CAJ | 학술논문

目的观察水浸润分离法在SMILE术中的安全性和有效性.方法前瞻性临床对照研究.将拟采用SMILE手术完成近视及近视散光患者72例(144眼)纳入研究,每例患者随机选取一眼常规分离角膜基质透镜,对侧眼水浸润分离角膜基质透镜.观察术中切口上皮损伤情况,光镜下观察透镜边缘的整齐程度.采用独立样本t检验比较2组术后视力、屈光状态、对比敏感度.结果术中发生角膜切口边缘上皮损伤水浸润分离组与常规分离组分别为2眼(3％)与14眼(19％),差异有统计学意义(x2=6.41,P＜0.01).采用水浸润法分离的角膜基质透镜边缘光滑整齐,常规分离的透镜边缘相对粗糙.水浸润法分离组与常规分离组术后第1天视力为4.98±0.06与4.89±0.53,等效球镜度为(+0.20±0.42)D与(+0.30±0.37)D,差异无统计学意义(t=-1.53,P＞0.05),残余散光度为(0.14±0.40)D与(0.41±0.57)D,差异有统计学意义(t=-3.29,P＜0.05).术后第1个月视力分别为4.99±0.06与4.97±0.06,等效球镜度分别为(+0.11±0.40)D与(+0.13±0.41)D,差异无统计学意义(t=-1.88,P＞0.05),残余散光度为(0.05±0.46)D与(0.36±0.66)D,差异有统计学意义(t=-3.41,P＜0.05).2组对比敏感度差异无统计学意义.结论与常规SMILE术中微透镜分离法相比,水浸润分离法可有效地减少术中角膜上皮的损伤,减小分离阻力,取出的角膜基质透镜表面更加平滑,边缘更加整齐,并明显减少了术后残余散光.
목적 관찰수침윤분리법재SMILE술중적안전성화유효성.방법 전첨성림상대조연구.장의채용SMILE수술완성근시급근시산광환자72례(144안)납입연구,매례환자수궤선취일안상규분리각막기질투경,대측안수침윤분리각막기질투경.관찰술중절구상피손상정황,광경하관찰투경 변연적정제정도.채용독립양본t검험비교2조술후시력、굴광상태、대비민감도.결과 술중발생각막절구변연상피손상수침윤분리조여상규분리조분별위2안(3％)여14안(19％),차이유통계학의의(x2=6.41,P＜0.01).채용수침윤법분리적각막기질투경변연광활정제,상규분리적투경변연상대조조.수침윤법분리조여상규분리조술후제1천시력위4.98±0.06여4.89±0.53,등효구경도위(+0.20±0.42)D여(+0.30±0.37)D,차이무통계학의의(t=-1.53,P＞0.05),잔여산광도위(0.14±0.40)D여(0.41±0.57)D,차이유통계학의의(t=-3.29,P＜0.05).술후제1개월시력분별위4.99±0.06여4.97±0.06,등효구경도분별위(+0.11±0.40)D여(+0.13±0.41)D,차이무통계학의의(t=-1.88,P＞0.05),잔여산광도위(0.05±0.46)D여(0.36±0.66)D,차이유통계학의의(t=-3.41,P＜0.05).2조대비민감도차이무통계학의의.결론 여상규SMILE술중미투경분리법상비,수침윤분리법가유효지감소술중각막상피적손상,감소분리조력,취출적각막기질투경표면경가평활,변연경가정제,병명현감소료술후잔여산광.
Objective To observe the safety and efficacy of liquid infiltration method to separate lenticule in small incision lenticule extraction (SMILE).Methods In this prospective study,72 patients were included.Randomly selected one eye was performed conventional method; the contralateral eye was performed liquid infiltration method.The corneal epithelium injury around the incision in surgery and the smoothness of the lenticule edge was observed under optical microscope.The differences of visual acuity,refraction,contrast sensitivity postoperatively between the two groups using independent samples t test.Results The corneal epithelium injuries were observed in 2 eyes in liquid infiltration method and 14 eyes in conventional method during surgery,the difference was statistically significant (x2=6.41,P＜0.01),the lenticule edges of liquid infiltration method were smoother than conventional method.The visual acuity,spherical equivalent (SE) and residual astigmatism of liquid infiltration method and conventional method 1 day postoperative were:4.98±0.06 and 4.89±0.53,+0.20±0.42 D and +0.30±0.37 D,0.14±0.40 D and 0.41±0.57 D respectively.The difference of residual astigmatism was statistically significant (t=-3.29,P＜0.05).The visual acuity,spherical equivalent and residual astigmatism of liquid infiltration method and conventional method 1 month postoperative were:4.99± 0.06 and 4.97±0.06,+0.11±0.40 D and +0.13±0.41 D,0.05±0.46 D and +0.36±0.66 D,respectively.The difference of residual astigmatism was statistically significant (t=-3.41,P＜0.05).The difference of contrast sensitivity was without statistically significant.Conclusion The liquid infiltration method makes the edge of lenticule smoother and effectively reduces the corneal epithelial injury and residual astigmatism.It is a safe and feasible skill in SMILE.