| Purpose: To compare the postoperative effect and visual quality after surgery of FS-LASIK and Trans PRK in low and moderate myopia patients,from the view of the subjective and objective.Methods: A prospective controlled study were carried out.From May 2019 to September 2019,91 patients(91 eyes,the right eye of each patient was selected as the observation eye.)of nearsightedness and astigmatism were collected,including 44 patients(44 eyes)who had undergone FS-LASIK and 47 patients(47 eyes)who had undergone Trans PRK.The efficacy and visual quality were measured preoperatively,1 month and 3 months postoperatively.The main examinations contain subjective visualquality and objective visual quality.The subjective visual quality includes uncorrected visual acuity(UCVA),best corrected visual acuity(BCVA)and national eye institute refractive error quality of life instrument(NEI-RQL-42).Standard logarithmic visual acuity chart was used in visual acuity examination,which was converted into log MAR during data analysis.Objective visual quality includes RMS of spherical aberration,coma and higher orders,strehl ratio(SR)and Q value on the anterior surface of the cornea under 6mm pupil diameter were collected by Sirius anterior analyzer(CSO,Italy).The difference graph of the tangential curvature of the anterior surface of the cornea was used to measure the postoperative effective optical zone.Statistical Methods: Statistical analysis was performed with SPSS(version 17.0,SPSS,Inc,Chicago,IL).Analysis of variance was used for objective visual quality parameters.The preoperative and postoperative scale scores and postoperative effect optical zone of the two groups were tested by Student’s t test.The relationship between postoperative effective optical zone and possible influencing parameters was analyzed by the Spearman correlation analysis.Results: 1.Vision and spherical equivalent Postoperative 1 month,UCVA FS-LASIK group was-0.0136±0.04,Trans PRK group was 0.085±0.05,and FS-LASIK group had better UCVA,with statistically significant difference(P=0.025).Postoperative 3 month,UCVA FS-LASIK group was-0.0318±0.05 and Trans PRK group-0.0149±0.06,showing no significant difference(P=0.105).Postoperative 1 month And postoperative 3 month,spherical equivalent(SE)FS-LASIK group were 0.238±0.43 D、0.1505± 0.34 D,Trans PRK group were 0.1436±0.44 D、0.104± 0.297 D,no statistically significant difference were observed in the two groups of each time point(P= 0.378,P= 0.383).2.Aberration Postoperative 1 month,the RMS of spherical aberration,coma and higher orders in the FS-LASIK group were 0.427±0.12μm,0.41±0.19 um and 0.706±0.17μm,and in the Trans PRK group were 0.315±0.16μm,0.300±0.14μm,0.594±0.17μm.Postoperative 3 month,the RMS of spherical aberration,coma and higher orders in the FS-LASIK group were 0.442±0.11μm,0.436±0.19μm and 0.707±0.18μm,and in the Trans PRK group were 0.362±0.18μm,0.319±0.17μm,and 0.609±0.26μm.The postoperative aberrations of the two groups were higher at each time point than before,and the difference was statistically significant(all P<0.05).The spherical aberration,coma and higher orders in the FS-LASIK group were all higher than those in the Trans PRK group one month after surgery,with statistically significant differences(all P<0.05).The spherical aberration and coma in the FS-LASIK group were higher than those in the Trans PRK group three months after surgery,with statistically significant differences(all P<0.05).The higher orders was no statistical difference between the two groups three months after surgery(P>0.05).3.SR and Q value At 1 month and 3 months after surgery,SR in the FS-LASIK group was 0.144±0.04 and 0.143±0.04,respectively.Trans PRK group was 0.139±0.04 and 0.137±0.04,respectively.The postoperative SR of FS-LASIK group was higher than before,and the difference was statistically significant(all P<0.05).There was no significant difference in SR before and after surgery in Trans PRK group.There were no statistically significant differences between the two groups at the various time points(all P>0.05).The Q value at 1 month and 3 months after surgery were 0.86±0.42 and 0.844±0.41 respectively in the FS-LASIK group.Trans PRK group was 0.71±0.454 and 0.68±0.42,the Q value of the two groups increased significantly after surgery,and the difference between each time pointafter surgery and that before surgery was statistically significant(all P<0.05).There was no significant difference between the two groups(all P>0.05).4.Effective optical zone The effective optical zone at 1 month and 3 months after surgery was as follows:FS-LASIK group 5.32±0.26 mm,5.28±0.25 mm,decreased 1.18±0.26mm(decreased 18.1±4.05%),1.22±0.25mm(decreased 18.73±3.85%),Trans PRK group 5.71±0.19 mm,5.67±0.18 mm,decreased 0.79±0.19mm(decreased 12.2±2.93%),0.83±0.18mm(decreased 12.82±2.79%).In the comparison between the two groups at postoperative 1 month and postoperative 3 months,the effective optical zone of the Trans PRK group was larger,with statistically significant difference(P=0.000,P=0.000).5.NEI-RQL-42 The total scores of the preoperative and postoperative scales in the FS-LASIK group were 54.50±14.81 points and 73.45±11.28 points,respectively;the total scores of the preoperative and postoperative scales in the Trans PRK group were 63.44±10.04 points and 74.24±11.29 points,respectively.The total scores of the two groups were significantly higher than those before surgery,and the difference was statistically significant(P<0.05).The total score of FS-LASIK group before surgery was lower than that of Trans PRK group,and the difference was statistically significant(P=0.007).There was no significant difference in total score between the two groups after surgery(P =0.773).Conclusions: 1.Both two operations can greatly raise vision and improve the life quality of patients;It takes more time to recover in Trans PRK.2.Both two operations have smaller effective optical zone than programmed optical zone;In the same case of programmed optical zone,Trans PRK acquires bigger effective optical zone than that of FS-LASIK.3.Both the aberrations are increased,but no negative effects are made on the subjective visual quality after these two operations.Besides,Trans PRK has less spherical aberration and coma than FS-LASIK.4.The Q value increases after these two operations.With time going by,it tends to recover to the original aspheric shape. |
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