耳穴压丸联合SMILE手术防治低、中度近视的疗效观察

Observation of the Therapeutic Effect of Auricular Pressure Pellet combined with SMILE Surgery in the Prevention and Treatment of Low and Moderate Myopia

目的观察耳穴压丸联合飞秒激光小切口角膜基质透镜取出术(SMILE)手术防治低、中度近视的疗效。方法纳入2022年6月—2022年12月中国中医科学院眼科医院诊治的SMILE术前焦虑患者120例(240只眼),随机分为对照组和观察组各60例(120只眼)。对照组予宣教+耳穴贴胶布+SMILE手术治疗;观察组予宣教+耳穴压丸+SMILE手术治疗。于压丸前和手术当日术前测评状态焦虑分量表(S-AI),于压丸前、术后1个月检测裸眼视力(UCVA)、等效球镜度(SE)和调制传递函数截止频率(MTF cut off),记录以上指标的数据并进行统计分析。结果治疗前2组S-AI评分、UCVA、SE和MTF cut off比较,差异均无统计学意义(P>0.05)。(1)S-AI评分:观察组手术当日S-AI评分低于压丸前(t=2.583,P=0.011),治疗后2组间比较,观察组低于对照组(t=2.448,P=0.016),差异均有统计学意义。(2)UCVA:2组治疗后UCVA均较治疗前提高(t_(观察组)=26.669,t_(对照组)=27.241,均P=0.000),差异均有统计学意义。术后2组间比较,差异无统计学意义(P>0.05)。(3)SE:2组治疗后SE均较治疗前好转(t_(观察组)=31.005,t_(对照组)=30.203,均P=0.000),差异均有统计学意义。治疗后2组间比较,差异无统计学意义(P>0.05)。(4)MTF cut off:2组治疗后MTF cut off均较治疗前提高(t_(观察组)=3.887,P=0.000;t_(对照组)=1.998,P=0.047),治疗后2组间比较,观察组高于对照组(t=2.398,P=0.017),差异均有统计学意义。结论耳穴压丸治疗能够有效缓解低、中度近视患者SMILE术前焦虑心理,提高术中配合度,获得更好的术后视觉质量。

OBJECTIVE To observe the effect of auricular pressure pellet combined with femtosecond small incision lenticule extraction(SMILE)surgery on the prevention and treatment of low and moderate myopia.METHODS A total of 120 patients(240 eyes)with preoperative anxiety undergoing SMILE surgery from June 2022 to December 2022 were recruited in Eye Hospital,China Academy of Chinese Medical Sciences.They were randomly divided into the control group(CG)and the observation group(OG),with 60 patients(120 eyes)in each group.In the control group,patients received education,ear acupressure adhesive tape and SMILE surgery treatment.In the observation group,patients received education,auricular pressure pellet and SMILE surgery treatment.State anxiety inventory(S-AI)scores were assessed before the acupressure treatment and on the day of surgery.Uncorrected visual acuity(UCVA),spherical equivalent(SE),and modulation transfer function cutoff frequency(MTF cut off)were measured before the acupressure treatment and one month after the surgery.Data on the above indicators were recorded and subjected to statistical analysis.RESULTS There were no significant differences in S-AI scores,UCVA,SE,and MTF cut off between the two groups before treatment(P>0.05).(1)S-AI scores:The S-AI scores of the observation group on the day of operation were lower than those before auricular pressure pellet(t=2.583,P=0.011).After treatment,the S-AI scores of the observation group were lower than those of the control group(t=2.448,P=0.016),the differences were statistically significant.(2)UCVA:The UCVA after treatment were significantly higher than those before treatment in both groups(t_(OG)=26.669,t_(CG)=27.241,both P=0.000),and the differences were statistically significant.There was no significant difference between two groups after operation(P>0.05).(3)SE:The SE of the two groups after treatment were better than those before treatment(t_(OG)=31.005,t_(CG)=30.203,both P=0.000),and the differences were statistically significant.There was no significant difference between the two groups after treatment(P>0.05).(4)MTF cut off:The MTF cut off after treatment were higher than those before treatment in both groups(t_(OG)=3.887,P=0.000;t_(CG)=1.998,P=0.047).After treatment,The MTF cut off of the observation group were higher than those of control group(t=2.398,P=0.017),the difference were statistically significant.CONCLUSIONS Auricular pressure pellet treatment can effectively alleviate preoperative anxiety in patients with low and moderate myopia undergoing SMILE surgery.It improves patient cooperation during the surgery and leads to better postoperative visual quality.