术前近视屈光度及术后角膜曲率变化与SMILE术后屈光回退的关系  

Relationship between preoperative myopic diopter and postoperative corneal curvature changes and postoperative refractive regression in patients with high myopia after SMILE

作　　者：钮丹 景聪荣 张君苒 Niu Dan;Jing Congrong;Zhang Junran(Department of Ophthalmology,Nanshi Hospital of Nanyang,Nanshi Hospital Affiliated to Henan University,Nanyang 473000,China)

机构地区：[1]南阳南石医院眼科、河南大学附属南石医院,南阳473000

出　　处：《中华眼外伤职业眼病杂志》2023年第8期630-635,共6页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的分析术前近视屈光度及术后角膜曲率变化与高度近视者飞秒激光小切口角膜基质透镜取出术(SMILE)术后屈光回退的关系。方法前瞻性队列研究。连续收集南阳南石医院2019年1月至2022年1月行SMILE术的高度近视者300例,术后随访1年,按术后有无发生屈光回退分为屈光回退组及无屈光回退组。分析两组的临床资料,均选取右眼纳入本研究。分析高度近视SMILE术后发生屈光回退的影响因素,术前近视屈光度及术后角膜曲率变化与术后屈光回退发生率的关系。结果本研究SMILE术后1年的屈光回退发生率为7.33%(22/300)。与无屈光回退组比较,屈光回退组术前近视屈光度、术后角膜曲率变化幅度较大(P<0.05)。多因素logistic回归分析显示:术前近视屈光度及术后角膜曲率变化幅度是高度近视SMILE术后发生屈光回退的相关因素(OR=0.43、1.62,均P<0.05)。术前近视屈光度与SMILE术后屈光回退发生率呈负相关(r=-0.30,P<0.05),术后角膜曲率变化幅度与屈光回退发生率呈正相关(r=0.23,P<0.05)。绘制受试者工作特征曲线发现,术前近视屈光度及术后角膜曲率变化幅度在术后屈光回退中有一定预测价值,联合预测药时曲线下面积(AUC)高于单一预测方法。结论术前近视屈光度及术后角膜曲率变化是高度近视SMILE术后屈光回退发生的影响因素,与屈光回退发生率存在相关性,可作为术后屈光回退发生的预测因子,且联合预测效能最高。Objective To analyze the relationship between preoperative myopia diopter and postoperative corneal curvature changes and refractive regression after femtosecond laser small incision corneal stroma lens extraction(SMILE)in high myopia patients.Methods This was a prospective cohort study.A total of 300 patients with high myopia undergone SMILE surgery in Nanyang Nanshi Hospital from Jan.2019 to Jan.2022 were continuously collected and followed up for 1 year after surgery.They were divided into the refractive regression group and the non-refractive regression group based on whether refractive regression occurred after surgery.The clinical data of both groups were analyzed,and the right eye was selected for inclusion in this study.The influencing factors of refractive regression after high-myopia SMILE surgery and the relationship between preoperative myopia diopter and postoperative corneal curvature and the incidence of postoperative refractive regression were analyzed.Results The incidence of refractive retraction in this study was 7.33%(22/300)at 1 year after SMILE.Compared with the non-refractive retraction group,the refractive power of preoperative myopia and postoperative corneal curvature were larger in the refractive regression group(P<0.05).Multivariate logistic regression analysis showed that the diopter of preoperative myopia and the variation of corneal curvature after surgery were the relevant factors for refractive regression after SMILE with high myopia(OR=0.43,1.62,all P<0.05).Preoperative myopia refractive power was negatively correlated with the incidence of refractive retraction after SMILE(r=-0.30,P<0.05),and the variation of corneal curvature after surgery was positively correlated with the incidence of refractive regression(r=0.23,P<0.05).By drawing the working characteristic curve of the subjects,it was found that the diopter of preoperative myopia and the variation of corneal curvature after surgery had certain predictive value in postoperative refractive retraction,and the area under the cu

关 键 词：屈光度 近视 差值 角膜曲率 近视 高度 飞秒激光小切口角膜基质透镜取出术 回退 屈光 

分 类 号：R779.6[医药卫生—眼科]