CAJ | 학술논문

目的探讨不同光学区飞秒激光小切口基质透镜取出术(SMILE)后全眼高阶像差的比较.方法回顾性病例研究.分别选取6.0 mm光学区SMILE手术患者26例,6.5 mm光学区SMILE手术患者29例,均选取右眼进行研究.应用WaveScan像差仪分别测量2种不同光学区SMILE术前、术后1个月、术后3个月的像差,并应用重复测量方差分析、独立样本t检验对所采集的数据进行处理.结果在术后1个月时,6.0 mm组总高阶像差、球差,6.5 mm组总高阶像差、彗差分别为(0.273±0.098)、(0.100±0.077)、(0.224±0.080)、(0.142±0.077)μm,均较术前增加(P＜0.05).术后3个月时,6.0 mm组球差,6.5 mm组总高阶像差、彗差、三叶草分别为(0.083±0.065)、(0.238±0.082)、(0.154±0.074)、(0.103±0.056) μm,均较术前增加(P＜0.05).2组间比较,彗差在术后1个月时6.5 mnm组显著低于6.0 mm组(t=2.416, P＜0.05),其中6.5 mm组垂直彗差小于6.0 mm组且差异有统计学意义(t=-2.021,P=0.049),其余各项差异均无统计学意义.术后1个月时,6.0 mm组总高阶像差、球差及6.5 mm组总高阶像差、彗差、三叶草均与透镜厚度呈正相关(r=0.502、0.661、0.672、0.580、0.383,P＜0.05);术后3个月时,6.0 mm组总高阶像差、球差、彗差及6.5 mim组总高阶像差与基质透镜厚度呈正相关(r=0.697、0.629、0.560、0.501,P＜0.05).结论不同光学区SMILE术后高阶像差结果不同,部分高阶像差(彗差)早期存在差异,可能与其特殊的手术方式及伤口愈合反应有关.
목적 탐토불동광학구비초격광소절 구기질투경취출술(SMILE)후전안고계상차적비교.방법 회고성병례연구.분별선취6.0 mm광학구SMILE수술환자26례,6.5 mm광학구SMILE수술환자29례,균선취우안진행연구.응용WaveScan상차의분별측량2충불동광학구SMILE술전、술후1개월、술후3개월적상차,병응용중복측량방차분석、독립양본t검험대소채집적수거진행처리.결과 재술후1개월시,6.0 mm조총고계상차、구차,6.5 mm조총고계상차、혜차분별위(0.273±0.098)、(0.100±0.077)、(0.224±0.080)、(0.142±0.077)μm,균교술전증가(P＜0.05).술후3개월시,6.0 mm조구차,6.5 mm조총고계상차、혜차、삼협초분별위(0.083±0.065)、(0.238±0.082)、(0.154±0.074)、(0.103±0.056) μm,균교술전증가(P＜0.05).2조간비교,혜차재술후1개월시6.5 mnm조현저저우6.0 mm조(t=2.416, P＜0.05),기중6.5 mm조수직혜차소우6.0 mm조차차이유통계학의의(t=-2.021,P=0.049),기여각항차이균무통계학의의.술후1개월시,6.0 mm조총고계상차、구차급6.5 mm조총고계상차、혜차、삼협초균여투경후도정정상관(r=0.502、0.661、0.672、0.580、0.383,P＜0.05);술후3개월시,6.0 mm조총고계상차、구차、혜차급6.5 mim조총고계상차여기질투경후도정정상관(r=0.697、0.629、0.560、0.501,P＜0.05).결론 불동광학구SMILE술후고계상차결과불동,부분고계상차(혜차)조기존재차이,가능여기특수적수술방식급상구유합반응유관.
Objective To investigate and analyze modifications to the diameters in different optical zones in higher order aberrations after small incision lenticule extraction surgery (SMILE).Methods Twenty-six patients (26 eyes) with a 6.0 mm optical zone diameter and 29 (29 eyes) with a 6.5 mm optical zone diameter were randomly included in a retrospective study.Only right eyes were investigated in the study.The higher order aberrations were measured with a WaveScan wavefront analyzer before surgery and at 1 month and 3 months postoperatively.A repeated measures analysis of variance and independent t test were used to analyze the collected data.Results At 1 month after SMILE, the total higher-order aberrations (HOA) and spherical aberrations in the 6.0 mm group, and the total HOA and coma in the 6.5 mm group were 0.273±0.098 μm, 0.100± 0.077 μm, and 0.224 ±0.080 μm, 0.142 ±0.077 μm, which were higher than preoperative measurements (P＜0.05).At 3 months after SMILE, spherical aberrations were 0.083±0.065 in the 6.0 mm group, and the total HOA, coma and trefoil were 0.238±0.082 μm, 0.154±0.074 and 0.103±0.056 in the 6.5 mm group, which were also higher than preoperative measurements (P＜0.05).At 1 month the coma in the 6.5 mm group was significantly lower than that in the 6.0 mm group (t=2.416, P＜0.05).And the vertical coma in the 6.5 mm group was also lower than that in the 6.0 mm group (t=-2.021, P=0.049).No significant differences between the two groups were found for the other parameters (P＞0.05).Correlation analysis showed that lenticular thickness was positively correlated with HOA and coma in the 6.0 mm group and the HOA, coma and trefoil in the 6.5 mm group one month after surge (r=0.502, 0.661, 0.672, 0.580, 0.383;P＜0.05).While at three months after surgery, lenticular thickness was positively correlated with HOA, coma and trefoil in the 6.0mm group and HOA in the 6.5 mm group (r=0.697, 0.629, 0.560, 0.501;P＜0.05).Conclusion Different optical zones show various results in parts of high order aberrations (coma) in the early stage after SMILE surgery.This might be related to the specific principle of the surgery and the reaction to corneal wound healing.