中华眼外伤职业眼病杂志
中華眼外傷職業眼病雜誌
중화안외상직업안병잡지
CHINESE JOURNAL OF OCULAR TRAUMA AND OCCUPATIONAL EYE DISEASE
2015年
4期
261-265
,共5页
乔宝笛%帖彪%赵宏%马时光
喬寶笛%帖彪%趙宏%馬時光
교보적%첩표%조굉%마시광
角膜磨镶术,飞秒激光辅助%飞秒激光小切口角膜基质透镜摘出术
角膜磨鑲術,飛秒激光輔助%飛秒激光小切口角膜基質透鏡摘齣術
각막마양술,비초격광보조%비초격광소절구각막기질투경적출술
Keratomileusis,laser in situ,femtosecond laser assisted(FS-LASIK)%Small incision lenticule extraction (SMILE)
目的 对比研究飞秒激光小切口角膜基质透镜摘出术(SMILE)和飞秒激光辅助的准分子激光原位角膜磨镶术(FS-LASIK)的效果.方法 前瞻性非随机队列研究.SMILE组和FSLASIK组各200例(200眼),测量术前及术后3个月术眼的裸眼视力(UCVA)、最佳矫正视力(BCVA)及屈光状态(等效球镜度)等,并采用Pentacam测量角膜后表面顶点高度及角膜波前像差.对各项指标进行组间比较,各组术后测量结果与术前值进行比较.结果 比较两组术后的视力、屈光度、安全性、有效性及可预测性,两组间的差异均无统计学意义(P＞0.05).SMILE组术前角膜后表面顶点高度为(1.96±2.15) μm,术后3个月为(2.08±1.87) μm,术前术后的差异无统计学意义(P=0.34,t=0.758);FS-LASIK组术前角膜后表面顶点高度为(2.21±2.73) μm,术后3个月为(2.34±2.46) μm,术前术后的差异亦无统计学意义(P =0.27,t=0.961);术后3个月两组间差异无统计学意义(t =2.527,P=0.16).与术前的角膜波前像差相比较,两组术后总像差均方根值、低阶像差均方根值、高阶像差均方根值、球差均方根值均增大,差异均有统计学意义(P=0.000);将两组的角膜波前像差变化值进行比较,虽然各个指标SMILE组均稍大于FS-LASIK组,但差异无统计学意义(P＞0.05).结论 SMILE和FS-LASIK均有良好的安全性、有效性与可预测性,两组术后角膜后表面均保持一定的稳定性,而微创无瓣是SMILE最显著的优点,可避免角膜瓣皱褶、移位、丢失等潜在风险.
目的 對比研究飛秒激光小切口角膜基質透鏡摘齣術(SMILE)和飛秒激光輔助的準分子激光原位角膜磨鑲術(FS-LASIK)的效果.方法 前瞻性非隨機隊列研究.SMILE組和FSLASIK組各200例(200眼),測量術前及術後3箇月術眼的裸眼視力(UCVA)、最佳矯正視力(BCVA)及屈光狀態(等效毬鏡度)等,併採用Pentacam測量角膜後錶麵頂點高度及角膜波前像差.對各項指標進行組間比較,各組術後測量結果與術前值進行比較.結果 比較兩組術後的視力、屈光度、安全性、有效性及可預測性,兩組間的差異均無統計學意義(P＞0.05).SMILE組術前角膜後錶麵頂點高度為(1.96±2.15) μm,術後3箇月為(2.08±1.87) μm,術前術後的差異無統計學意義(P=0.34,t=0.758);FS-LASIK組術前角膜後錶麵頂點高度為(2.21±2.73) μm,術後3箇月為(2.34±2.46) μm,術前術後的差異亦無統計學意義(P =0.27,t=0.961);術後3箇月兩組間差異無統計學意義(t =2.527,P=0.16).與術前的角膜波前像差相比較,兩組術後總像差均方根值、低階像差均方根值、高階像差均方根值、毬差均方根值均增大,差異均有統計學意義(P=0.000);將兩組的角膜波前像差變化值進行比較,雖然各箇指標SMILE組均稍大于FS-LASIK組,但差異無統計學意義(P＞0.05).結論 SMILE和FS-LASIK均有良好的安全性、有效性與可預測性,兩組術後角膜後錶麵均保持一定的穩定性,而微創無瓣是SMILE最顯著的優點,可避免角膜瓣皺褶、移位、丟失等潛在風險.
목적 대비연구비초격광소절구각막기질투경적출술(SMILE)화비초격광보조적준분자격광원위각막마양술(FS-LASIK)적효과.방법 전첨성비수궤대렬연구.SMILE조화FSLASIK조각200례(200안),측량술전급술후3개월술안적라안시력(UCVA)、최가교정시력(BCVA)급굴광상태(등효구경도)등,병채용Pentacam측량각막후표면정점고도급각막파전상차.대각항지표진행조간비교,각조술후측량결과여술전치진행비교.결과 비교량조술후적시력、굴광도、안전성、유효성급가예측성,량조간적차이균무통계학의의(P＞0.05).SMILE조술전각막후표면정점고도위(1.96±2.15) μm,술후3개월위(2.08±1.87) μm,술전술후적차이무통계학의의(P=0.34,t=0.758);FS-LASIK조술전각막후표면정점고도위(2.21±2.73) μm,술후3개월위(2.34±2.46) μm,술전술후적차이역무통계학의의(P =0.27,t=0.961);술후3개월량조간차이무통계학의의(t =2.527,P=0.16).여술전적각막파전상차상비교,량조술후총상차균방근치、저계상차균방근치、고계상차균방근치、구차균방근치균증대,차이균유통계학의의(P=0.000);장량조적각막파전상차변화치진행비교,수연각개지표SMILE조균초대우FS-LASIK조,단차이무통계학의의(P＞0.05).결론 SMILE화FS-LASIK균유량호적안전성、유효성여가예측성,량조술후각막후표면균보지일정적은정성,이미창무판시SMILE최현저적우점,가피면각막판추습、이위、주실등잠재풍험.
Objective To compare the efficacy of femtosecond laser small incision lenticule extraction(SMILE) and femtosecond laser assisted LASIK(FS-LASIK).Methods This is a prospective nonrandom cohort study.There were 200 eyes of 200 cases in both SMILE group and FS-LASIK group respectively.Uncorrected visual acuity(UCVA),best corrected visual acuity(BCVA) and residual refraction (spherical equivalent,SE) were measured before surgery and 3 months after surgery.Vertex altitude of corneal posterior surface and corneal wavefront aberrations were measured by pentacam.Data were compared between two groups and between preoperation and postoperation in same group.Results Difference was not statistically significant in visual acuities,SE,safety,effectiveness and predictability between two groups (P ＞ 0.05).Pre-operative and postoperative vertex altitude of corneal posterior surface in SMILE group were (1.96 ± 2.15) μm,and (2.08 ± 1.87) μm,whereas those in FS-LASIK group were (1.96 ± 2.15) μm,and (2.08 ± 1.87) μm,and there were no statistically significant differences between preoperative and postoperative resuits in both groups (P ＞ 0.05).There was no statistically significant difference in postoperative outcome between two groups(t =2.527,P =0.16).Compared with pre-operative results,the corneal aberrations increased after surgeries,including root mean square of total (RMS TOTAL),root mean square of lower-order abberation (RMS LOA),root mean square of higher-order abberation (RMS HOA) and root mean square of spherical abberation (RMS Z4,0) (P =0.000).Although corneal aberrations in SMILE group were bigger than those in FS-LASIK group,but there were no statistically significant differences between two groups (P ＞ 0.05).Conclusion Both SMILE group and FS-LASIK group have good safety,effectiveness and predictability,and corneal posterior surfaces of two groups all keep stable after surgery.Small incision without corneal flap is the most significant advantage of SMILE which can avoid potential risks,such as striation,shift and losing of corneal flap.
