摘要
目的比较SMILE、FS-LASIK及Trans-PRK手术后角膜厚度和屈光度的稳定性。设计回顾性病例系列。研究对象2021年1月~2021年7月SMILE、FS-LASIK及Trans-PRK三种手术的近视患者108例,每组36例,以右眼作为研究对象。方法回顾术前及术后2周、1个月、3个月、6个月和1年的角膜顶点厚度(ACT)及等效球镜度(SE),比较一种手术不同时间及各时间点三种手术的ACT、SE。主要指标ACT、SE。结果术后ACT比较:SMILE术后2周最薄,其次是术后1个月(P均<0.05);FS-LASIK除了术后1个月、6个月与3个月比较无统计学意义外,其余各时间点比较均为逐渐增厚(P均<0.001);Trans-PRK术后1个月和3个月与其他时间比较差异均有统计学意义(P均<0.05),术后早期ACT较厚,然后逐渐变薄,后又逐渐增厚并趋于稳定;同一时间点三种手术方式比较:各时间点SMILE及Trans-PRK的ACT都比FS-LASIK厚,差异均有统计学意义(P<0.05)。术后SE比较:SMILE术后2周比1年屈光度较高,差异有统计学意义(P=0.037);FS-LASIK术后早期(1个月)屈光度不稳定(P均<0.05);Trans-PRK术后1个月、6个月与1年比较有统计学意义(P均=0.002);同一时间点三种手术方式比较:术后2周时SMILE比FS-LASIK屈光度低,差异有统计学意义(P=0.022),其余各时间点三种手术之间均无统计学意义。在术后1年时SMILE、FS-LASIK及Trans-PRK的SE在±0.50 D内占比分别为61%、53%和64%,在±1.00 D内占比分别为93%、89%和89%。结论三种手术方式均在3~6个月后均趋向稳定并稍有增厚,各时间点SMILE与Trans-PRK的角膜厚度均厚于FS-LASIK;三种手术的SE随时间均有轻度回退,但SMILE与Trans-PRK术后在不同的屈光度范围内各有优势,均优于FS-LASIK。对于中低度近视或薄角膜可优选Trans-PRK,对于中高度近视可优选SMILE,对于高度近视或薄角膜选择FS-LASIK时需多关注回退问题。
Objective To compare the corneal thickness and diopter stability after SMILE、FS-LASIK and T-PRK for correcting myopia.Design Retrospective cases series.Participants From January 2021 to July 2021,108 patients(108 right eyes)who underwent corneal refractive surgery in Zhengzhou Aier Eye Hospital.According to the accepted surgery,the patients were divided into SMILE(36 eyes),FS-LASIK(36 eyes)and T-PRK(36 eyes).Methods Apical corneal thickness(ACT)and spherical equivalent(SE)were reviewed preoperative,2 weeks,1 month,3 months,6 months and 1 year after surgery.The ACT and SE of one kind of surgery at different time and each time point were analyzed.Main Outcome Measures ACT,SE.Results Comparison of postoperative ACT:After SMILE the thinnest was 2 weeks,and the second was 1 month(all P<0.05).After FS-LASIK,there were no significant differences between 1 month,6 months with 3 months,but the thickness were gradually increased at other times(all P<0.001).There were significant differences between 1 month and 3 months with other times after Trans-PRK(all P<0.05).The ACT became thicker in the early period after Trans-PRK,then became thinner,until stablily.Statistically significant differences of SMILE and Trans-PRK were thicker than FS-LASIK at any time(P<0.05).Comparison of postoperative SE:Statistically significant differences of 2 weeks after SMILE was higher than 1 year(P=0.037).The diopter was unstable in the 1 month after FS-LASIK(all P<0.05).There were significant differences between 1 month,6 months with 1 year after Trans-PRK(all P=0.002).Statistically significant differences of SMILE was lower than FS-LASIK at 2 weeks(P=0.002).There was no statistical significance between the three surgery at other time.At 1 year after surgery,SE within range±0.50 D at SMILE,FS-LASIK and Trans-PRK group was 61%,53%and 64%,respectively,and SE within range±1.00 D was 93%,89%and 89%,respectively.Conclusion The ACT all tended to be stable and slightly thickened after 3~6 months of the three refractive surgery.The corneal thicknes
作者
徐玲玲
游昌涛
李帅飞
陈东栋
Xu Lingling;You Changtao;Li Shuaifei;Chen Dongdong(Zhengzhou AIER Eye Hospital,Zhengzhou 450000,China)
出处
《眼科》
CAS
2023年第6期496-501,共6页
Ophthalmology in China
关键词
SMILE
FS-LASIK
Trans-PRK
角膜顶点厚度
屈光度
small incision lenticule extraction
femtosecond flap excimer laser in situ keratomileusis
smart pulse technology combined with excimer laser refractive keratectomy
apical corneal thickness
spherical equivalent
