飞秒激光小切口角膜基质透镜取出术对眼高阶像差影响的研究进展  

Advancements in understanding how small incision lenticule extraction impacts ocular high order aberrations

作　　者：杜一帆 齐林嵩 李莹[1] DU Yifan;QI Linsong;LI Ying(Department of Ophthalmology,Peking Union Medical College,Chinese Academy of Medical Sciences,Beijing 100730,China;Department of Ophthalmology,Air Force Medical Center,Beijing 100142,China)

机构地区：[1]中国医学科学院北京协和医学院眼科,北京100730 [2]空军特色医学中心眼科,北京100142

出　　处：《山东大学耳鼻喉眼学报》2025年第1期152-161,共10页Journal of Otolaryngology and Ophthalmology of Shandong University

基　　金：国家自然科学基金(82000863)。

摘　　要：飞秒激光小切口角膜基质透镜取出术(small incision lenticule extraction,SMILE)是目前临床矫正近视的主流手术方式之一,由于其具有准确、安全、可预测及恢复快等优点,目前已在临床广泛开展。但术后由高阶像差(high order aberration,HOA)产生的夜间视力下降、眩光、光晕、星芒等视觉症状影响着手术人群的视觉质量。本文通过总结有关SMILE术后HOA的变化研究,发现虽然SMILE不可避免引入HOA,但相比于部分其他类型的屈光手术能够明显地减少术后HOA的诱导,尤其是总HOA及球差的诱导,甚至与波前像差引导的个性化切削无明显差异。而术前近视及散光程度、术中角膜帽厚度、激光能量、集中度及定位方法的选择等也均会影响着术后HOA的大小,各类HOA的产生的影响机制及与SMILE的关系尚待进一步研究。Small incision lenticule extraction(SMILE)is a prominent corneal refractive surgery method for addressing myopia.It employs femtosecond laser technology to create a lenticle within the cornea,which is then removed through small incisions around the cornea.This procedure has gained popularity in clinical practice due to its notable advantages including precision,safety,predictability,and swift recovery times.However,post-SMILE surgery,some patients experience visual symptoms like reduced nighttime vision,glare,halos,and starbursts,attributed to high order aberrations(HOAs),which affect the visual quality of the patients.This review examines the impact of SMILE surgery on HOAs and observes that while SMILE does introduce HOAs,it tends to minimize the induction of postoperative HOAs compared to certain other refractive surgery techniques.Notably,it significantly reduces total HOAs and spherical aberrations and,in some cases,even shows no significant difference when compared to personalized treatments guided by wavefront aberrations.Several factors influence the extent of post-SMILE HOAs,including the degree of preoperative myopia and astigmatism,corneal cap thickness during surgery,laser energy,concentration,and choice of positioning methods.However,further research is required to delve into the mechanisms behind various HOAs and their relationship with SMILE surgery.

关 键 词：高阶像差 近视 飞秒激光小切口角膜基质透镜取出术 

分 类 号：R778[医药卫生—眼科]