中华实验眼科杂志
中華實驗眼科雜誌
중화실험안과잡지
CHINESE JOURNAL OF EXPERIMENTAL OPHTHALMOLOGY
2015年
2期
159-164
,共6页
徐路路%王雁%刘洋辰%吴文静
徐路路%王雁%劉洋辰%吳文靜
서로로%왕안%류양신%오문정
散射%近视,近视散光/手术%视觉质量%飞秒激光小切口基质透镜取出术%飞秒激光辅助准分子激光角膜原位磨镶术
散射%近視,近視散光/手術%視覺質量%飛秒激光小切口基質透鏡取齣術%飛秒激光輔助準分子激光角膜原位磨鑲術
산사%근시,근시산광/수술%시각질량%비초격광소절구기질투경취출술%비초격광보조준분자격광각막원위마양술
Straylight%Myopia,myopia astigmatism/surgery%Visual quality%Small incision lenticule extraction%Femtosecond laser assisted laser in situ keratomileusis
背景 飞秒激光小切口基质透镜取出术(SMILE)是一种新的微创无瓣屈光矫治手术方式,具有良好的安全性及可预测性,但目前有关其术后视觉质量的研究尚少.了解SMILE术后散射的变化情况对于评估其术后视觉质量具有重要意义. 目的 对比分析SMILE与飞秒激光辅助准分子激光角膜原位磨镶术(FS-LASIK)矫治近视及近视散光后术眼眼内散射光计量值的变化情况.方法 采用回顾性研究方法,选取2011年1月至2013年6月在天津市眼科医院拟行SMILE和FS-LASIK的近视及近视散光患者68例127眼,其中SMILE组35例64眼,FS-LASIK组33例63眼,使用C-Quant散射光计量仪分别于术前及术后1周、1个月、6个月测量散射光计量值,比较2个组术眼术后不同时间眼内散射光计量值的改变,并分析2种手术因素与术眼眼内散射光计量值的关系.结果 FS-LASIK组术后1周、1个月时散射光计量值分别为(1.03±0.19)D和(0.95±0.16)D,明显高于术前的(0.88±0.18)D,差异均有统计学意义(P=0.000、0.012),而SMILE组术后1周、1个月和6个月散射光计量值分别为(0.98±0.16)、(0.95±0.14)和(0.94±0.16)D,与术前的(0.91±0.15)D相比,差异均无统计学意义(均P＞0.05),但2个组间术眼散射光计量值的总体比较差异无统计学意义(F分组=0.077,P=0.781).术后不同时间点FS-LASIK组散射光计量值的变化量均高于SMILE组(F分组=14.798,P＜0.001),术后1周时2个组间差异有统计学意义(P＜0.01).术后1周、1个月、6个月SMILE组术眼眼内散射光计量值的变化量与切削比均呈负相关(R2=0.123、0.145、0.098,均P＜0.05).结论 SMILE手术前后术眼内散射光计量值变化不明显,而FS-LASIK术后眼内散射光计量值增加,尤以早期最为显著.2种手术后的散射光计量值随时间的延长逐渐恢复.
揹景 飛秒激光小切口基質透鏡取齣術(SMILE)是一種新的微創無瓣屈光矯治手術方式,具有良好的安全性及可預測性,但目前有關其術後視覺質量的研究尚少.瞭解SMILE術後散射的變化情況對于評估其術後視覺質量具有重要意義. 目的 對比分析SMILE與飛秒激光輔助準分子激光角膜原位磨鑲術(FS-LASIK)矯治近視及近視散光後術眼眼內散射光計量值的變化情況.方法 採用迴顧性研究方法,選取2011年1月至2013年6月在天津市眼科醫院擬行SMILE和FS-LASIK的近視及近視散光患者68例127眼,其中SMILE組35例64眼,FS-LASIK組33例63眼,使用C-Quant散射光計量儀分彆于術前及術後1週、1箇月、6箇月測量散射光計量值,比較2箇組術眼術後不同時間眼內散射光計量值的改變,併分析2種手術因素與術眼眼內散射光計量值的關繫.結果 FS-LASIK組術後1週、1箇月時散射光計量值分彆為(1.03±0.19)D和(0.95±0.16)D,明顯高于術前的(0.88±0.18)D,差異均有統計學意義(P=0.000、0.012),而SMILE組術後1週、1箇月和6箇月散射光計量值分彆為(0.98±0.16)、(0.95±0.14)和(0.94±0.16)D,與術前的(0.91±0.15)D相比,差異均無統計學意義(均P＞0.05),但2箇組間術眼散射光計量值的總體比較差異無統計學意義(F分組=0.077,P=0.781).術後不同時間點FS-LASIK組散射光計量值的變化量均高于SMILE組(F分組=14.798,P＜0.001),術後1週時2箇組間差異有統計學意義(P＜0.01).術後1週、1箇月、6箇月SMILE組術眼眼內散射光計量值的變化量與切削比均呈負相關(R2=0.123、0.145、0.098,均P＜0.05).結論 SMILE手術前後術眼內散射光計量值變化不明顯,而FS-LASIK術後眼內散射光計量值增加,尤以早期最為顯著.2種手術後的散射光計量值隨時間的延長逐漸恢複.
배경 비초격광소절구기질투경취출술(SMILE)시일충신적미창무판굴광교치수술방식,구유량호적안전성급가예측성,단목전유관기술후시각질량적연구상소.료해SMILE술후산사적변화정황대우평고기술후시각질량구유중요의의. 목적 대비분석SMILE여비초격광보조준분자격광각막원위마양술(FS-LASIK)교치근시급근시산광후술안안내산사광계량치적변화정황.방법 채용회고성연구방법,선취2011년1월지2013년6월재천진시안과의원의행SMILE화FS-LASIK적근시급근시산광환자68례127안,기중SMILE조35례64안,FS-LASIK조33례63안,사용C-Quant산사광계량의분별우술전급술후1주、1개월、6개월측량산사광계량치,비교2개조술안술후불동시간안내산사광계량치적개변,병분석2충수술인소여술안안내산사광계량치적관계.결과 FS-LASIK조술후1주、1개월시산사광계량치분별위(1.03±0.19)D화(0.95±0.16)D,명현고우술전적(0.88±0.18)D,차이균유통계학의의(P=0.000、0.012),이SMILE조술후1주、1개월화6개월산사광계량치분별위(0.98±0.16)、(0.95±0.14)화(0.94±0.16)D,여술전적(0.91±0.15)D상비,차이균무통계학의의(균P＞0.05),단2개조간술안산사광계량치적총체비교차이무통계학의의(F분조=0.077,P=0.781).술후불동시간점FS-LASIK조산사광계량치적변화량균고우SMILE조(F분조=14.798,P＜0.001),술후1주시2개조간차이유통계학의의(P＜0.01).술후1주、1개월、6개월SMILE조술안안내산사광계량치적변화량여절삭비균정부상관(R2=0.123、0.145、0.098,균P＜0.05).결론 SMILE수술전후술안내산사광계량치변화불명현,이FS-LASIK술후안내산사광계량치증가,우이조기최위현저.2충수술후적산사광계량치수시간적연장축점회복.
Background Small incision lenticule extraction (SMILE) was a new procedure which is miniinvasion and flapless,but few attentions were paid to the visual quality after SMILE.To understand the changes of intraocular straylight after SMILE is of important significance for the assession of the visual quality after the procedure.Objective This study was to compare the characteristic of straylight between SMILE and femtosecond laser assisted laser in situ keratomileusis (FS-LAISK) after surgery.Methods A retrospective study was designed.Written informed consent was obtained from each patient prior to accepting the surgery.One hundred and twenty-seven eyes of 68 patients with myopia and myopic astigmatism were included in Tianjin Eye Hospital from January 2011 to July 2013.SMILE was performed on 64 eyes of 35 patients and FS-LASIK was carried out in 63 eyes of 33 patients at the same period.Stray light was detected with C-Quant stray light meter before and 1 week,1 month and 6 months after surgery.The changes of stray light values following the surgery were compared between the two groups,and the correlations between postoperative stray light values with operative parameters were analyzed.Results The mean stray light values were (1.03 ±0.19)D and (0.95±0.16)D at 1 week and 1 month after surgery,which were higher than (0.88 ±0.18)D at preoperation in the FS-LASIK group (P =0.000,0.012).The stray light values were (0.98±0.16),(0.95±0.14) and (0.94±0.16)D at 1 week,1 month or 6 months after surgery,and no statistically significant differences were found in comparison with (0.91 ±0.15)D in preoperation in the SMILE group (all at P＞0.05).No significant intergroup difference was seen in the stray light values (Fgroup =0.077,P=0.781).The stray light differences of various time points after surgery and before surgery were increased in the FS-LASIK group compared with SMILE group (Fgroup =14.798,P＜0.001),with the significant difference in postoperative 1 week between the two groups (P＜0.01).The negative correlations were found between stray light values at 1 week,1 month and 6 months after SMILE with the lenticule thickness/central corneal thickness (CCT) (R2=0.123,0.145,0.098,all at P＜0.05) or between stray light change.Conclusions Intraocular stray light appears less change in operative eyes after SMILE.However,intraocular stray light increases in the eyes received FS-LASIK,especially at early stage after operation.The stray light shifts return to normal with the lapse of postoperative time.
