摘要
目的比较双眼分别采用飞秒激光小切口角膜基质透镜取出术(SMILE)和飞秒激光制瓣准分子激光原位角膜磨镶术(FS-LASIK)治疗近视散光的术后视觉质量。设计回顾性病例系列。研究对象2015-2017年滨州沪滨爱尔眼科医院行SMILE手术屈光矫正(SMILE组),但有一只眼角膜瘢痕或角膜薄而选择FS-LASIK术的患者(FS-LASIK组)19例。方法比较两种术式术后3个月裸眼视力(UCVA)、最佳矫正视力(BCVA)、等效球镜度和高阶像差的变化。主要指标UCVA、BCVA、等效球镜度、高阶像差。结果术后3个月所有术眼UCVA均达到或超过术前BCVA:术后3个月无一例BCVA较术前下降;术后3个月等效球镜度在±0.50 D范围内的百分比,SMILE组为97%,高于FS-LASIK组(90%)(χ^2=0.279,P=0.59)。两组无一眼术后等效球镜度在±1.00 D以外。两组术后3个月总高阶像差和球差与术前相比均增大(t=-3.29,-3.41;P=0.02,0.02)。术后3个月总高阶相差、球差引入量SMILE组小于FS-LASIK组(t=-3.43,-3.45;P=0.01,0.01);水平慧差两组比较无显著性差异(t=-0.37;P=0.72),垂直慧差FS-LASIK组引入更少(t=2.71;P=0.04)。结论短期随访结果显示,SMILE手术比FS-LASIK手术导致的术后总高阶像、球差更少,慧差未见明显差异。
Objective To compare the visual quality of myopic astigmatism with small-incision lenticule extraction(SMILE)and femtosecond laser-assisted laser in situ keratomileusis(FS-LASIK).Design Retrospective case series.Participants 19 cases of patients with myopia were included from 2015 to 2017 in Binzhou Hubin Aier Eye Hospital,in which SMILE surgery were performed on one eye(SMILE group),and FS-LASIK were performed on the other eye(FS-LASIK group)duo to corneal scarring or thin cornea.Methods All patients were followed up for 3 months.Uncorrected distance visual acuity(UCVA),manifest refraction and corneal aberrations were measured preoperatively and at 3 months postoperatively.Main Outcome Measures UCVA,manifest refraction and corneal aberrations.Results Three months after surgery,there were no statistically significant differences in UCVA or best corrected visual acuity(BCVA)and spherical equivalence(SE)between SMILE group and(FS-LASIK group(P>0.05).The SMILE group had a significantly higher percentage of eyes whose SE range was-0.50 D to+0.50 D compared with the FS-LASIK group(χ^2=0.279,P=0.59).There were statistically significant differences in higher-order aberrations,spherical aberrations induced by SMILE and FS-LASIK 3 months after surgery(t=-3.29,-3.41;P=0.02,0.02).The SMILE group induced far fewer spherical aberrations than FS-LASIK group(t=-3.43,-3.45;P=0.01,0.01).There were no statistically significant differences on horizontal coma induced by both groups(t=-0.37;P=0.72).The FS-LASIK group induces far fewer vertical coma(t=2.71;P=0.04).Conclusion Short-term follow-up results showed that SMILE had fewer total high-order aberrations and spherical aberrations than FS-LASIK,and there was no significant difference in coma aberration between SMILE and FS-LASIK.
作者
李晓静
李敬震
LI Xiao-jing;LI Jing-zhen(Binzhou Hubin Aier Eye Hospital,Shandong 256603,China)
出处
《眼科》
CAS
2019年第4期302-306,共5页
Ophthalmology in China
