全飞秒激光小切口角膜基质内透镜取出术在屈光不正患者中的疗效及安全性分析  

Efficacy and safety of femtosecond laser small incision lenticule extraction in patients with refractive errors

作　　者：秦庆[1] 王晓莉[2] 杨建芳[1] Qin Qing;Wang Xiao-li;Yang Jian-fang(Department of Ophthalmology,Ziyang Traditional Chinese Medicine Hospital,Ziyang,Sichuan 641300,China;Department of Ophthalmology,Jianyang People's Hospital,Jianyang,Sichuan 641499,China)

机构地区：[1]资阳市中医医院眼科,四川资阳641300 [2]简阳市人民医院眼科,四川简阳641499

出　　处：《中国现代医学杂志》2025年第4期79-84,共6页China Journal of Modern Medicine

基　　金：四川省科技计划项目(No:2022YFS0234)。

摘　　要：目的探讨全飞秒激光小切口角膜基质内透镜取出术(SMILE)在屈光不正患者中的疗效及安全性。方法选取2022年10月—2023年12月在资阳市中医医院行角膜屈光矫治的屈光不正患者92例,患眼184只眼。采用随机数字表法分为SMILE组46例(患眼92只眼)与飞秒激光制瓣的准分子激光原位角膜磨镶术(FSLASIK)组46例(患眼92只眼),SMILE组行SMILE治疗,FS-LASIK组行FS-LASIK治疗。治疗前、治疗后1和6个月,比较两组的裸眼视力(UCVA)、双眼最佳矫正视力(BCVA)、角膜表面非球面参数Q值、规则指数(SRI)及脂质层厚度。结果SMILE组与FS-LASIK组患者治疗前、治疗后1和6个月的UCVA、BCVA、非球面参数Q值、SRI、眼表脂质层厚度比较,结果:(1)不同时间点UCVA、BCVA、非球面参数Q值、SRI比较,差异均有统计学意义(P<0.05);不同时间点眼表脂质层厚度比较,差异无统计学意义(P>0.05)。(2)SMILE组与FSLASIK组患者UCVA、BCVA、眼表脂质层厚度比较,差异均无统计学意义(P>0.05);两组患者非球面参数Q值、SRI比较,差异均有统计学意义(P<0.05)。(3)两组患者的UCVA、BCVA、非球面参数Q值、SRI变化趋势比较,差异均有统计学意义(P<0.05);两组患者眼表脂质层厚度变化趋势比较,差异无统计学意义(P>0.05)。两组术后并发症发生率比较,差异无统计学意义(P>0.05)。结论SMILE治疗屈光不正有助于减小角膜形态变化及损伤,提高术后角膜稳态,促进术后视力恢复。Objective To explore the efficacy and safety of femtosecond laser small incision lenticule extraction(SMILE)in patients with refractive errors.Methods The 92 patients with refractive errors(184 affected eyes)who underwent corneal refractive therapy at Ziyang Traditional Chinese Medicine Hospital from October 2022 to December 2023 were selected.Using a random number table method,they were divided into the SMILE group and the femtosecond laser-assisted laser in situ keratomileusis(FS-LASIK)group,with 46 cases(92 affected eyes)in each group.The patients in the SMILE group received SMILE treatment,while those in the FS-LASIK group received FS-LASIK treatment.The uncorrected visual acuity(UCVA),best corrected visual acuity(BCVA),corneal Q value,surface regularity index(SRI),and lipid layer thickness were compared between the two groups before treatment,1 month after treatment,and 6 months after treatment.Results The comparison of UCVA,BCVA,corneal Q value,SRI and lipid layer thickness in the SMILE group and the FS-LASIK group before treatment,1 month after treatment,and 6 months after treatment showed that all(P<0.05)but not lipid layer thickness(P>0.05)were different among the time points,and that UCVA,BCVA and lipid layer thickness were not different(P>0.05)but corneal Q value and SRI were different between the two groups(P<0.05).The change trends of UCVA,BCVA,corneal Q value and SRI(P<0.05)but not the change trend of lipid layer thickness(P>0.05)were different between the two groups.There was no statistically significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusions SMILE for the treatment of refractive errors helps reduce morphological changes and damage to the cornea,improves postoperative corneal stability,and promotes faster recovery of vision after surgery.

关 键 词：屈光不正 全飞秒激光 小切口角膜基质内透镜取出术 

分 类 号：R778[医药卫生—眼科]