低中重度散光微切口角膜基质透镜摘除术术后3个月视觉质量研究  

Visual quality research of low moderately severe astigmatism at postoperative 3 months after SMILE

作　　者：吴丹[1] 叶巍[2] 陈祥菲[3] 高永月 夏元[1] 黄振平[1] 

机构地区：[1]南京大学医学院南京军区总医院眼科,江苏省南京市210002 [2]第二军医大学南京军区总医院眼科,上海市200082 [3]南京大学医学院南京军区总医院干部内分泌科,江苏省南京市210002 [4]南京大学医学院南京军区总医院神经外科,江苏省南京市210002

出　　处：《眼科新进展》2016年第9期849-852,共4页Recent Advances in Ophthalmology

摘　　要：目的分析微切口角膜基质透镜摘除术(SMILE)手术矫正散光的临床疗效,比较术前不同散光的术后残留散光度及视觉质量。方法将2015年6~7月于我院行SMILE患者65例(127眼)按术前散光度数进行分组,0^-1.00 D为A组51眼、>-1.00^-2.00D为B组40眼、>-2.00^-3.00 D为C组36眼。复查术后4 h、1周、1个月、3个月小瞳下自动验光仪的散光值及视觉对比敏感度,并用客观视觉质量分析系统检测客观散射指数(OSI)和调制传递函数截止频率(MTFcutoff)。结果 3组术后各时间段裸眼视力、球镜度数和柱镜度数与术前差异显著(均为P<0.05),但3组间在术后相同时间点差异均无统计学意义(均为P>0.05)。随时间增加,在眩光和无眩光条件下各组对比敏感度均提高,且3个月时最佳(P<0.05);术后3个月各组间相比,B组在眩光和无眩光条件时各空间频率下的表现均更佳,但差异无统计学意义(均为P>0.05)。各组内在不同时间段相比OSI和MTFcutoff无明显差异(均为P>0.05),术后3个月,3组OSI分别为1.273±0.967、1.125±0.772、1.208±0.652,MTFcutoff分别为24.275±8.214、28.188±8.343、25.543±2.279,各组间均无明显差异(均为P>0.05)。结论 SMILE矫正散光安全、有效、稳定、可预测性佳,术后视觉质量好。Objective To analyze the effects of correcting astigmatism with small incision lenticule extraction （SMILE） and compare each preoperative astigmatism regions postoperative astigmatism and visual quality. Methods A total of 65 patients （ 127 eyes） operated with SMILE were grouped according to the preoperative astigmatism degree from June to July 2015. Divided the patients into three groups：Group A included 51 eyes （ astigmatism 0 - 1.00 D）, group B included 40 eyes （ 〉 - 1.00 - - 2.00 D） ,group C included 36 eyes （ 〉 -2.00 - -3.00 D）. The astigmatism was re-examined using automatic optometry unit under small pupil, visual contrast sensitivity and OSI, MTF cutoff were also re-examined using OQAS at 4 hours, 1 week, 1 month and 3 month after surgery. Results The postoperative UCVA, refraction and astigmatism had the significant differences compared with the post-operation （ all P 〈 0.05 ）, but there was no statistical significance among three groups at each follow-up time point （ all P 〉 0. 05 ）. With time increase,the contrast sensitivity was improved under the condition of glare or not in each group, and it performed better at 3 months than 4 hours, 1 week and 1 month （P 〈 0.05 ）. The contrast sensitivity of each group had no significant difference with the glare or not at postoperative 3 months （ all P 〉 0.05 ）. No significant difference was detected in each group in the MTF cutoff and OSI at any time point after surgery （ all P 〉 0.05 ）. At postoperative 3 months, OSI in the three groups were 1. 273 ± 0. 967, 1. 125 ± 0. 772, 1. 208 ±0. 652, respectively, and MTF cutoff were 24. 275 ± 8. 214, 28. 188 ± 8.343,25. 543 ± 2. 279, and all the difference was not statistically significant （ all P 〉 0. 05 ）. Conclusion SMILE can provide good clinical safety, efficacy, stability and relatively good predictability, visual quality in the correction of astigmatism.

关 键 词：飞秒 微切口角膜基质透镜摘除术 散光 视觉对比敏感度 客观散射指数 调制传递函数截止频率 视觉质量 

分 类 号：R779.6[医药卫生—眼科]