基于观察屏的手动旋转补偿法在SMILE矫正顺规散光中的应用效果  

Efficacy of observation screen-based manual cyclotorsion compensation in the correction of with-the-rule astigmatism during SMILE

作　　者：卢雅琳 熊健[1] 黄菲 艾冲 桂馥[1] LU Yalin;XIONG Jian;HUANG Fei;AI Chong;GUI Fu(Ophthalmic Center,the Second Affiliated Hospital,Nanchang University,Nanchang 330006,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330006

出　　处：《眼科新进展》2025年第5期365-369,共5页Recent Advances in Ophthalmology

基　　金：国家自然科学基金项目(编号:82260214);江西省卫生健康委科技计划项目(编号:SKJP 220224218)。

摘　　要：目的探讨基于观察屏的手动旋转补偿法在飞秒激光小切口角膜基质透镜取出术(SMILE)矫正顺规散光中的应用效果。方法本研究为前瞻性研究。选取2024年4月至9月在南昌大学第二附属医院眼科中心接受SMILE及Q值引导飞秒激光辅助原位角膜磨镶术(FS-LASIK)的患者各40例。采用随机数字法将SMILE患者的一眼纳入手动旋转补偿组(旋转组,40眼),对侧眼纳入未手动旋转补偿组(未旋转组,40眼);同时,随机抽取Q值引导FS-LASIK患者的一眼纳入FS-LASIK组(40眼)。分别于术前及术后3个月检查并记录各组患者年龄、裸眼远视力(UDVA)、球镜度、柱镜度、等效球镜度(SE)及矫正远视力(CDVA)。采用Alpins矢量分析法对散光进行矢量分析,散光评价指标包括:目标矫正散光(TIA)、手术矫正散光(SIA)、差异矢量(DV)、矫正指数(CI)、成功指数(IOS)、误差角度(AE)及误差角度的绝对值(|AE|)。结果术前,旋转组、未旋转组和FS-LASIK组患者的年龄、球镜度、柱镜度、SE、CDVA比较差异均无统计学意义(均为P>0.05)。术后3个月时,旋转组患者的UDVA及柱镜度均优于未旋转组,差异均有统计学意义(均为P<0.05),而CDVA、球镜度及SE差异均无统计学意义(均为P>0.05)。旋转组与FS-LASIK组的UDVA、CDVA及各屈光参数差异均无统计学意义(均为P>0.05)。术后3个月时,对散光进行Alpins矢量分析结果显示:旋转组的SIA、CI、IOS及|AE|均优于未旋转组,差异均有统计学意义(均为P<0.05);而TIA、DV、AE差异均无统计学意义(均为P>0.05)。旋转组与FS-LASIK组的各项散光矢量参数比较,差异均无统计学意义(均为P>0.05)。线性趋势拟合方程表明各组患者TIA与SIA均呈高度线性相关。结论基于观察屏的手动旋转补偿SMILE在矫正顺规散光时,其效果与Q值引导的FS-LASIK相当,且优于传统SMILE水印中心法。Objective To evaluate the efficacy of the manual cyclotorsion compensation method based on the observation screen in the correction of with-the-rule astigmatism during small incision lenticule extraction(SMILE).Methods This prospective study enrolled 40 patients who underwent SMILE and another 40 patients who underwent Q-value-guided femtosecond laser-assisted laser in situ keratomileusis(FS-LASIK)at the Ophthalmology Center of the Second Affiliated Hospital of Nanchang University from April to September 2024.Through the random number method,one eye of each patient who underwent SMILE was assigned to the manual cyclotorsion compensation group(the cyclotorsion group,40 eyes),while the contralateral eye was assigned to the non-cyclotorsion group(the non-cyclotorsion group,40 eyes).Meanwhile,one eye of each patient who underwent FS-LASIK was randomly selected for the FS-LASIK group(40 eyes).The age,uncorrected distance visual acuity(UDVA),spherical power,cylindrical power,spherical equivalent(SE),and corrected distance visual acuity(CDVA)were recorded before surgery and 3 months after surgery,respectively.Astigmatism was subjected to Alpins vector analysis,and the indicators for assessing astigmatism included target-induced astigmatism(TIA),surgically-induced astigmatism(SIA),difference vector(DV),correction index(CI),success index(IOS),angle of error(AE),and absolute value of angle of error(|AE|).Results Before surgery,there was no significant difference in age,spherical power,cylindrical power,SE,and CDVA among the cyclotorsion group,the non-cyclotorsion group,and the FS-LASIK group(all P>0.05).At 3 months after surgery,the cyclotorsion group showed better UDVA and lower cylindrical power than the non-cyclotorsion group,with statistically significant differences(both P<0.05);however,there was no significant difference in CDVA,spherical power,and SE between the two groups(all P>0.05).Besides,there was no significant difference in UDVA,CDVA,or refractive parameters between the cyclotorsion and FS-LASIK groups(all P>

关 键 词：飞秒激光小切口角膜基质透镜取出术 观察屏 顺规散光 旋转补偿法 Alpins矢量分析 

分 类 号：R778[医药卫生—眼科]