不同资历医师行SMILE中发生非计划分离的独立风险因素  

Independent risk factors related to unintended initial dissection of the posterior plane in small incision lenticule extraction performed by surgeons with different qualifications

作　　者：祝泽宇 王庆 熊健[1] 王楠叶[1] 徐静静 俞康 郭哲梁 徐一铖 俞益丰[1] ZHU Zeyu;WANG Qing;XIONG Jian;WANG Nanye;XU Jingjing;YU Kang;GUO Zheliang;XU Yicheng;YU Yifeng(Ophthalmic Center,the Second Affiliated Hospital,Nanchang University,Nanchang 330000,Jiangxi Province,China;Nanchang University,Nanchang 330000,Jiangxi Province,China)

机构地区：[1]南昌大学第二附属医院眼科中心,江西省南昌市330000 [2]南昌大学,江西省南昌市330000

出　　处：《眼科新进展》2024年第7期540-543,共4页Recent Advances in Ophthalmology

基　　金：国家自然科学基金项目(编号:82260214);江西省自然科学基金项目(编号:20212ACB206022);江西省卫生健康委员会科技计划项目(编号:202110043)。

摘　　要：目的探讨不同资历医师行飞秒激光小切口角膜基质透镜取出术(SMILE)中发生非计划分离(UIDPP)的独立风险因素。方法选取2021年4月至9月由三名不同资历的手术医师完成的1600例(3003眼)SMILE患者作为研究对象,男911例,女689例,患者年龄(21.82±3.55)岁。记录患者UIDPP发生情况,同时汇总患者年龄、性别、眼别、主刀医师、手术熟练程度、主觉验光、角膜中央厚度、角膜基质透镜厚度、角膜小切口位置、透镜边切厚度等参数。运用二分类Logistic回归分析UIDPP发生的独立风险因素。检验水准:α=0.05。结果本研究共观测3003眼,UIDPP发生率为6.56%(197眼),所有术眼均成功取出透镜。多因素Logistic回归分析发现,手术医师(P=0.035)、手术熟练程度(P=0.026)、术眼眼别(P=0.007)、角膜基质透镜厚度(P<0.001)和透镜边切厚度(P<0.001)均为UIDPP发生的独立风险因素。其余指标差异均无统计学意义(均为P>0.05)。结论手术医师、手术熟练程度、术眼眼别、角膜基质透镜厚度和透镜边切厚度为UIDPP发生的独立风险因素。Objective To investigate independent risk factors for unintended initial dissection of the posterior plane(UIDPP)during small incision lenticule extraction(SMILE)by surgeons with different qualifications.Methods A total of 1600 patients(3003 eyes)who underwent SMILE performed by three surgeons with different qualifications from April to September 2021 were selected as the research subjects,including 911 males and 689 females,with an average age of(21.82±3.55)years.The incidence of UIDPP in patients was recorded,along with a comprehensive summary of the age,gender,eyes,surgeons,surgical proficiency,subjective refraction,central corneal thickness,lenticule thickness,side cut angle,and peripheral lenticule thickness of the patients.Independent risk factors of UIDPP were analyzed using the binary logistic regression.Test level:α=0.05.Results In this study,the incidence of UIDPP was 6.56%(197/3003),and the lenticule was successfully removed in all eyes.Multivariate logistic regression analysis demonstrated that surgeon(P=0.035),surgical proficiency(P=0.026),eyes(P=0.007),lenticule thickness(P<0.001),and peripheral lenticule thickness(P<0.001)were independent risk factors associated with the UIDPP during SMILE surgery.No significant differences were observed in other parameters(all P>0.05).Conclusion Surgeons,surgical proficiency,eyes,lenticule thickness,and peripheral lenticule thickness are independent risk factors of UIDPP.

关 键 词：近视 飞秒激光小切口角膜基质透镜取出术 并发症 非计划分离 

分 类 号：R778[医药卫生—眼科]