SMILE和Epi-LASIK术后1年患者视觉质量及眼内散射情况——基于双通道视觉质量分析系统(OQAS)的对比研究  

Comparison of visual quality and intraocular scattering between SMILE and Epi-LASIK by double-channel visual quality analysis system at a year after operation

作　　者：陈祥菲 赵明 陆燕 王春红 黄振平 CHEN Xiangfei;ZHAO Ming;LU Yan;WANG Chunhong;HUANG Zhenping(Department of Endocrinology,Geriatric Research Center,Jinling Hospital,Nanjing 210002,Jiangsu Province,China;Department of Ophthalmolgy,Jinling Hospital,Nanjing 210002,Jiangsu Province,China)

机构地区：[1]中国人民解放军东部战区总医院干部内分泌科,江苏省南京市210002 [2]中国人民解放军东部战区总医院眼科,江苏省南京市210002

出　　处：《眼科新进展》2020年第6期554-558,共5页Recent Advances in Ophthalmology

基　　金：国家自然科学基金资助(编号81270979);南京军区南京总医院科研基金(编号2016061);江苏省青年医学人才项目(编号QNRC20160905)。

摘　　要：目的采用双通道视觉质量分析系统(optical quality analysis system,OQAS)比较飞秒激光小切口基质透镜取出术(small incision lenticule extraction,SMILE)和去瓣机械法准分子激光角膜上皮瓣下磨镶术(epipolis laser in situ keratomileusis,Epi-LASIK)术后1 a患者视觉质量及眼内散射情况。方法本研究为回顾性病例对照研究。选取2013年3月至2014年8月在中国人民解放军东部战区总医院接受角膜屈光手术的近视眼患者95例(189眼)。按手术方式分为SMILE组52例(103眼),去瓣Epi-LASIK组43例(86眼)。观察并比较两组患者术后1 a的裸眼视力(UCVA)、最佳矫正视力(BCVA)、眼内客观散射指数(OSI)、MTF截止空间频率(MTF cutoff)、斯特列尔比值(SR)、100%、20%、9%对比度的OQAS值(OV100%、OV20%、OV9%)和患者满意度等。结果术后1 a,SMILE组和去瓣Epi-LASIK组UCVA较术前均显著提高(均为P<0.05);但两组间UCVA差异无统计学意义(P>0.05)。术后1 a,两组BCVA与术前相比以及两组间相比差异不大,均无统计学意义(均为P>0.05)。术后1 a,SMILE组和去瓣Epi-LASIK组的有效系数分别为1.039和1.038,安全性指数分别为1.066和1.046。术后1 a,两组患者OSI的差异无统计学意义(P>0.05)。SMILE组MTF cutoff和SR略高于去瓣Epi-LASIK组,但差异均无统计学意义(均为P>0.05)。另外,两组患者OV100%、OV20%、OV9%值随图像对比度的降低均有依次递减的趋势,但两组间差异均无统计学意义(均为P>0.05)。术后1 a,SMILE组中,OSI与年龄呈正相关,与术前等效球镜度、SR呈负相关;MTF cutoff与年龄呈负相关,与SR呈正相关,而与术前等效球镜度无相关性。去瓣Epi-LASIK组中,OSI与年龄呈正相关,与术前等效球镜度、SR呈负相关;MTF cutoff与年龄成负相关,与术前等效球镜度、SR呈正相关。术后1 a,SMILE组和去瓣Epi-LASIK组的手术满意度问卷调查评分分别为(9.52±0.80)分和(9.26±0.99)分(总分为10分),差异无统计学意义(P>0.05)。SMObjective To compare visual quality and ocular scattering between small incision lenticule extraction(SMILE)and off-flap epipolis laser in situ keratomileusis(Epi-LASIK)by double-channel optical quality analysis system(OQAS)at a year after operation.Methods The retrospective case-control study was conducted on 95 cases(189 eyes)who underwent corneal refractive therapy in General Hospital of Eastern Theater Command from March 2013 to August 2014.All cases were divided into SMILE group(52 patients,103 eyes)and off-flap EPi-LASIK group(43 patients;86 eyes)according to operation mode.Uncorrected visual acuity(UCVA),best corrected visual acuity(BCVA),objective scattering index(OSI),modulation transfer function cutoff frequency(MTF cutoff),Strehl ratio(SR)and OQAS values(OV100%,OV20%,OV9%)at contrasts of 100%,20%and 9%,as well as patients’satisfaction were compared between the two groups at a year after operation.Results At a year after operation,UCVA improved significantly comparing with preoperative levels in SMILE group and off-flap Epi-LASIK group(both P<0.05);but there was no significant difference in UCVA between the two groups(P>0.05).The postoperative BCVA were not statistically different from preoperative levels in both two groups,and there were no significant differences in BCVA between the two groups at a year after operation(all P>0.05).At a year after operation,the effective coefficients of SMILE and Epi-LASIK group were 1.039 and 1.038,respectively,and the safety indexes were 1.066 and 1.046,respectively.There were no significant differences in OSI between the two groups(P>0.05).MTF cutoff and SRof in the SMILE group were slightly higher than those in the Epi-LASIK group,with no significant differences(both P>0.05).Besides,the values of OV100%,OV20%and OV9%decreased with the reduction of image contrast,but there were no significant differences between the two groups(all P>0.05).In the SMILE group,OSI was positively correlated with age,and negatively correlated with preoperative spherical equivalent and

关 键 词：飞秒激光 小切口基质透镜取出术 去瓣机械法准分子激光角膜上皮瓣下磨镶术 视觉质量 

分 类 号：R779.63[医药卫生—眼科]