SMILE术后眼前节结构变化及其影响因素  

Alternation of Ocular Anterior Segment Structure and Its Influencing Factors after Small Incision Lenticule Extraction

作　　者：徐志伟[1] 伍海建[1] Zhiwei Xu;Haijian Wu(Department of Ophthalmology,Taizhou Municipal Hospital,Taizhou 318000,China)

机构地区：[1]台州市立医院眼科中心,台州318000

出　　处：《中华眼视光学与视觉科学杂志》2024年第2期127-133,共7页Chinese Journal Of Optometry Ophthalmology And Visual Science

基　　金：台州市社会发展科技计划项目(20ywa34)

摘　　要：目的:观察飞秒激光小切口角膜基质透镜取出术(SMILE)术后1年内眼前节结构的变化,并分析其影响因素。方法:前瞻性非随机自身对照研究。连续性收集2019年1月至2021年10月在台州市立医院眼科中心接受SMILE手术矫正近视的患者29例(58眼)。采用Oculyzer眼前节分析系统测量术前、术后1个月及1年的中央角膜后表面曲率(PCC)、中央角膜后表面高度(PCE),2、4、6 mm处的角膜后表面平均高度(PME)、中央前房深度(ACD)、前房容积(ACV)。采用Lenstar生物测量仪测量术前、术后1个月及1年的眼轴长度(AL)、中央角膜厚度(CCT)、中央ACD、晶状体厚度(LT)。应用重复测量方差分析比较患者术前、术后1个月及1年眼前节各参数的变化,Pearson相关分析中央ACD变化值与角膜、晶状体等参数的相关性。结果:与术前相比,SMILE术后1个月、1年Oculyzer测得的中央PCC、中央PCE,2、4、6 mm处的角膜PME变化差异均无统计学意义(均P>0.05),中央ACD变浅(均P<0.001),ACV变小(P=0.001,P<0.001)。与术前相比,SMILE术后1个月、1年Lenstar测得的中央ACD变浅(均P<0.001),LT变厚(均P<0.001),晶状体位置前移(均P<0.001)。与术前相比,术后1个月、1年的中央ACD差值与同一时间点LT差值呈负相关(r=-0.96,P<0.001;r=-0.83,P<0.001);而与AL差值、CCT差值、中央PCC差值等均无相关性(均P>0.05)。结论:SMILE术后1年内,角膜后表面保持稳定,前房变浅,LT增加,且前房变浅与LT增加之间存在相关性。Objective:To investigate the alternation of ocular anterior segment structure and its influencing factors after small incision lenticule extraction(SMILE).Methods:This was a non-randomized prospective self-control study.Totally 29 patients(58 eyes)with myopia who underwent SMILE surgery in Taizhou Municipal Hospital from January 2019 to October 2021 were included continuously.Central posterior corneal curvature(PCC),central posterior corneal elevation(PCE),posterior mean elevation(PME)at 2 mm,4 mm,6 mm,central anterior chamber depth(ACD),and anterior chamber volume(ACV)were measured by Oculyzer preoperatively and 1 month,1 year postoperatively.Axial length(AL),central corneal thickness(CCT),central ACD and lens thickness(LT)were measured by Lenstar preoperatively and 1 month,1 year postoperatively.Repeated measure analysis of variance and Pearson correlation analysis were used for data analysis.Results:After SMILE surgery,central ACD was shallower(both P<0.001)and ACV was smaller(P=0.001,P<0.001)at 1 month and 1 year postoperatively,while no significant differences in the amount of central PCC,central PCE,2 mm,4 mm,6 mm PME(all P>0.05)were noted over time measured by Oculyzer.Compared with preoperative measurements,the central ACD became shallower(both P<0.001),LT became thicker(both P<0.001),and the lens position shifted forward(both P<0.001)at 1 month and 1 year after SMILE surgery based on the measurement results of Lenstar.Compared with preoperation,the alternations of central ACD at 1 month and 1 year postoperatively were negatively correlated with the alternations of LT(r=-0.96,P<0.001;r=-0.83,P<0.001).While there were no significant correlation between the alternation of central ACD and the alternations of AL,the alternations of CCT,the alternations of central PCC,etc.(all P>0.05).Conclusions:Within one year after SMILE,posterior corneal surface remained stable,while central ACD was shallower,LT was thicker,and the alternation of central ACD correlated to the alternations of LT.

关 键 词：近视 飞秒激光小切口角膜基质透镜取出术 角膜后表面高度 前房深度 晶状体厚度 

分 类 号：R779.6[医药卫生—眼科]