SMILE术后散射的变化特征及相关影响因素

Analysis of stray light changes and relevant factors after SMILE

目的探讨SMILE术后眼内散射的变化，并对其相关影响因素进行分析。方法前瞻性病例研究。选取拟行SMILE手术的近视及近视散光患者67例（67眼），应用C-quant散射仪分别测量患者手术前、术后1周、术后1个月、术后3个月及术后6个月眼内散射光计量值，并与年龄、球镜度、等效球镜度、CCT、角膜平均曲率值（Km）、角膜曲率半径等做相关分析，同时采用Pearson相关分析术后散射光计量值变化与角膜帽直径、小切口大小、切削深度、切削比、剩余角膜厚度（RBT）、RBT／CCT、能量等关系。结果SMILE手术前、术后1周、术后1个月、术后3个月、术后6个月的散射光计量值分别为0．93±0．16、0．97±0．14、0．94±0．17、0．94±0．17、0．90±0．17，术后1周散射光计量值较术前稍增加，但差异无统计学意义，各时间点散射光计量值比较差异无统计学意义（F=2．253，P〉0．05）；术后散射光计量值的变化与术中相关参数无明显相关性，仅在术后3个月散射光计量值与切口大小呈较弱正相关（r=0．356，P〈0．01）。结论SMILE术后散射光计量值较术前虽有变化，但变化不明显。术后由散射变化造成视觉质量下降的可能性较小。

Objective To investigate the characteristics and relevant factors of intraocular stray light before and after small incision lenticular extraction （SMILE）. Methods In a prospective case study, 67 myopic and myopic astigmatism patients （67 eyes） underwent SMILE surgery in Tianjin Eye Hospital. Stray light measurements were taken before SMILE surgery and 1 week, 1 month, 3 months and 6 months after surgery using an Oculus C-Quant stray light meter. Pearson correlation was used to identify correlations in stray light values for such factors as age, spherical equivalent refractive error, central corneal thickness （CCT）, mean keratometric value, and corneal curvature radius as well as for surgical factors such as cap diameter, hinge width, ablation depth, ablation ratio, residual bed thickness, RBT/CCT and energy. Results The stray fight values preoperatively, and 1 week, 1 month, 3 months and 6 months after SMILE surgery were 0.93±0.16, 0.97±0.14, 0.94±0.17, 0.94±0.17, and 0.90±0.17, respectively. The mean stray light value was slightly higher 1 week after surgery but no significant differences were found. There were no significant differences when the various time points were compared （F=2.253, P〉0.05）. While the changes in stray light values after surgery were not correlated with surgical parameters, there was a slight positive correlation with hinge width at 3 months after surgery （r=0.356, P〈0.01 ）. Conclusion There are no significant differences in stray light between pre- and post-SMILE surgery. It may be possible that a change in stray light could cause a decrease in visual quality.