飞秒制瓣LASIK和小切口基质透镜切除术后角膜前表面高阶像差变化的比较

Comparison of higher-order aberration changes in anterior corneal surface between FS-LASIK and SMILE surgery

对行飞秒制瓣准分子激光原位角膜磨镶术(FSLASIK)的84只眼和行小切口基质透镜切除术(SMILE)的110只眼,根据手术方式分为FS-LASIK组和SMILE组,于术前、术后1周、1个月及3个月利用Pentacam测量患者角膜前表面的高阶像差(包括总高阶像差、球差、水平慧差以及垂直慧差),高阶像差用泽尼克多项式描述。结果显示FSLASIK组在术后不同时期角膜前表面各高阶像差中除了水平慧差较术前无差异,总高阶像差和球差较术前均显著增加,垂直慧差较术前显著减少;SMILE组术后不同时期总高阶像差、球差、水平像差均显著增加,垂直慧差显著降低(P<0.05)。SMILE组术后不同时期的总高阶像差和球差以及其较术前的变化值均低于FS-LASIK组(P<0.05)。SMILE术后的总高级像差和球差的增加较FS-LASIK术少。

84 eyes that underwent femtosecond laser-assisted laser in situ keratomileusis （ FS-LASIK） , and 110 eyes that underwent small incision lenticule extraction （ SMILE） surgery were included in this prospective case se-ries study. HOAs included （ total HOAs, spherical aberration, horizontal coma aberration, and vertical coma aber-ration） were measured preoperatively after 1 week, 1 month , and 3 months postoperatively by Pentacam. The ab-errations were described as Zernike polynomials. Significantly increased total HOAs and SA and significantly de-creased vertical coma were noted at 1 week, 1 month, and 3 months after FS-LASIK （ P〈0.05 ） . However, no significant increase was found in postoperatively horizontal coma. There were significant increases in total HOAs, SA, and horizontal coma and a decrease in the vertical coma at each postoperative examination in SIMLE group （ P〈0.05 ） . The total HOAs and SA were significantly smaller in SMILE group than that in FS-LASIK group at 1 week, 1 month, and 3 months postoperatively. The changes in total HOAs and SA were also significantly smaller in SMILE group than that in FS-LASIK group at each postoperative examination. Compared with FS-LASIK, SMILE can induce fewer total higher-order aberrations and spherical aberration after operation.