Trans-PRK、FS-LASIK和SMILE矫正近视散光的对比观察  

Comparative observation of Trans-PRK, FS-LASIK, and SMILE for myopia with astigmatism

作　　者：周其亮 周跃华 周春阳 于嘉 李辰 ZHOU Qiliang;ZHOU Yuehua;ZHOU Chunyang;YU Jia;LI Chen(The Academy of Ophthalmology,Chengdu University of Traditional Chinese Medicine,Chengdu 610075,Sichuan,China;Ophthalmology Beijing Ming Vision,Beijing 100062,China)

机构地区：[1]成都中医药大学眼科学院,四川成都610075 [2]北京茗视光眼科,北京100191

出　　处：《山东大学耳鼻喉眼学报》2023年第1期85-93,共9页Journal of Otolaryngology and Ophthalmology of Shandong University

摘　　要：目的 探讨Trans-PRK、FS-LASIK和SMILE矫正近视散光的临床效果。方法 选择Trans-PRK组54眼、FS-LASIK组55眼和SMILE组56眼进行回顾性病例研究,随访6个月,比较三组的术前术后各个时间点的视力、屈光度、高阶像差,评估三种不同术式的安全性、有效性。结果 (1)三组术前基线数据差异无统计学意义(P=0.148, 0.148, 0.31, 0.285, 0.283, 0.901);(2)术后1、3、6个月三组之间的UCVA差异无统计学意义(P=0.902),组内比较时Trans-PRK组术后6个月视力高于术后1个月差异具有统计学意义(χ2=0.571,P=0.014);(3)三组间只有在术后1个月柱镜度数差异具有统计学意义(χ2=9.411,P=0.009),两两比较时FS-LASIK组柱镜度数小于SMILE组差异具有统计学意义(χ2=24.400,P=0.004),在术后3、6个月三组之间的柱镜度数差异无统计学意义(P=0.159, 0.106);(4)术后1、3、6个月三组之间的SE差异无统计学意义(P=0.132, 0.299, 0.643);(5)术后1、3、6个月三组间彗差差异具有统计学意义(χ2=20.939,20.129,19.208,P均<0.001),Trans-PRK组小于FS-LASIK组及SMILE组差异具有统计学意义(P=0.008, 0.019, 0.034,<0.001,<0.001,<0.001),组内比较Trans-PRK组及FS-LASIK组术后3、6个月彗差高于术前差异具有统计学意义(P=0.003,<0.001),SMILE组术后1、3、6个月彗差高于术前差异具有统计学意义(P均<0.001);(6)术后1、3、6个月三组间球差差异具有统计学意义(χ2=47.363,24.167, 22.913,P均<0.001),FS-LAISK组在术后的1、3、6个月球差均高于Trans-PRK组与SMILE组差异具有统计学意义(P<0.001,<0.001,0.005,<0.001,0.007,<0.001),组内比较时Trans-PRK、组与FS-LASIK组术后1、3、6个月球差高于术前差异具有统计学意义(P均<0.001),SMILE组术后3、6个月球差高于术前差异具有统计学意义(χ2=-1.726,-1.858,P均<0.001),SMILE组术后1月球差低于术后3、6个月差异具有统计学意义(χ2=-1.085,-1.217,P均<0.001);(7)三组患者在术后1、3、6个月的高阶像差差异有统计学�Objective This paper was aimed to investigate the clinical effect of Trans-PRK, conventional FS-LASIK, and SMILE for the correction of myopia and astigmatism. Methods In this retrospective study, we evaluated 54 eyes in the Trans-PRK group, 55 eyes in the FS-LASIK group, and 56 eyes in the SMILE group. ALL eyes follow-up period was 6 months. The visual acuity, diopters, and higher-order aberrations of the three groups were compared before and after surgery, and the safety and effectiveness of the three different methods were evaluated. Results(1)There was no significant difference in the preoperative baseline data among the three groups(P=0.148, 0.148, 0.31, 0.285, 0.283, 0.901).(2)There was also no significant difference in uncorrected visual acuity among the three groups at 1, 3, and 6 months after surgery(P=0.902). In the intra-group comparison, the UCVA at 6 months after surgery in the Trans-PRK group was higher than that at 1 month after surgery(χ~2= 0.571, P=0.014).(3)The power of the cylinder among the three groups differed only at 1 month after the operation(χ~2= 9.411, P=0.009). The degree of the cylinder in the FS-LASIK group was statistically significantly less than that in the SMILE group at 1-month post-operatively(χ~2=24.400, P=0.004), while there was no significant difference among the three groups at 3 and 6 months after surgery(P=0.159, 0.106).(4)There was no significant difference in spherical equivalent among the three groups at 1, 3, and 6 months after the operation(P=0.132, 0.299, 0.643).(5)There was a significant difference in coma among the three groups at 1, 3, and 6 months post-operatively(χ~2=20.939, 20.129, 19.208, all P<0.001), and the coma of the Trans-PRK group being statistically significantly less than that of the other two groups(P=0.008, 0.019, 0.034, <0.001, <0.001, <0.001). In the intra-group comparison, the coma of the Trans-PRK and FS-LASIK groups at 3 and 6 months after surgery were significantly higher than that before surgery(P=0.003, <0.001). The coma of the SMILE gro

关 键 词：Trans-PRK手术 FS-LASIK手术 SMILE手术 屈光度 高阶像差 

分 类 号：R771[医药卫生—眼科]