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[Study on the change of optical zone after femtosecond laser assisted laser in situ keratomileusis].

Objective: To explore the change of optical zone after femtosecond laser assisted laser in sitn keratomileusis(FS-LASIK) so as to provide the reference for measurement and design of clinical optical zone. Methods: This retrospective case series study covers 41 eyes of 24 patients (7 males and 17 females, aged from 18 to 42 years old) with myopia and myopic astigmatism who have received FS-LASIK surgery at Corneal Refractive Department of Qingdao Eye Hospital and completed over 6 months of clinical follow-up. Pentacam system (with the application of 6 corneal topographic map modes including: the pure axial curvature topographic map, the pure tangential curvature topographic map, the axial curvature difference topographic map, the tangential curvature difference topographic map, the postoperative front elevation map and the corneal thickness difference topographic map), combined with transparent concentric software (a system independently developed by Qingdao Eye Hospital) was used to measure the optical zone at 1, 3 and 6 months postoperatively, the optical zone diameters measurement results among different follow-up times in group were analyzed with the repeated measures analysis of variance, and the actual measured values and the theoretical design values of the optical zone were analyzed with independent-samples t-testing. Spearman correlation coefficient (r(s)) have been applied to evaluate the relationship between postoperative optical zone measurement values and the potential influencing factors. Results: The optical zone diameters measured by pure axial curvature topographic map at 1, 3 and 6 months after FS-LASIK showed (6.55±0.50)mm, (6.50±0.53)mm and (6.48±0.53)mm respectively. The differences between values are of no statistical significance (F=1.60, P=0.21), the optical zone diameter measured by pure tangential curvature topographic map at 1, 3 and 6 months after FS-LASIK showed (5.44±0.46)mm, (5.46±0.52)mm and (5.44±0.50)mm respectively, the differences between values are of no statistical significance (F=0.17, P=0.85). The optical zone diameters measured by postoperative front elevation map at 1, 3 and 6 months after FS-LASIK showed (5.06±0.28)mm, (5.12±0.32)mm and (5.17±0.28)mm respectively. The differences between the values of 3 and 6 months postoperatively are of no statistical significance (F=6.14, P=0.15), the optical zone diameters measured by axial curvature difference topographic map at 1, 3 and 6 months after FS-LASIK showed (6.51±0.37)mm, (6.45±0.41)mm and (6.41±0.40)mm respectively, and the differences between the values of 3 and 6 months postoperatively are of no statistical significance (F=7.25, P=0.05). The optical zone diameters measured by tangential curvature difference topographic map at 1, 3 and 6 months after FS-LASIK showed (5.21±0.23)mm, (5.16±0.19)mm and (5.17±0.20) mm respectively, and the differences between the values of 1 and 3 months postoperatively are of statistical significance (F=1.75, P=0.04). The optical zone diameters measured by corneal thickness difference topographic map at 1, 3 and 6 months after FS-LASIK showed (6.53±0.40)mm, (6.39±0.43)mm and (6.41±0.47)mm respectively, and the differences between the values of 1 and 3 months postoperatively are of statistical significance (F=1.67, P=0.032). The actual measured optical zone values from the 6 different modes of Pentacam system are less than the theoretical design values (7.75 mm), and the differences were statistical significance (t=-15.42, -29.39, -59.27, -21.47, -81.69, -18.22, P<0.01). Conclusions: The optical zone measurement values tend to be stable at 3 months after FS-LASIK. The actual measured values from all the 6 different modes of Pentacam system were less than the theoretical design values. The results from pure tangential curvature topographic map, the tangential curvature difference topographic map and the postoperative front elevation map showed greater variation with clear border, which was beneficial for eccentric research. The results from pure axial curvature topographic map, the axial curvature difference topographic map and the corneal thickness difference topographic map were close to the theoretically designed values. Furthermore, the axial curvature difference topographic map showed clearer border and less variation thus maybe more favorable for measuring optical zone in clinical application.(Chin J Ophthalmol, 2018, 54: 39-47).