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首页> 美国卫生研究院文献>International Journal of Environmental Research and Public Health >Differences in Simulated Refractive Outcomes of Photorefractive Keratectomy (PRK) and Laser In-Situ Keratomileusis (LASIK) for Myopia in Same-Eye Virtual Trials
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Differences in Simulated Refractive Outcomes of Photorefractive Keratectomy (PRK) and Laser In-Situ Keratomileusis (LASIK) for Myopia in Same-Eye Virtual Trials

机译：同眼虚拟试验中近视眼屈光性角膜切除术（PRK）和激光原位角膜磨镶术（LASIK）的模拟屈光结果差异

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摘要

The use of computational mechanics for assessing the structural and optical consequences of corneal refractive procedures is increasing. In practice, surgeons who elect to perform PRK rather than LASIK must often reduce the programmed refractive treatment magnitude to avoid overcorrection of myopia. Building on a recent clinical validation study of finite element analysis (FEA)-based predictions of LASIK outcomes, this study compares predicted responses in the validated LASIK cases to theoretical PRK treatments for the same refractive error. Simulations in 20 eyes demonstrated that PRK resulted in a mean overcorrection of 0.17 ± 0.10 D relative to LASIK and that the magnitude of overcorrection increased as a function of attempted correction. This difference in correction closely matched (within 0.06 ± 0.03 D) observed differences in PRK and LASIK from a historical nomogram incorporating thousands of cases. The surgically induced corneal strain was higher in LASIK than PRK and resulted in more forward displacement of the central stroma and, consequently, less relative flattening in LASIK. This FE model provides structural confirmation of a mechanism of action for the difference in refractive outcomes of these two keratorefractive techniques, and the results were in agreement with empirical clinical data.
机译：用于评估角膜屈光手术的结构和光学后果的计算力学的使用正在增加。在实践中，选择执行PRK而不是LASIK的外科医生必须经常减少编程的屈光治疗幅度，以避免近视矫正过度。基于最近的基于有限元分析（FEA）的LASIK结局预测的临床验证研究，该研究比较了在相同屈光误差的情况下，将经过验证的LASIK病例与理论PRK治疗的预测反应进行了比较。在20只眼中进行的仿真表明，相对于LASIK，PRK导致平均过校正量为0.17±0.10 D，并且过校正量随尝试校正的程度而增加。这种校正差异非常匹配（在0.06±0.03 D之内），从包含数千个案例的历史列线图中观察到PRK和LASIK的差异。 LASIK手术引起的角膜应变高于PRK，导致中央基质的向前移位更多，因此LASIK的相对扁平度较小。该FE模型为这两种屈光屈光技术的屈光结果差异提供了一种作用机理的结构确认，其结果与临床经验数据相符。

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