CAJ | 학술논문

目的：对比观察飞秒激光微切口透镜取出术( SMILE)与前弹力层下准分子激光原位角膜磨镶术( SBK)矫正近视的临床效果。方法前瞻性病例对照研究。纳入近视及近视散光患者共计544例(1080只眼),SMILE手术258例(510只眼),SBK手术286例(570只眼),术后检查裸眼视力、最佳矫正视力、角膜后表面顶点高度、角膜前表面高阶像差( HOA)、泪膜破裂时间( BUT)及泪液分泌试验( SchirmerⅠ试验)。采用卡方检验、方差分析及独立样本t检验对结果进行统计分析。结果视力：各时间点两组比较差异均无统计学意义。角膜后表面顶点平均高度：术后1周、1个月及3个月,两组比较差异均无统计学意义。术源性高阶像差：角膜前表面总高阶像差、慧差、三叶草差及球差,各时间点两组比较差异均无统计学意义。泪膜破裂时间：术后1个月,SMILE组和SBK组分别为(7.22±2.43)s和(5.87±1.33)s,差异有统计学意义；术后3个月,差异无统计学意义。 SchirmerⅠ试验：术后1个月,SMILE组和SBK组分别为(8.71±2.56)mm和(8.24±2.48)mm,差异有统计学意义；术后3个月,差异无统计学意义。结论 SMILE和SBK矫正近视同样安全有效,SMILE术后早期泪膜稳定性较好。
목적：대비관찰비초격광미절구투경취출술( SMILE)여전탄력층하준분자격광원위각막마양술( SBK)교정근시적림상효과。방법전첨성병례대조연구。납입근시급근시산광환자공계544례(1080지안),SMILE수술258례(510지안),SBK수술286례(570지안),술후검사라안시력、최가교정시력、각막후표면정점고도、각막전표면고계상차( HOA)、루막파렬시간( BUT)급루액분비시험( SchirmerⅠ시험)。채용잡방검험、방차분석급독립양본t검험대결과진행통계분석。결과시력：각시간점량조비교차이균무통계학의의。각막후표면정점평균고도：술후1주、1개월급3개월,량조비교차이균무통계학의의。술원성고계상차：각막전표면총고계상차、혜차、삼협초차급구차,각시간점량조비교차이균무통계학의의。루막파렬시간：술후1개월,SMILE조화SBK조분별위(7.22±2.43)s화(5.87±1.33)s,차이유통계학의의；술후3개월,차이무통계학의의。 SchirmerⅠ시험：술후1개월,SMILE조화SBK조분별위(8.71±2.56)mm화(8.24±2.48)mm,차이유통계학의의；술후3개월,차이무통계학의의。결론 SMILE화SBK교정근시동양안전유효,SMILE술후조기루막은정성교호。
Objective To compare the clinical results of small incision lenticule extraction ( SMILE) and sub-Bowman keratomileusis ( SBK) for correction of myopia. Methods Total of 1080 eyes of 544 cases were enrolled in this prospective case-control study. In the groups, 510 eyes of 258 cases were treated with small incision lenticule extraction as the SMILE group, and 570 eyes of 286 cases were treated with sub-Bowman keratomileusis as the SBK group. The uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), corneal posterior surface’s vertex altitude, high order aberrations(HOA), tear film break-up time(BUT) and Schirmer Ⅰtest were obtained and compared between preoperation and 1and 3 months after surgery. Data were analyzed using chi-square test, ANOVA and independent t test. Results UCVA:There were not satistically significant differences between two groups at each time. Corneal posterior surface’s vertex altitude(μm): There were not satistically significant differences between two groups at 1 week, 1 and 3 months after operation. Surgically induced HOA(μm): For the total HOA、coma、trefoil、spherical aberration of the anterior surface, there were not satistically significant differences between two groups at each time. BUT(s): at 1 month after operation, the BUT was (7. 22 ± 2. 43) s and (5. 87 ± 1. 33) s in SMILE and SBK group respectively, and there were satistically significant differences between two groups. At 3 month after operation, there were not satistically significant differences between two groups. SchirmerⅠtest(mm): at 1 month after operation, the value was (8. 71 ± 2. 56) mm and (8. 24 ± 2. 48) mm in SMILE and SBK group respectively, and there were satistically significant differences between two groups. At 3 month after operation, there were not satistically significant differences between two groups. Conclusion SMILE and SBK have equal safety and efficacy for myopia correction. SMILE has a better stability for tear film in early period of postoperation.