全飞秒激光手术对近视眼患者视力改善及角膜非球面系数和角膜全层厚度的影响  

Effect of full femtosecond laser surgery on visual acuity improvement,corneal aspherical coefficient and corneal thickness in myopic patients

作　　者：祁晓君 明春平 杨卫国 张娟 QI Xiao-jun;MING Chun-ping;YANG Wei-guo(Department of Ophthalmology,Cangzhou People's Hospital,Cangzhou Hebei 061000,China)

机构地区：[1]沧州市人民医院眼科,河北沧州061000

出　　处：《临床和实验医学杂志》2023年第2期196-199,共4页Journal of Clinical and Experimental Medicine

基　　金：河北省2021年度医学科学研究课题计划(编号:20210295)。

摘　　要：目的研究飞秒激光小切口透镜取出术(SMILE)对近视眼患者视力改善、角膜非球面系数(Q值)和角膜全层厚度的影响。方法回顾性选取2021年5月至2022年4月入沧州市人民医院眼科的100例(200眼)中高度近视患者,均行SMILE治疗;比较术前与术后1 d、7 d、14 d、1个月、3个月、6个月视力指标[裸眼视力(UC-VA)、最佳矫正视力(BC-VA)、等效屈光度(SE)]、角膜形态参数[角膜非球面Q值、角膜表面规则指数(SRI)、角膜全层厚度、角膜曲率(K)]变化,并观察并发症(视力恢复迟缓、角膜瓣缘出血、角膜感染)发生情况。结果手术前后视力指标比较:术后1 d、7 d、14 d、1个月、3个月、6个月的UC-VA、BC-VA、SE均明显高于术前,差异均有统计学意义(P<0.05)。手术前后角膜形态参数比较:术后1 d、7 d、14 d、1个月、3个月、6个月的角膜全层厚度、K均明显低于术前,术后角膜非球面Q值、SRI均明显高于术前,差异均有统计学意义(P<0.05)。并发症发生情况:100例患者中,2例视力恢复迟缓,1例角膜瓣缘出血,无1例患者出现角膜感染,经对症处理均可缓解。结论全飞秒激光手术可有效提升近视患者视力水平与改善角膜形态参数,且并发症少,安全性高。Objective To investigate the effect of femtosecond laser small incision lenticule extraction(SMILE)on visual acuity improvement,corneal aspherical coefficient(Q value)and corneal full-thickness thickness in myopia patients.Methods A total of 100 patients(200 eyes)with moderate to high myopia who were admitted to the Department of Ophthalmology of Cangzhou People’s Hospital from May 2021 to April 2022 were retrospectively selected,and all received SMILE treatment;preoperative and postoperative 1 d,7 d,14 d,1 month,3 months,6 months visual acuity index[uncorrected visual acuity(UC-VA),best corrected visual acuity(BC-VA),equivalent diopter(SE)],corneal morphological parameters[corneal aspheric Q value,Corneal surface regularity index(SRI),full-thickness corneal thickness,corneal curvature(K)]changes,and the occurrence of complications(sluggish vision recovery,corneal flap hemorrhage,corneal infection)were observed.Results Comparison of visual acuity indexes before and after surgery:UC-VA,BC-VA,and SE at 1 d,7 d,14 d,1 month,3 months,and 6 months after surgery were significantly higher than those before surgery,and the difference was significant(P<0.05).Comparison of corneal morphological parameters before and after surgery:the corneal full-thickness thickness and K at 1 d,7 d,14 d,1 month,3 months,and 6 months after surgery were significantly lower than those before surgery.The value and SRI were significantly higher than those before operation,and the difference was significant(P<0.05).Complication Among the 100 patients,2 patients had delayed vision recovery,1 patient had corneal flap hemorrhage,and 1 patient had corneal infection,which could be relieved by symptomatic treatment.Conclusion Full femtosecond laser surgery can effectively improve the visual acuity and corneal morphological parameters in patients with myopia,with fewer complications and high safety.

关 键 词：近视眼 全飞秒激光手术 视力 角膜形态 并发症 

分 类 号：R779.63[医药卫生—眼科]