PURPOSE To evaluate epithelial Zernike indices as a differentiator of epithelial remodeling after different refractive procedures. METHODS Optical coherence tomography (OCT) images of 22 laser in situ keratomileusis, 22 small incision lenticule extraction, 15 photorefractive keratectomy (PRK), and 17 transepithelial PRK eyes were evaluated retrospectively before and after surgery. A custom algorithm was used to calculate the epithelial Zernike indices from the three-dimensional distribution of epithelial thickness distribution. The epithelial Zernike indices were also compared with the local measurements of epithelial thickness, used conventionally from the current clinical OCT. A decision tree classifier was built, one in which flap/cap and surface procedures were classified (2G) and another in which all surgical groups were classified separately (4G). RESULTS Local measurements of thicknesses changed significantly after all surgeries (P < .05), but these changes were similar in magnitude between the surgical platforms (P > .05). The surgeries not only changed the epithelial Zernike indices (P < .05), but also resulted in differential changes in epithelial thickness distribution based on the type of surgery (P < .05). In the 2G analyses with local measurements of epithelial thickness, the area under the curve, sensitivity, and specificity were 0.57 ± 0.07, 42.11%, and 57.89%, respectively. Further, the accuracy was limited to less than 60%. In the 2G analyses with epithelial Zernike indices, the area under the curve, sensitivity, and specificity were 0.79 ± 0.05, 86.4%, and 71.9%, respectively. Here, the accuracy was limited between 70% and 80%. Similar trends were observed with 4G analyses. CONCLUSIONS The epithelial Zernike indices were significantly better in identifying surgery-specific three-dimensional remodeling of the thickness compared to local measurements of epithelial thickness. Further, the changes in Zernike indices were independent of the magnitude of refractive error but not the type of surgery. [J Refract Surg. 2020;36(2):97-103.].

中文翻译：

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上皮Zernike指数和人工智能可以区分皮瓣和非皮瓣屈光手术之间的上皮重塑。

目的评估上皮Zernike指数，作为不同屈光手术后上皮重塑的区分因素。方法回顾性分析术前和术后22例激光原位角膜磨镶术，22例小切口微透镜摘除术，15例屈光性角膜切除术（PRK）和17例经上皮PRK眼的光学相干断层扫描（OCT）图像。使用自定义算法从上皮厚度分布的三维分布计算上皮Zernike指数。还将上皮Zernike指数与上皮厚度的局部测量值进行了比较，这些测量通常是根据当前临床OCT使用的。建立了决策树分类器，一种是将瓣/帽和表面手术分类（2G），另一种是将所有外科手术组分别分类（4G）。结果在所有手术后，局部厚度测量值均发生了显着变化（P <.05），但在手术平台之间，这些变化的幅度相似（P> .05）。手术不仅改变了上皮的Zernike指数（P <.05），而且还导致了基于手术类型的上皮厚度分布的差异性变化（P <.05）。在局部测量上皮厚度的2G分析中，曲线下面积，灵敏度和特异性分别为0.57±0.07、42.11％和57.89％。此外，精度被限制为小于60％。在具有上皮Zernike指数的2G分析中，曲线下的面积，灵敏度，特异性分别为0.79±0.05、86.4％和71.9％。在此，精度限制在70％至80％之间。通过4G分析观察到了类似的趋势。结论与局部测量上皮厚度相比，上皮Zernike指数在识别特定于手术的厚度三维重建方面要好得多。此外，Zernike指数的变化与屈光不正的大小无关，而与手术类型无关。[J Refract Surg。2020; 36（2）：97-103。]。结论与局部测量上皮厚度相比，上皮Zernike指数在识别特定于手术的厚度三维重建方面要好得多。此外，Zernike指数的变化与屈光不正的大小无关，而与手术类型无关。[J Refract Surg。2020; 36（2）：97-103。]。结论与局部测量上皮厚度相比，上皮Zernike指数在识别特定于手术的厚度三维重建方面要好得多。此外，Zernike指数的变化与屈光不正的大小无关，而与手术类型无关。[J Refract Surg。2020; 36（2）：97-103。]。