飞秒激光小切口角膜基质透镜取出术治疗中度、高度近视的优势研究  

Study onadvantages of small incision lenticule extraction (SMILE) in treatment of moderate and high myopia

作　　者：崔燕[1] 刘红杰 张珍珍 刘霞[1] 任延军[1] CUI Yan;LIU Hongjie;ZHANG Zhenzhen;LIU Xia;REN Yanjun(Department of Refractive Surgery,Handan Eye Hospital/Handan Third Hospital,Handan 056001,China)

机构地区：[1]邯郸市眼科医院/邯郸市第三医院屈光手术科,河北邯郸056001

出　　处：《新疆医科大学学报》2024年第7期961-964,969,共5页Journal of Xinjiang Medical University

基　　金：河北省卫生健康委科研项目(20210806)。

摘　　要：目的 分析飞秒激光小切口角膜基质透镜取出术(SMILE)治疗中度、高度近视的优势。方法 回顾性分析2023年5月至2023年10月在本院行飞秒激光术治疗的100例中度、高度近视患者临床资料,根据术式将患者分为两组,行飞秒激光辅助的原位角膜磨镶术(FS-LASIK)者为A组(49例98眼),行SMILE者为B组(51例102眼)。分别比较两组中度、高度近视患者不同术式治疗后角膜形态、视觉质量参数、眼压、泪膜破裂时间、Schirmer Ⅰ值、眼部舒适度评分(Kolcaba评分)、眼部视觉模拟评分量表评分(VAS评分)的差异。结果 (1)两组中度、高度近视患者术后3个月,角膜后表面曲率、角膜后表面顶点高度、非球面因子Q值差异无统计学意义(P>0.05)。(2)术后1、7 d,两组Z_(3)^(1)、Z_(3)^(-1)比较差异无统计学意义(P>0.05);但B组角膜前表面高阶像差、Z_(4)^(0)均低于A组(P<0.05)。B组中度、高度近视患者术后角膜前表面高阶像差、Z_(4)^(0)均低于A组(P<0.05);两组术后Z_(3)^(1)、Z_(3)^(-1)比较差异无统计学意义(P>0.05)。(3)两组中度、高度近视患者术后3个月眼压、泪膜破裂时间、Schirmer Ⅰ值差异均无统计学意义(P>0.05)。(4)术后3个月,两组中度、高度近视患者眼压、泪膜破裂时间、Schirmer Ⅰ值、Kolcaba评分、VAS评分差异均无统计学意义(P>0.05)。结论 FS-LASIK、SMILE手术治疗均可实现对中度、高度近视患者屈光矫正效果,治疗后均可获得稳定角膜表面形态,患者主观眼部感受均良好,但SMILE术后短期内视觉质量提升优势显著。Objective To analyze the advantages of femtosecond laser small incision lenticule extraction(SMILE) in the treatment of moderateand high myopia.Methods The clinical data of 100 patients with moderateand high myopia treated by femtosecond laser from May 2023 to October 2023 inthe Hospital were retrospectively analyzed.The patients were divided into 2 groups according to the operation type.Femtosecond laser in situ keratomileusis(FS-LASIK) was performed in group A(49 cases,98 eyes) and SMILE was performed in group B(51 cases,102 eyes).Compare the differences in corneal morphology,visual quality parameters,intraocular pressure,tear film rupture time,Schirmer I value,eye comfort score(Kolcaba score) and visual analog scale(VAS score) between the 2 groups of moderate and high myopia patients after the different surgical treatments.Results(1) There was no significant difference in the corneal posterior surface curvature,corneal posterior surface apex height and aspheric factor Q value between the 2 groups of moderate and high myopic patients 3 months after the surgery(P>0.05).(2) There was no significant difference in Z_(3)^(1) and Z_3^(-1) between the 2 groups at 1 and 7 days after the surgery(P>0.05).The high-order abbreviation of the anterior corneal surface and Z_(4)^(0) in group B were lower than those in group A at 1 and 7 days after the surgery(P<0.05).The high-order abbreviation of the anterior corneal surface and Z_(4)^(0) in group B were lower than those in group A in moderate and high myopic patients(P<0.05).There was no significant difference in Z_(3)^(1) and Z_3^(-1) between the 2 groups after the surgery(P>0.05).(3) There was no statistically significant difference in intraocular pressure,tear film rupture time and Schirmer I value between the 2 groups of moderate and high myopia patients at 3 months after the surgery(P>0.05).(4) There was no statistically significant difference in intraocular pressure,tear film rupture time,Schirmer I value Kolcaba score and VAS score between the 2 groups of moderate and

关 键 词：飞秒激光辅助原位角膜磨镶术(FS-LASIK) 飞秒激光小切口角膜基质透镜取出(SMILE) 角膜形态 视觉质量 

分 类 号：R778[医药卫生—眼科]