CAJ | 학술논문

目的探讨SMILE矫正近视的安全性、有效性、可预测性及稳定性等.方法前瞻性研究.符合屈光手术常规适应证的94例(170眼)近视患者入选,行常规SMILE手术.患者年龄为18～44岁,平均(26.8±4.7)岁,术前等效球镜度(SE)-3.25～-9.13 D,平均(-6.20±1.37)D,散光0.00～-3.25 D,中位数-0.75(0.75)D,角膜厚度484～600 μm,平均(554.7±27.5) μm.常规检查包括UCVA、BCVA、屈光度、眼压及角膜地形图、像差、裂隙灯显微镜检查等.术后随访6～24个月.采用配对t检验、线性回归分析进行统计分析.结果所有病例手术顺利.术后2年UCVA≥1.0、≥0.8的眼数分别为97％、100％.100％的术眼BCVA达到或高于术前BCVA,35％BCVA提高1行,10％BCVA提高2行.术后SE为(-0.01±0.45)D,87％术眼SE在±0.50 D以内,100％术眼SE在±1.00 D以内.术后总高阶像差、球差、彗差均方根值与术前比较均增加(t=-6.861、-2.078、-5.672,P＜0.05),分别增加(0.15±0.12)μm、(0.04±0.11)μm、(0.14±0.14)μm.结论 SMILE矫正近视临床效果肯定,具有较好的有效性、安全性、可预测性及稳定性;术后高阶像差、球差、彗差均增加,球差增加较少.
목적 탐토SMILE교정근시적안전성、유효성、가예측성급은정성등.방법 전첨성연구.부합굴광수술상규괄응증적94례(170안)근시환자입선,행상규SMILE수술.환자년령위18～44세,평균(26.8±4.7)세,술전등효구경도(SE)-3.25～-9.13 D,평균(-6.20±1.37)D,산광0.00～-3.25 D,중위수-0.75(0.75)D,각막후도484～600 μm,평균(554.7±27.5) μm.상규검사포괄UCVA、BCVA、굴광도、안압급각막지형도、상차、렬극등현미경검사등.술후수방6～24개월.채용배대t검험、선성회귀분석진행통계분석.결과 소유병례수술순리.술후2년UCVA≥1.0、≥0.8적안수분별위97％、100％.100％적술안BCVA체도혹고우술전BCVA,35％BCVA제고1행,10％BCVA제고2행.술후SE위(-0.01±0.45)D,87％술안SE재±0.50 D이내,100％술안SE재±1.00 D이내.술후총고계상차、구차、혜차균방근치여술전비교균증가(t=-6.861、-2.078、-5.672,P＜0.05),분별증가(0.15±0.12)μm、(0.04±0.11)μm、(0.14±0.14)μm.결론 SMILE교정근시림상효과긍정,구유교호적유효성、안전성、가예측성급은정성;술후고계상차、구차、혜차균증가,구차증가교소.
Objective To investigate the clinical efficacy,safety,predictability and stability of femtosecond laser small incision lenticule extraction (SMILE) for the treatment of myopia.Methods In this prospective observational study,94 patients (170 eyes) with myopia underwent SMILE surgeries.The average age of the patients was 26.8±4.7 years (range 18 to 44 years).The mean preoperative spherical equivalent (SE) was-6.20±1.37 diopters (D),from-3.25 to-9.13 D.The median myopic astigmatism was-0.75 (0.75) D,up to-3.25 D.The mean corneal thickness was 554.7±27.5 μm (range 484 to 600 μm).Routine ophthalmic examinations were performed.The patients were followed from 6 months to 2 years with uncorrected visual acuity (UCVA),best corrected visual acuity (BCVA),manifest refraction,intraocular pressure,corneal topography,and slit lamp examinations.The results were analyzed with a paired t test and linear regression analysis.Results All procedures were completed successfully.At the long-term follow-up examination,97％ of eyes had a UCVA of 1.0 or better and 100％ of eyes had a UCVA of 0.8 or better.BCVA was equal to or better than the preoperative BCVA in 100％ of eyes.35％ gained one line and 10％ gained two lines of BCVA.The mean postoperative SE was-0.01±0.45 D and 87％ and 100％ were within ±0.50 and ±1.00 D of the attempted correction.The root mean square (RMS) values of total higher order aberrations (HOA),spherical aberrations and coma increased by a significant amount after surgery:0.15±0.12 μm,0.04±0.11 μm,0.14±0.14 μm (t=-6.861,-2.078,-5.672,P＜0.05).Conclusion The SMILE procedure is safe,effective,predictable and the results were stable for treating myopia.HOA,spherical and coma aberrations increased postoperatively but the change in spherical aberrations was small.