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Background <p>The aim of this study was to investigate changes in corneal biomechanical properties after femtosecond laser in situ keratomileusis (FS-LASIK) and orthokeratology (Ortho-K).</p> Methods <p>In this retrospective comparative study, patients were divided into an Ortho-K group (37 eyes) and a LASIK group (35 eyes) based on whether they underwent Ortho-K correction or FS-LASIK surgery. Keratometry measurement (Km), spherical equivalent (SE), non-contact tonometry (NCT), central corneal thickness (CCT), corneal hysteresis (CH), and corneal resistance factor (CRF) were assessed at baseline and 1&#xa0;month after treatment (Ortho-K or LASIK).</p> Results <p>No significant baseline differences existed between the two groups. After correction, the LASIK group showed significantly lower values in Km, SE, CCT, NCT, CH, and CRF compared to the Ortho-K group (all <i>P</i> &lt; 0.05). Intragroup comparisons revealed significant postoperative reductions in the LASIK group for CCT (from 543.37 ± 36.75&#xa0;µm to 476.80 ± 38.75&#xa0;µm, <i>P</i> &lt; 0.001), CH (from 10.68 ± 1.46&#xa0;mmHg to 9.03 ± 1.52&#xa0;mmHg, <i>P</i> &lt; 0.001), and CRF (from 10.18 ± 1.89&#xa0;mmHg to 7.68 ± 1.89&#xa0;mmHg, <i>P</i> &lt; 0.001). In the Ortho-K group, CH and CRF decreased significantly (CH: 10.98 ± 1.43 to 9.81 ± 1.19&#xa0;mmHg, <i>P</i> = 0.005; CRF: 10.77 ± 1.70 to 9.42 ± 1.52&#xa0;mmHg, <i>P</i> &lt; 0.001), but CCT change was insignificant. Analysis of ORA signals confirmed a greater biomechanical impact after LASIK, with significant reductions in both P1 and P2 (both<i> P</i> &lt; 0.001), compared to only a P1 reduction in the Ortho-K group (<i>P</i> = 0.033).</p> Conclusions <p>Although both FS-LASIK and Ortho-K reduce CH and CRF values as measured by the ORA, their clinical implications are fundamentally different. The changes induced by FS-LASIK represent a true biomechanical weakening of the cornea, whereas the reductions observed after Ortho-K are primarily measurement artifacts caused by alterations in corneal curvature. Consequently, a more comprehensive approach is required for accurately assessing the corneal biomechanical status following Ortho-K.</p>

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Comparative corneal biomechanical changes after FS-LASIK and orthokeratology

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月19日

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  • Wei Gan,
  • Shizhao Yang,
  • Yu Zhang,
  • Qingqing Hu,
  • Peiyun He,
  • Zhiyu Du

摘要

Background

The aim of this study was to investigate changes in corneal biomechanical properties after femtosecond laser in situ keratomileusis (FS-LASIK) and orthokeratology (Ortho-K).

Methods

In this retrospective comparative study, patients were divided into an Ortho-K group (37 eyes) and a LASIK group (35 eyes) based on whether they underwent Ortho-K correction or FS-LASIK surgery. Keratometry measurement (Km), spherical equivalent (SE), non-contact tonometry (NCT), central corneal thickness (CCT), corneal hysteresis (CH), and corneal resistance factor (CRF) were assessed at baseline and 1 month after treatment (Ortho-K or LASIK).

Results

No significant baseline differences existed between the two groups. After correction, the LASIK group showed significantly lower values in Km, SE, CCT, NCT, CH, and CRF compared to the Ortho-K group (all P < 0.05). Intragroup comparisons revealed significant postoperative reductions in the LASIK group for CCT (from 543.37 ± 36.75 µm to 476.80 ± 38.75 µm, P < 0.001), CH (from 10.68 ± 1.46 mmHg to 9.03 ± 1.52 mmHg, P < 0.001), and CRF (from 10.18 ± 1.89 mmHg to 7.68 ± 1.89 mmHg, P < 0.001). In the Ortho-K group, CH and CRF decreased significantly (CH: 10.98 ± 1.43 to 9.81 ± 1.19 mmHg, P = 0.005; CRF: 10.77 ± 1.70 to 9.42 ± 1.52 mmHg, P < 0.001), but CCT change was insignificant. Analysis of ORA signals confirmed a greater biomechanical impact after LASIK, with significant reductions in both P1 and P2 (both P < 0.001), compared to only a P1 reduction in the Ortho-K group (P = 0.033).

Conclusions

Although both FS-LASIK and Ortho-K reduce CH and CRF values as measured by the ORA, their clinical implications are fundamentally different. The changes induced by FS-LASIK represent a true biomechanical weakening of the cornea, whereas the reductions observed after Ortho-K are primarily measurement artifacts caused by alterations in corneal curvature. Consequently, a more comprehensive approach is required for accurately assessing the corneal biomechanical status following Ortho-K.