SMILE与FS-LASIK术后散射变化特性的比较  

Characteristics of straylight after small incision lenticule extraction versus femtosecond laser-assisted laser in situ keratomileusis

作　　者：徐路路[1] 王雁[1] 刘洋辰[1] 吴文静[1] 

机构地区：[1]天津医科大学眼科临床学院 天津市眼科医院 天津市眼科学与视觉科学重点实验室 天津市眼科研究所,300020

出　　处：《中华实验眼科杂志》2015年第2期159-164,共6页Chinese Journal Of Experimental Ophthalmology

基　　金：国家自然科学基金项目（81170873）

摘　　要：背景 飞秒激光小切口基质透镜取出术（SMILE）是一种新的微创无瓣屈光矫治手术方式,具有良好的安全性及可预测性,但目前有关其术后视觉质量的研究尚少.了解SMILE术后散射的变化情况对于评估其术后视觉质量具有重要意义. 目的 对比分析SMILE与飞秒激光辅助准分子激光角膜原位磨镶术（FS-LASIK）矫治近视及近视散光后术眼眼内散射光计量值的变化情况.方法 采用回顾性研究方法,选取2011年1月至2013年6月在天津市眼科医院拟行SMILE和FS-LASIK的近视及近视散光患者68例127眼,其中SMILE组35例64眼,FS-LASIK组33例63眼,使用C-Quant散射光计量仪分别于术前及术后1周、1个月、6个月测量散射光计量值,比较2个组术眼术后不同时间眼内散射光计量值的改变,并分析2种手术因素与术眼眼内散射光计量值的关系.结果 FS-LASIK组术后1周、1个月时散射光计量值分别为（1.03±0.19）D和（0.95±0.16）D,明显高于术前的（0.88±0.18）D,差异均有统计学意义（P=0.000、0.012）,而SMILE组术后1周、1个月和6个月散射光计量值分别为（0.98±0.16）、（0.95±0.14）和（0.94±0.16）D,与术前的（0.91±0.15）D相比,差异均无统计学意义（均P＞0.05）,但2个组间术眼散射光计量值的总体比较差异无统计学意义（F分组=0.077,P=0.781）.术后不同时间点FS-LASIK组散射光计量值的变化量均高于SMILE组（F分组=14.798,P＜0.001）,术后1周时2个组间差异有统计学意义（P＜0.01）.术后1周、1个月、6个月SMILE组术眼眼内散射光计量值的变化量与切削比均呈负相关（R^2=0.123、0.145、0.098,均P＜0.05）.结论 SMILE手术前后术眼内散射光计量值变化不明显,而FS-LASIK术后眼内散射光计量值增加,尤以早期最为显著.2种手术后的散射光计量值随时间的延长逐渐恢复.Background Small incision lenticule extraction （SMILE） was a new procedure which is miniinvasion and flapless,but few attentions were paid to the visual quality after SMILE.To understand the changes of intraocular straylight after SMILE is of important significance for the assession of the visual quality after the procedure.Objective This study was to compare the characteristic of straylight between SMILE and femtosecond laser assisted laser in situ keratomileusis （FS-LAISK） after surgery.Methods A retrospective study was designed.Written informed consent was obtained from each patient prior to accepting the surgery.One hundred and twenty-seven eyes of 68 patients with myopia and myopic astigmatism were included in Tianjin Eye Hospital from January 2011 to July 2013.SMILE was performed on 64 eyes of 35 patients and FS-LASIK was carried out in 63 eyes of 33 patients at the same period.Stray light was detected with C-Quant stray light meter before and 1 week,1 month and 6 months after surgery.The changes of stray light values following the surgery were compared between the two groups,and the correlations between postoperative stray light values with operative parameters were analyzed.Results The mean stray light values were （1.03 ±0.19）D and （0.95±0.16）D at 1 week and 1 month after surgery,which were higher than （0.88 ±0.18）D at preoperation in the FS-LASIK group （P =0.000,0.012）.The stray light values were （0.98±0.16）,（0.95±0.14） and （0.94±0.16）D at 1 week,1 month or 6 months after surgery,and no statistically significant differences were found in comparison with （0.91 ±0.15）D in preoperation in the SMILE group （all at P〉0.05）.No significant intergroup difference was seen in the stray light values （Fgroup =0.077,P=0.781）.The stray light differences of various time points after surgery and before surgery were increased in the FS-LASIK group compared with SMILE group （Fgroup =14.798,P〈0.001）,with the significant difference in postoperative 1 week between

关 键 词：散射 近视 近视散光/手术 视觉质量 飞秒激光小切口基质透镜取出术 飞秒激光辅助准分子激光角膜原位磨镶术 

分 类 号：R779.63[医药卫生—眼科]