2.0mm小切口飞秒激光角膜基质透镜取出术与飞秒激光辅助的LASIK矫正近视的疗效比较  

Comparison of 2.0 mm small incision lenticule extraction and femtosecond laser LASIK for myopia

作　　者：梅波[1] 张卉卉[1] 段丽[1] 朱涛[1] 付竞[1] 周维[1] 赵春焕[1] 易湘龙[1] 

机构地区：[1]新疆医科大学第一附属医院眼科,新疆维吾尔自治区乌鲁木齐市830054

出　　处：《眼科新进展》2016年第12期1133-1137,共5页Recent Advances in Ophthalmology

基　　金：国家自然科学基金委员会地区科学基金项目(编号:81260150;81560161);中国博士后科学基金面上基金(编号:2014M562485);2012年高等学校博士学科点专项科研基金(编号:20126517120004);新疆维吾尔自治区自然科学基金(编号:2016D01C318);新疆医科大学第一附属医院2012青年科研专项基金(编号:2012QN08;2015ZRQN23)~~

摘　　要：目的比较2.0 mm微切口飞秒激光角膜基质透镜取出术(2.0 mm small incision lenticule extraction,2.0 mm SMILE)与飞秒激光辅助的LASIK(laser in situ keratomileusis with femtosecond laser,FS-LASIK)矫正近视的疗效。方法研究纳入行2.0 mm SMILE的近视患者48例(96眼),同期行FS-LASK者50例(100眼),记录并比较两组术前及术后1d、1周、1个月、3个月及6个月的裸眼视力(uncorrected visual acuity,UCVA)、最佳矫正视力(best corrected visual acuity,BCVA)、屈光度、生活质量量表(quality of life,QOL)得分及手术满意度量表评分。结果在术后1周以后SMILE组视力高于FS-LASIK组,且状态较FS-LASIK组更为稳定。术后1个月、3个月、6个月SMILE组UCVA≥术前BCVA的比例高于FS-LASIK组,差异均有统计学意义(均为P<0.05)。术后早期(术后1周)SMILE组存在1例过矫,而FS-LASIK组存在1例欠矫,但在术后1个月、3个月、6个月两组手术患者均在±1.00 D范围内。术后平均角膜前表面形态变异指数及垂直不对称指数在各时间点均为FS-LASIK组大于SMILE组,差异均有统计学意义(均为P<0.05)。两组术前及术后6个月QOL得分组间比较,差异均无统计学意义(均为P>0.05),术后6个月QOL得分均较术前有所增加,且差异均有统计学意义(SMILE:t=-13.85,P=0.00;FS-LASIK:t=-13.21,P=0.00),而两组术后6个月QOL得分比较,差异无统计学意义(P>0.05)。两组均有较高的再次手术选择率及手术推荐率,并且未发生严重的并发症。结论 2.0 mm SMILE与FS-LASIK均具有良好的有效性、稳定性以及可预测性,术后都可获得良好的视力及良好的生活质量,前者更好地保持了角膜前表面的形态。Objective To compare and evaluate the postoperative outcomes of 2.0 mm small incision lenticule extraction （2.0 mm SMILE） and laser in situ keratom- ileusis with femtosecond laser （FS-LASIK） for myopia. Methods Forty-eight patients （96 eyes） with myopia were selected for 2.0 mm SMILE and another 50 patients （ 100 eyes） were selected for FS-LASIK at the same time. Uncorrected visual acuity （ UCVA）, best corrected visual acuity （ BCVA）, spherical equivalent （ SE ） and quality of life （QOL） were measured preoperatively and 1 day, 7 days, l month, 3 months and 6 months postoperatively, Results The average visual acuity of SMILE group were higher than those of FS-LASIK group at 1 week, 1 month,3 months and 6 months post- operatively ,and visual acuity state of the SMILE group was more stable. The rates to get postoperative BCVA less than preoperative BCVA at 1 month,3 months,5 months after operation in SMILE group were higher than those in FS-LASIK group,and the differences were statistically significant （ all P 〈0.05 ）. 1 eye was overcorrected in SMILE group and 1 eye was undercorrected at 1 week postoperatively. SE were within ± 1.00 D of the at- tempted correction at 1 month,3 months,6 months postoperatively of two groups. The index of surface variance and vertical asymmetry of SMILE group was higher than those of FS-LASIK group at each follow-up time after surgery, the difference were statistically significant（ all P 〈 0.05 ）. There was no significant difference in the score of QOL before surgery and 6 months after surgery between two groups （ all P 〉 0.05 ） The postoperative average QOL scores of two groups were higher than before surgery, and the difference were statistically significant （ SMILE： t = - 13.85, P = 0.00; FS-LASIK： t = - 13.21, P = 0. 00）. Two groups had a high degree of satisfaction and rate of recommended surgery to others. In the two groups,no serious complication was occurred. Conclusion 2.0 nun SMILE and FS-LASIK are effective,stable a

关 键 词：飞秒激光 2.0 mm小切口飞秒激光角膜基质透镜取出术 LASIK 近视 

分 类 号：R778.1[医药卫生—眼科]