiple factors causing myopia and the possible treatments: A mini review.

参考文献：1990-2020年全球失明和远视障碍的原因：系统评价和荟萃分析-柳叶刀全球健康。https://www.thelancet.com/journals/langlo/article/PIIS2214-109X（17） 30393-5/全文。Shinojima，A.，Negishi，K.，Tsubota，K。＆Kurihara，T。引起近视的多种因素和可能的治疗方法：迷你评论。

Front. Public Health https://doi.org/10.3389/fpubh.2022.897600 (2022).Article .

前面。公共卫生https://doi.org/10.3389/fpubh.2022.897600(2022).第条。

PubMed

PubMed

PubMed Central

公共医学中心

Google Scholar

谷歌学者

Holden, B. A. et al. Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050. Ophthalmology 123, 1036–1042 (2016).Article

Holden，B.A.等人，《2000年至2050年全球近视和高度近视患病率及时间趋势》。眼科1231036-1042（2016）。文章

PubMed

PubMed

Google Scholar

谷歌学者

Sugar, A., Hood, C. T. & Mian, S. I. Patient-reported outcomes following LASIK: Quality of life in the PROWL studies. JAMA 317, 204–205 (2017).Article

Sugar，A.，Hood，C.T。＆Mian，S.I。患者报告了LASIK术后的结果：潜行研究中的生活质量。JAMA 317204–205（2017）。文章

PubMed

PubMed

Google Scholar

谷歌学者

Trokel, S. L., Srinivasan, R. & Braren, B. Excimer laser surgery of the cornea. Am. J. Ophthalmol. 96, 710–715 (1983).Article

Trokel，S.L.，Srinivasan，R。＆Braren，B。角膜准分子激光手术。美国眼科杂志。96710-715（1983）。文章

CAS

中科院

PubMed

PubMed

Google Scholar

谷歌学者

Hersh, P. S. et al. Results of phase III excimer laser photorefractive keratectomy for myopia. Ophthalmology 104, 1535–1553 (1997).Article

Hersh，P.S.等人。III期准分子激光屈光性角膜切削术治疗近视的结果。眼科1041535-1553（1997）。文章

CAS

中科院

PubMed

PubMed

Google Scholar

谷歌学者

Wen, D. et al. postoperative efficacy, predictability, safety, and visual quality of laser corneal refractive surgery: A network meta-analysis. Am. J. Ophthalmol. 178, 65–78 (2017).Article

Wen，D。等人。激光角膜屈光手术的术后疗效，可预测性，安全性和视觉质量：网络荟萃分析。美国眼科杂志。178,65-78（2017）。文章

PubMed

PubMed

Google Scholar

谷歌学者

Mifflin, M. D., Betts, B. S., Nguyen, J. & Pouly, S. High myopic photorefractive keratectomy outcomes with the Alcon Wavelight® EX500 excimer laser. Clin. Ophthalmol. 12, 1041–1048 (2018).Article

Mifflin，M.D.，Betts，B.S.，Nguyen，J。＆Pouly，S。使用Alcon Wavelight®EX500准分子激光器进行高度近视光折变性角膜切削术的结果。临床。眼科。121041-1048（2018）。文章

CAS

中科院

PubMed

PubMed

PubMed Central

公共医学中心

Google Scholar

谷歌学者

Mifflin, M. D., Mortensen, X. M., Betts, B. S., Gross, C. & Zaugg, B. Accuracy of Alcon WaveLight® EX500 optical pachymetry during LASIK. Clin. Ophthalmol. 11, 1513–1517 (2017).Article

Mifflin，M.D.，Mortensen，X.M.，Betts，B.S.，Gross，C。＆Zaugg，B。Alcon WaveLight®EX500光学测厚术在LASIK期间的准确性。临床。眼科。111513-1517（2017）。文章

PubMed

PubMed

PubMed Central

公共医学中心

Google Scholar

谷歌学者

Randleman, J. B., Russell, B., Ward, M. A., Thompson, K. P. & Stulting, R. D. Risk factors and prognosis for corneal ectasia after LASIK. Ophthalmology 110, 267–275 (2003).Article

Randleman，J.B.，Russell，B.，Ward，M.A.，Thompson，K.P。＆Stulting，R.D。LASIK术后角膜扩张的危险因素和预后。眼科110267-275（2003）。文章

PubMed

PubMed

Google Scholar

谷歌学者

Randleman, B. J., Caster, A. I., Banning, C. S. & Stulting, D. R. Corneal ectasia after photorefractive keratectomy. J. Cataract Refract. Surg. 32, 1395 (2006).Article

Randleman，B.J.，Caster，A.I.，Banning，C.S。＆Stulting，D.R。角膜屈光性角膜切除术后的角膜扩张。J、 白内障折射。Surg.321395（2006）。文章

PubMed

PubMed

Google Scholar

谷歌学者

Fagerholm, P. Wound healing after photorefractive keratectomy. J. Cataract Refract. Surg. 26, 432 (2000).Article

Fagerholm，P。光折变性角膜切除术后的伤口愈合。J、 白内障折射。外科杂志26432（2000）。文章

CAS

中科院

PubMed

PubMed

Google Scholar

谷歌学者

Wilson, S. E. Biology of keratorefractive surgery- PRK, PTK, LASIK, SMILE, inlays and other refractive procedures. Exp. Eye Res. 198, 108136 (2020).Article

Wilson，S.E。角膜屈光手术生物学-PRK，PTK，LASIK，SMILE，嵌体和其他屈光手术。Exp.Eye Res.198108136（2020）。文章

ADS

广告

CAS

中科院

PubMed

PubMed

PubMed Central

公共医学中心

Google Scholar

谷歌学者

Sedaghat, M.-R. et al. Corneal epithelial thickness mapping after photorefractive keratectomy for myopia. J. Refract. Surg. 35, 632–641 (2019).Article

Sedaghat，M.-R.等人。近视屈光性角膜切削术后的角膜上皮厚度图。J、 折射。外科35632-641（2019）。文章

PubMed

PubMed

Google Scholar

谷歌学者

de Ortueta, D., von Rüden, D. & Arba-Mosquera, S. Refractive effect of epithelial remodelling in myopia after transepithelial photorefractive keratectomy. Vision (Basel) 6, 74 (2022).Article

de Ortueta，D.，von Rüden，D。＆Arba-Mosquera，S。经上皮光折变性角膜切除术后近视上皮重塑的屈光效应。愿景（巴塞尔）6，74（2022）。文章

PubMed

PubMed

Google Scholar

谷歌学者

Moshirfar, M. et al. Mechanisms of optical regression following corneal laser refractive surgery: Epithelial and stromal responses. Med. Hypothesis Discov. Innov. Ophthalmol 7, 1–9 (2018).PubMed

Moshirfar，M.等人。角膜激光屈光手术后光学退化的机制：上皮和基质反应。医学假说发现。因诺夫。眼科7,1-9（2018）。PubMed出版社

PubMed Central

公共医学中心

Google Scholar

谷歌学者

Shetty, R. et al. Early corneal and epithelial remodeling differences identified by OCT imaging and artificial intelligence between two transepithelial PRK platforms. J. Refract. Surg. 36, 678–686 (2020).Article

Shetty，R。等人。通过OCT成像和人工智能在两个跨上皮PRK平台之间鉴定的早期角膜和上皮重塑差异。J、 折射。外科杂志36678-686（2020）。文章

PubMed

PubMed

Google Scholar

谷歌学者

Chen, X. et al. postoperative changes in corneal epithelial and stromal thickness profiles after photorefractive keratectomy in treatment of myopia. J. Refract. Surg. 31, 446–453 (2015).Article

Chen，X。等人。屈光性角膜切削术治疗近视后角膜上皮和基质厚度的术后变化。J、 折射。Surg.31446-453（2015）。文章

PubMed

PubMed

Google Scholar

谷歌学者

Leccisotti, A. Corneal ectasia after photorefractive keratectomy. Graefe’s Arch Clin. Exp. Ophthalmol. 245, 869–875 (2007).Article

Leccisotti，A。光折变性角膜切除术后的角膜扩张。格雷夫的拱形诊所。。245869-875（2007）。文章

Google Scholar

谷歌学者

Febbraro, J.-L. et al. Comparison of laser platform estimation and objective measurement of maximum ablation depth using scheimpflug pachymetry in myopic femtosecond laser in situ keratomileusis. Cornea 39, 316–320 (2020).Article

Febbraro，J.-L.等人。近视飞秒激光原位角膜磨镶术中使用scheimpflug测厚仪进行激光平台估计和最大消融深度客观测量的比较。角膜39316-320（2020）。文章

PubMed

PubMed

Google Scholar

谷歌学者

Kanellopoulos, A. J., Georgiadou, S. & Asimellis, G. Objective evaluation of planned versus achieved stromal thickness reduction in myopic femtosecond laser-assisted LASIK. J. Refract. Surg. 31, 628–632 (2015).Article

Kanellopoulos，A.J.，Georgiadou，S。＆Asimellis，G。近视飞秒激光辅助LASIK中计划与实现的基质厚度减少的客观评估。J、 折射。Surg.31628-632（2015）。文章

PubMed

PubMed

Google Scholar

谷歌学者

Christiansen, S. M., Neuffer, M. C., Sikder, S., Semnani, R. T. & Moshirfar, M. The effect of preoperative keratometry on visual outcomes after moderate myopic LASIK. Clin. Ophthalmol. 6, 459–464 (2012).PubMed

Christiansen，S.M.，Neuffer，M.C.，Sikder，S.，Semnani，R.T。＆Moshirfar，M。术前角膜曲率测量对中度近视LASIK术后视力结果的影响。临床。眼科。6459-464（2012）。PubMed出版社

PubMed Central

公共医学中心

Google Scholar

谷歌学者

Shapira, Y. et al. Comparison of three epithelial removal techniques in PRK: Mechanical, alcohol-assisted, and transepithelial laser. J. Refract. Surg. 31, 760–766 (2015).Article

Shapira，Y.等人。PRK中三种上皮去除技术的比较：机械，酒精辅助和跨上皮激光。J、 折射。Surg.31760-766（2015）。文章

PubMed

PubMed

Google Scholar

谷歌学者

Borderie, M. et al. New parameters in assessment of human donor corneal stroma. Acta Ophthalmol. 95, e297–e306 (2017).Article

Borderie，M.等人。评估人类供体角膜基质的新参数。眼科学报。95，e297–e306（2017）。文章

PubMed

PubMed

Google Scholar

谷歌学者

Meek, K. M. & Knupp, C. Corneal structure and transparency. Progress Retinal Eye Res. 49, 1–16 (2015).Article

Meek，K.M。和Knupp，C。角膜结构和透明度。《视网膜眼研究进展》49,1-16（2015）。文章

Google Scholar

谷歌学者

Roy, A. S. & Dupps, W. J. Effects of altered corneal stiffness on native and postoperative LASIK corneal biomechanical behavior: A whole-eye finite element analysis. J. Refract. Surg. 25, 875–887 (2009).Article

Roy，A.S.＆Dupps，W.J.角膜僵硬度改变对LASIK术后角膜生物力学行为的影响：全眼有限元分析。J、 折射。Surg.25875-887（2009）。文章

Google Scholar

谷歌学者

Cao, H., Jhanji, V. & Wang, Y. Relationship between postoperative residual refractive error and preoperative corneal stiffness in small-incision lenticule extraction. J. Cataract Refract. Surg. 49, 942 (2023).PubMed

Cao，H.，Jhanji，V。＆Wang，Y。小切口晶状体摘除术后残余屈光不正与术前角膜僵硬之间的关系。J、 白内障折射。Surg.49942（2023）。PubMed出版社

Google Scholar

谷歌学者

Georgeon, C. et al. Corneal and epithelial thickness mapping: Comparison of swept-source- and spectral-domain-optical coherence tomography. J. Ophthalmol. 2021, 3444083 (2021).PubMed

Georgeon，C。等。角膜和上皮厚度映射：扫描源和光谱域光学相干断层扫描的比较。J、 眼科。。PubMed出版社

PubMed Central

公共医学中心

Google Scholar

谷歌学者

Download referencesAuthor informationAuthors and AffiliationsGroupe de Recherche Clinique #32, Transplantation Et Thérapies Innovantes de La Cornée, Sorbonne Université, Hôpital National des 15-20, Paris, FranceBenjamin Memmi, Juliette Knoeri, Loïc Leveziel, Cristina Georgeon, Nacim Bouheraoua & Vincent BorderieService d’ophtalmologie 5, Hôpital National des 15-20, 28 Rue de Charenton, 75012, Paris, FranceVincent BorderieAuthorsBenjamin MemmiView author publicationsYou can also search for this author in.

下载参考资料作者信息作者和附属机构临床研究组32，角膜移植和创新疗法，索邦大学，巴黎国家医院15-20，Francebenjamin Memmi，Juliette Knoeri，Loïc Leveziel，Cristina Georgeon，Nacim Bouheraoua&Vincent BorderieService d'Ophtalmologie 5，巴黎沙伦顿街28号，75012，francevincent borderieauthorsbenjamin memmiview作者出版物您也可以在中搜索此作者。

PubMed Google ScholarJuliette KnoeriView author publicationsYou can also search for this author in

PubMed Google ScholarJuliette KnoeriView作者出版物您也可以在

PubMed Google ScholarLoïc LevezielView author publicationsYou can also search for this author in

PubMed Google ScholarCristina GeorgeonView author publicationsYou can also search for this author in

PubMed Google ScholarCristina GeorgenView作者出版物您也可以在

PubMed Google ScholarNacim BouheraouaView author publicationsYou can also search for this author in

PubMed Google ScholarNacim BouheraouaView作者出版物您也可以在

PubMed Google ScholarVincent BorderieView author publicationsYou can also search for this author in

PubMed Google ScholarVincent BorderieView作者出版物您也可以在

PubMed Google ScholarContributionsContributions of authors: design of the study (B.M., V.B.); conduct of the study (B.M., J.K., L.L., C.G., N.B., V.B.); collection, management, analysis, and interpretation of data (B.M., C.G., J.K., N.B., V.B.); preparation, review, and approval of manuscript (B.M., J.K., L.L., N.B., V.B.).Corresponding authorCorrespondence to.

PubMed谷歌学术贡献作者贡献：研究设计（B.M.，V.B.）；进行研究（B.M.，J.K.，L.L.，C.G.，N.B.，V.B.）；数据的收集，管理，分析和解释（B.M.，C.G.，J.K.，N.B.，V.B.）；手稿的准备，审查和批准（B.M.，J.K.，L.L.，N.B.，V.B.）。对应作者对应。

Vincent Borderie.Ethics declarations

Vincent Borderie。道德宣言

Competing interests

相互竞争的利益

The authors declare no competing interests.

作者声明没有利益冲突。

Additional informationPublisher's noteSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.Rights and permissions

Additional informationPublisher的noteSpringer Nature在已发布地图和机构隶属关系中的管辖权主张方面保持中立。权限和权限

Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material.

开放获取本文是根据知识共享署名非商业性NoDerivatives 4.0国际许可证授权的，该许可证允许以任何媒介或格式进行任何非商业性使用，共享，分发和复制，只要您对原始作者和来源给予适当的信任，提供知识共享许可证的链接，并指出您是否修改了许可材料。

You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.

根据本许可证，您无权共享源自本文或其部分的改编材料。本文中的图像或其他第三方材料包含在文章的知识共享许可证中，除非该材料的信用额度中另有说明。如果材料未包含在文章的知识共享许可证中，并且您的预期用途未被法律法规允许或超出允许的用途，则您需要直接获得版权所有者的许可。

To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/..

要查看此许可证的副本，请访问http://creativecommons.org/licenses/by-nc-nd/4.0/..

Reprints and permissionsAbout this articleCite this articleMemmi, B., Knoeri, J., Leveziel, L. et al. Analysis of corneal remodeling post-myopic photorefractive keratectomy with the WaveLight® EX500 excimer laser.

转载和许可本文引用本文Memmi，B.，Knoeri，J.，Leveziel，L。等人用WaveLight®EX500准分子激光分析近视屈光性角膜切削术后的角膜重塑。

Sci Rep 14, 20888 (2024). https://doi.org/10.1038/s41598-024-71604-yDownload citationReceived: 01 February 2024Accepted: 29 August 2024Published: 07 September 2024DOI: https://doi.org/10.1038/s41598-024-71604-yShare this articleAnyone you share the following link with will be able to read this content:Get shareable linkSorry, a shareable link is not currently available for this article.Copy to clipboard.

。https://doi.org/10.1038/s41598-024-71604-yDownload引文接收日期：2024年2月1日接受日期：2024年8月29日发布日期：2024年9月7日OI：https://doi.org/10.1038/s41598-024-71604-yShare本文与您共享以下链接的任何人都可以阅读此内容：获取可共享链接对不起，本文目前没有可共享的链接。复制到剪贴板。

Provided by the Springer Nature SharedIt content-sharing initiative

由Springer Nature SharedIt内容共享计划提供

Subjects

主题

Corneal diseasesRefractive errors

角膜疾病屈光不正

CommentsBy submitting a comment you agree to abide by our Terms and Community Guidelines. If you find something abusive or that does not comply with our terms or guidelines please flag it as inappropriate.

评论通过提交评论，您同意遵守我们的条款和社区指南。如果您发现有虐待行为或不符合我们的条款或准则，请将其标记为不合适。