摘要
目的:探讨高度散光患者行角膜标记的飞秒激光小切口角膜基质透镜取出手术(SMILE)后视觉质量的影响。方法:纳入2020年7月至2021年2月在我院行SMILE手术的近视合并高度散光患者,共53例(74眼),术中均行角膜标记。对比术前和术后1个月(1mo)的屈光度(球镜度,柱镜度)、裸眼视力(UDVA)、最佳矫正视力(CDVA)、角膜曲率、中央角膜厚度CCT和高阶像差。结果:术后1mo,SMILE术后的视力、验光球镜度、柱镜度较术前均有显著改善,99%术眼的UDVA达成0.8及以上,CDVA与术前相比无统计学差异(P=0.144)。术后66眼(89%)的柱镜度在-0.50D及以下,与术前对比具有统计学差异(P<0.001)。术后1mo球镜度、角膜曲率、CCT较术前均显著降低,具有统计学差异(P<0.001)。术后1mo水平三叶草Z33和水平慧差Z31较术前均无明显变化(P=0.062,0.113);而总高阶像差均方根RMSHOA、垂直慧差Z3-1、斜轴三叶草Z3-3、球差Z40较术前均有所增加,具有统计学差异(P<0.001)。结论:使用角膜标记的SMILE术后虽然产生部分角膜高阶像差,但能够有效改善患者视力、屈光度,仍然是高度散光患者矫正屈光不正的一个安全有效的选择。
Objective:To investigate the effect of corneal marked femtosecond laser small incision stromal lens extraction(SMILE)on visual quality in patients with high astigmatism.Methods:A total of 53 patients(74 eyes)with myopia and high astigmatism who underwent SMILE surgery in our hospital from July 2020 to February 2021 were included,and corneal marking was performed during the operation.The refraction(spherical,cylindrical),uncorrected visual acuity(UDVA),best-corrected visual acuity(CDVA),corneal curvature,central corneal thickness CCT and higher-order aberrations were compared before and 1 month after surgery(1mo).Results:At 1mo after operation,the visual acuity,refraction spherical power and cylinder power after SMILE were significantly improved compared with those before operation,UDVA of 99%of the eyes reached 0.8 or above,and there was no significant difference in CDVA compared with before operation(P=0.144).After operation,66 eyes(89%)had cylindrical power below-0.50D,which was significantly different from that before operation(P<0.001).The spherical power,corneal curvature and CCT at 1mo after operation were significantly lower than those before operation,with statistical difference(P<0.001).At 1mo after operation,the horizontal clover Z33 and horizontal coma Z31 had no significant changes compared with those before operation(P=0.062,0.113)The spherical aberration Z40 increased compared with that before operation,with statistical difference(P<0.001).Conclusion:SMILE using corneal markers produces some corneal higher-order aberrations after surgery,but it can effectively improve patients'visual acuity and refraction.It is still a safe and effective option for correction of refractive errors in patients with high astigmatism.
作者
杨翠
郑志源
陆强
Yang Cui(Optometry Center,Foshan Second People's Hospital,Foshan Guangdong 528000)
出处
《黑龙江医药》
CAS
2022年第4期945-948,共4页
Heilongjiang Medicine journal
关键词
高度散光
角膜标记
小切口角膜透镜取出术
飞秒激光
视觉质量
High astigmatism
Corneal marking
Small incision keratolens extraction
Femtosecond laser
Visual quality
