SMILE治疗大散光2a的疗效观察  

Clinical study of SMILE on the correction of large astigmatism for 2a

作　　者：李庆和 李岳美 齐绍文 Qing-He Li;Yue-Mei Li;Shao-Wen Qi(Department of Ophthalmology,the 152rd Hospital of Chinese People's Liberation Army,Pingdingshan 467000,Henan Province,China;Department of Pathology,Pingdingshan Medical College,Pingdingshan 467000,Henan Province,China)

机构地区：[1]解放军第152医院眼科,中国河南省平顶山市467000 [2]平顶山学院医学院病理系,中国河南省平顶山市467000

出　　处：《国际眼科杂志》2018年第6期1153-1156,共4页International Eye Science

摘　　要：目的:观察小切口基质内透镜取出术(small incision lenticule extraction,SMILE)治疗大散光患者的2a临床疗效。方法:回顾性分析在我院手术的大散光患者17例33眼,年龄18～36岁,其中散光-3.50～-4.00D者12例24眼,散光-4.25～-5.00D 5例9眼;合并球镜+1.00～0D者4例7眼,合并-1.00～0D者13例26眼。采用小切口基质内透镜取出术,手术切口长度为2mm,位于120°,角膜帽的厚度均为120μm,透镜直径6.6～6.8 mm,帽直径为7.3～7.5 mm。观察时间点为术后1 d,1 wk,1、3、6 mo,1、2 a。分别观察术后裸眼视力、术后等效球镜、残余残光度数、角膜地形图SimK平均值及SimK值的差值。结果:与术前裸眼视力相比,术后1d裸眼视力差异有统计学意义(P<0.05),与术后1wk裸眼视力相比,术后1、3、6mo,1、2a差异均无统计学意义(P>0.05)。裸眼视力均无增加或减少两行及以上,目标屈光度为+0.25D。与术后1d相比,术后各时间点等效球镜及残余散光差异均无统计学意义(P>0.05)。术后各时间点SimK等效值、SimK差值差异无统计学意义(P>0.05)。结论:远期观察SMILE治疗大散光均安全有效,稳定性及可预期高,术后2a角膜形态良好,值得临床应用。AIM:To observe the surgical results of large astigmatism with small incision lenticule extraction(SMILE)for 2a.METHODS:Totally 33 eyes of 17 consecutive patients were enrolled in this retrospective study,aged from 18 to 36 years old,which included 24 eyes of 12 patients with astigmatism within-3.50D to-4.00D and 9 eyes of 5 patients within-4.25D to-5.00D,7 eyes of 4 patients with sphere within 0 to+1.00D and 26 eyes of 13 patients within-1.00D to 0.Intended cap diameters was 7.3-7.5mm,lenticule diameter was 6.6-6.8mm,the thickness of cap was 120um,the surgical incision was 2mm.We observed the results after 1d,1wk,1,3,6mo,1 and 2a.Preoperative best corrected visual acuity,spherical equivalent refraction,postoperative uncorrected visual acuity,SimK equivalent value and SimK value was observed.RESULTS:Compared with preoperation,uncorrected visual acuity showed significant difference statistically at 1d postoperatively(P<0.05).Compared with 1wk postoperatively,uncorrected visual acuity showed no significant difference statistically at postoperative 1,3,6mo,1 and 2a(P>0.05).Uncorrected visual acuity did not increase or decrease more than two lines.The target diopter was+0.25D.Compared with 1d postoperatively,the spherical equivalent refraction and residual astigmatism showed no significant difference statistically at each postoperative period(P>0.05).postoperative SimK equivalent value and SimK value difference showed no significant difference statistically compared with each postoperative period(P>0.05).CONCLUSION:It is both safe,effective,predictable and stable to correct large astigmatism with SMILE by long-term observation,postoperative 2a.The corneal morphology is good and worthy of clinical application.

关 键 词：小切口基质内透镜取出术 大散光 临床研究 

分 类 号：R779.6[医药卫生—眼科]