全飞秒激光小切口角膜基质内透镜取出术在屈光不正患者中的疗效及安全性分析

Efficacy and safety of femtosecond laser small incision lenticule extraction in patients with refractive errors

摘要:

目的 探讨全飞秒激光小切口角膜基质内透镜取出术（SMILE）在屈光不正患者中的疗效及安全性。方法 选取2022年10月—2023年12月在资阳市中医医院行角膜屈光矫治的屈光不正患者92例，患眼184只眼。采用随机数字表法分为SMILE组46例（患眼92只眼）与飞秒激光制瓣的准分子激光原位角膜磨镶术（FS-LASIK）组46例（患眼92只眼），SMILE组行SMILE治疗，FS-LASIK组行FS-LASIK治疗。治疗前、治疗后1和6个月，比较两组的裸眼视力（UCVA）、双眼最佳矫正视力（BCVA）、角膜表面非球面参数Q值、规则指数（SRI）及脂质层厚度。结果 SMILE组与FS-LASIK组患者治疗前、治疗后1和6个月的UCVA、BCVA、非球面参数Q值、SRI、眼表脂质层厚度比较，结果 ①不同时间点UCVA、BCVA、非球面参数Q值、SRI比较，差异均有统计学意义（P <0.05）；不同时间点眼表脂质层厚度比较，差异无统计学意义（P >0.05）。②SMILE组与FS-LASIK组患者UCVA、BCVA、眼表脂质层厚度比较，差异均无统计学意义（P >0.05）；两组患者非球面参数Q值、SRI比较，差异均有统计学意义（P <0.05）。③两组患者的UCVA、BCVA、非球面参数Q值、SRI变化趋势比较，差异均有统计学意义（P <0.05）；两组患者眼表脂质层厚度变化趋势比较，差异无统计学意义（P >0.05）。两组术后并发症发生率比较，差异无统计学意义（P >0.05）。结论 SMILE治疗屈光不正有助于减小角膜形态变化及损伤，提高术后角膜稳态，促进术后视力恢复。

Abstract:

Objective To explore the efficacy and safety of femtosecond laser small incision lenticule extraction (SMILE) in patients with refractive errors.Methods The 92 patients with refractive errors (184 affected eyes) who underwent corneal refractive therapy at Ziyang Traditional Chinese Medicine Hospital from October 2022 to December 2023 were selected. Using a random number table method, they were divided into the SMILE group and the femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) group, with 46 cases (92 affected eyes) in each group. The patients in the SMILE group received SMILE treatment, while those in the FS-LASIK group received FS-LASIK treatment. The uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), corneal Q value, surface regularity index (SRI), and lipid layer thickness were compared between the two groups before treatment, 1 month after treatment, and 6 months after treatment.Results The comparison of UCVA, BCVA, corneal Q value, SRI and lipid layer thickness in the SMILE group and the FS-LASIK group before treatment, 1 month after treatment, and 6 months after treatment showed that all (P < 0.05) but not lipid layer thickness (P > 0.05) were different among the time points, and that UCVA, BCVA and lipid layer thickness were not different (P > 0.05) but corneal Q value and SRI were different between the two groups (P < 0.05). The change trends of UCVA, BCVA, corneal Q value and SRI (P < 0.05) but not the change trend of lipid layer thickness (P > 0.05) were different between the two groups. There was no statistically significant difference in the incidence of postoperative complications between the two groups (P > 0.05).Conclusions SMILE for the treatment of refractive errors helps reduce morphological changes and damage to the cornea, improves postoperative corneal stability, and promotes faster recovery of vision after surgery.