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Early Changes Among FLEx, LASIK and FS-LASIK

Not Applicable
Completed
Conditions
Astigmatism
Myopia
Interventions
Procedure: lenticule extraction
Procedure: laser in situ keratomileusis
Procedure: FS assisted laser in situ keratomileusis
Registration Number
NCT02551796
Lead Sponsor
Sun Yat-sen University
Brief Summary

To evaluate the short-term changes in ocular surface measures and tear inflammatory mediators after lenticule extraction (FLEx), laser in situ keratomileusis (LASIK) and femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) procedures.

Detailed Description

Laser in situ keratomileusis (LASIK) with a microkeratome has been accepted wildly in the past 20 years. Gradually, laser in situ keratomileusis with a femtosecond laser-created flap (FS-LASIK)has been a popular ophthalmic procedure for the correction of refractive error. This first all-in-one FS-laser system was designed to perform the refractive lenticule extraction (ReLEx) procedures, femtosecond lenticule extraction (FLEx).They have the same feature: corneal flap.

Ocular surface disruption during corneal refractive surgery is commonly considered to be closely related to the development of dry eye. Multiple etiologies contribute to this ocular surface disruption, including the flap creation and stromal ablation involved in previous refractive surgery techniques. Corneal nerve damage has been considered the main cause of dry eye, due to disrupted afferent sensory nerves, reduced blink reflex, and increased tear evaporation leading to tear film instability. In addition, postoperative inflammatory mediator fluctuations are also a key factor related to ocular surface damage. Extensive research has described the effects of cytokines, chemokines and growth factors in modulating corneal wound healing, cell migration, and apoptosis on the ocular surface after refractive surgery.

This prospective clinical study is going to analyze the short-term changes in ocular surface measures and tear inflammatory mediators after FLEx, LASIK and FS-LASIK procedures.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
75
Inclusion Criteria
  • minimum age of 18 years(range from 18 year to 31 years); corneal thickness 500 μm with calculated residual stromal bed after treatment greater than 300 μm; preoperative spherical equivalent refraction between
  • 2.00 diopter (D) and -6.50 D; preoperative cylindrical equivalent refraction between -0.25 D and -1.50 D; preoperative corneal curvature from 42.0 D to 46.0 D with a regular topographic pattern, verified with an Atlas topographer; monocular best corrected visual acuity of 20/20 or better and stable refractive error (less than 0.5 D change) for 24 months before surgery
Exclusion Criteria
  • systemic disease that contraindicated the surgery (such as diabetes, glaucoma and systemic collagen vascular disease); corneal abnormality or disease; a history of tear supplement usage or contact lens wear during the past year

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
lenticule extractionlenticule extractionThe patients in this group chose to receive the lenticule extraction surgery.
laser in situ keratomileusislaser in situ keratomileusisThe patients in this group chose to receive the laser in situ keratomileusis surgery.
FS assisted laser in situ keratomileusisFS assisted laser in situ keratomileusisThe patients in this group chose to receive the FS assisted laser in situ keratomileusis surgery.
Primary Outcome Measures
NameTimeMethod
scale of Schirmer I testup to 1month after surgery
scale of corneal fluorescein stainingup to 1month after surgery
scale of noninvasive tear breakup timeup to 1month after surgery
questionnaire of ocular surface disease indexup to 1month after surgery
scale of central corneal sensitivityup to 1month after surgery
scale of tear meniscus heightup to 1month after surgery
concentration of Interleukin-1αup to 1month after surgery
concentration of tumor necrosis factor-αup to 1month after surgery
concentration of nerve growth factorup to 1month after surgery
interferon-γup to 1month after surgery
concentration of transforming growth factor-β1up to 1month after surgery
concentration of matrix metalloproteinase-9up to 1month after surgery
Secondary Outcome Measures
NameTimeMethod
Correlation between interferon-γ and corneal fluorescein stainingup to 1month after surgery
Correlation between transforming growth factor-β1 and corneal fluorescein stainingup to 1month after surgery
Correlation between matrix metalloproteinase-9 and corneal fluorescein stainingup to 1month after surgery
Correlation between Interleukin-1α and ocular surface disease indexup to 1month after surgery
Correlation between tumor necrosis factor-α and ocular surface disease indexup to 1month after surgery
Correlation between nerve growth factor and ocular surface disease indexup to 1month after surgery
Correlation between interferon-γ and ocular surface disease indexup to 1month after surgery
Correlation between transforming growth factor-β1 and ocular surface disease indexup to 1month after surgery
Correlation between matrix metalloproteinase-9 and ocular surface disease indexup to 1month after surgery
Correlation between Interleukin-1α and corneal fluorescein stainingup to 1month after surgery
Correlation between nerve growth factor and corneal fluorescein stainingup to 1month after surgery
Correlation between tumor necrosis factor-α and corneal fluorescein stainingup to 1month after surgery

Trial Locations

Locations (1)

Hainan Eye Hospital, Zhongshan Ophthalmic Center of Sun Yat-sen University

🇨🇳

Haikou, Hainan, China

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