飞秒激光SMILE术对近视性屈光参差患者视功能参数和稳定性的随访分析  

Follow-up Analysis on Visual Function Parameters and Stability in Patients with Myopic Anisometropia Given Individualized Femtosecond Laser SMILE

作　　者：刘红杰 崔燕[1] 刘霞[1] 张珍珍 白鹏飞 任延军[1] LIU Hongjie;CUI Yan;LIU Xia;ZHANG Zhenzhen;BAI Pengfei;REN Yanjun(Department of Refractive Surgery,Handan Eye Hospital,Handan Third Hospital,Handan 056000,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,邯郸市056000

出　　处：《中国激光医学杂志》2025年第1期18-22,共5页Chinese Journal of Laser Medicine & Surgery

基　　金：2022年度河北省医学科学研究课题(20220480)。

摘　　要：目的探讨飞秒激光小切口基质透镜取出术(small incision lenticule extraction,SMILE)对近视性屈光参差患者视功能参数和稳定性的影响。方法选取2022年1月至2023年6月近视性屈光参差患者186例,所有患者均予以SMILE手术,分别于术前、术后1周、术后1个月、术后3个月、术后6个月和术后12个月评估患者视功能(包括视力、屈光度、双眼等效球镜差值),记录角膜滞后量、角膜阻力因子、彗差、三叶草、球差、总高阶像差的改变及稳定性。结果所有患者术后裸眼视力较术前明显提升,屈光度、双眼等效球镜差值明显降低(P<0.05),且术后6~12个月上述视功能参数趋于稳定。所有患者术后角膜滞后量、角膜阻力因子较术前降低(P<0.05),随着时间的推移逐渐趋于正常。所有患者术后彗差、三叶草、球差、总高阶像差均较术前显著增加(P<0.05),且术后6~12个月上述角膜像差参数趋于稳定。结论SMILE治疗近视性屈光参差具有术后视力恢复快、屈光状态稳定等优点,能有效地矫正双眼的屈光参差状态,并维持长期效果。Objective To investigate the visual function parameters and stability of incision after femtosecond laser small incision lenticule extraction(SMILE)in patients with myopia anisometropia.Methods Totally 186 patients with myopic anisometropia given SMILE surgery between Jan.2022 to Jun.2023 were selected.Their visual functions(including visual acuity,diopter and equivalent spherical difference of both eyes)were evaluated before surgery and 1 week and 1,3,6,12 months after the surgery respectively.The changes and stability of their corneal hysteresis,corneal resistance factor,coma,trefoil,spherical aberration and total higher order aberration were recorded.Results After the surgery,the naked eye visual acuity of all the patients was significantly improved,and their diopter and binocular equivalent spherical difference remarkably decreased(P<0.05),which tended to be stable 6 to 12 months after the surgery.For all the patients,the corneal hysteresis and corneal resistance factor level decreased after the surgery(P<0.05),which gradually normalized over time.In addition,their coma,trefoil,spherical aberration and total high-order aberration significantly increased after the surgery(P<0.05),which tended to be stable 6 to 12 months after the surgery.Conclusions SMILE for the treatment of myopic anisometropia exhibits such advantages as rapid postoperative visual recovery and stable refractive status while being able to effectively correct the anisometropia of both eyes and maintain long-term effect.

关 键 词：近视性屈光参差 飞秒激光 小切口基质透镜取出术 视功能 稳定性 

分 类 号：R779.63[医药卫生—眼科] R778.11[医药卫生—临床医学]