小切口基质内透镜取出术及飞秒激光LASIK治疗高度近视的临床对比研究  

Clinical comparative study of small incision lenticule extraction and femtosecond laser-assisted LASIK for high myopia

作　　者：李庆和[1] 李岳美 侯红超 宋学英[1] 胡长娥[1] 齐绍文[1] 

机构地区：[1]解放军第152中心医院眼科 [2]平顶山学院医学院,河南省平顶山市467000 [3]襄城县人民医院,河南省许昌市461700

出　　处：《眼科新进展》2016年第6期562-565,共4页Recent Advances in Ophthalmology

摘　　要：目的对比研究小切口基质内透镜取出术(small incision lenticule extraction,SMILE)及飞秒激光LASIK(femtosecond laser in situ keratomileusis,FS-LASIK)治疗高度近视患者的手术疗效。方法 40例80眼高度近视患者(等效球镜度数为-7.00^-10.50 D)根据手术方式不同分为2组,其中SMILE组20例40眼行SMILE,FS-LASIK组20例40眼行Visu Max FSLASIK,观察时间点为术后1 d、1周、1个月、3个月、6个月。分别观察两组术后裸眼视力、等效球镜度数、最佳矫正视力、角膜地形图形态等。结果安全性:术后3个月SMILE组和FS-LASIK组最佳矫正视力达到术前最佳矫正视力的比例分别为97.5%(39/40)、95.0%(38/40)(P>0.05),术后最佳矫正视力/术前最佳矫正视力分别为1.15±0.12、1.09±0.14(P>0.05)。有效性:术后3个月SMILE组和FS-LASIK组裸眼视力达到术前最佳矫正视力的比例分别为95.0%(38/40)、80.0%(32/40)(P<0.05),术后裸眼视力/术前最佳矫正视力分别为1.11±0.13、0.98±0.14(P<0.05)。可预测性(精确性):术后3个月SMILE组和FSLASIK组等效球镜在±0.50 D的比例分别为95.0%(38/40)、70.0%(28/40)(P<0.05);等效球镜在±0.75 D的比例分别为97.5%(39/40)、82.5%(33/40)(P<0.05)。稳定性:与术后1周相比,术后1个月、3个月及6个月各时间点SMILE组和FSLASIK组等效球镜度数的差异均无统计学意义(P>0.05)。角膜地形图形态:SMILE组和FS-LASIK组角膜地形图都以平滑型最多,分别占82.5%(33/40)、60.0%(24/40),两组比较差异有统计学意义(P<0.05)。结论 SMILE及FS-LASIK治疗高度近视均安全、稳定,而SMILE有效性、可预测性、精确性、术后角膜形态均稍好于FS-LASIK,矫正高度近视更值得临床应用。Objective To compare the clinical surgical results of small incision lenticule extraction（SMILE） and femtosecond laser LASIK（FS-LASIK） for high myopia.Methods Eighty eyes of 40 consecutive patients were enrolled in this retrospective study and divided into 2 groups according to the operation method：FS-LASIK group（40 eyes 20 cases） and SMILE group（40 eyes 20 cases）,the spherical refraction was from- 7.00 D to- 10.50 D.The results were observed at postoperative 1 day,1 week,1 month,3 months and 6 months.Postoperative best corrected visual acuity,spherical equivalent refraction,uncorrected visual acuity,corneal topography were observed.Results Security index：After 3 months,the ratio of postoperative best corrected visual acuity reach to the preoperative best corrected visual acuity in SMILE group and FS-LASIK group were 97.5%（39/40） and 95.0%（38/40）,respectively（P〉0.05）,the postoperative best corrected visual acuity /preoperative best corrected visual acuity were 1.15 ±0.12,1.09 ±0.14,respectively（P〉0.05）.Effective index：The ratio of postoperative uncorrected visual acuity reach to the preoperative best corrected visual acuity in SMILE group and FS-LASIK group were 95.0%（38/40） and 80.0%（32/40）（P〈0.05）,the uncorrected visual acuity/preoperative best corrected visual acuity were 1.11 ±0.13 and 0.98 ±0.14（P〈0.05）.Predictability：After 3 months,the rate of spherical equivalent refraction within ±0.50 D were 95.0%（38 /40） and 70.0%（28 /40）（P〈0.05）,within ±0.75 D were 97.5%（39/40） and 82.5%（33/40）（P〈0.05）.Stability：Compared with postoperative 1 week,there was no statistical difference in spherical equivalent refraction of FS-LASIK group and SMILE group at postoperative 1month,3 months and 6 months（P〉0.05）.After surgery,the corneal topography of two groups were mainly smooth,the rates were 82.5%（33/40） and 60.0%（24/40）,respectively,the difference was statistically significant（P〈0.05）.Conclusion Both FS-LA

关 键 词：小切口基质内透镜取出术 VisuMax飞秒激光LASIK 高度近视 

分 类 号：R778.11[医药卫生—眼科]