VisuMax飞秒激光小切口角膜基质透镜切除术矫正近视的疗效观察

Evaluation of the therapeutic effectsof femtosecond laser small incision lenticule extraction on myopia

目的观察VisuMax全飞秒激光微小切口角膜基质透镜切除术（SMILE）矫正近视的临床疗效。方法20例（40只眼）近视及近视散光患者行SMILE手术,术后第1天、1周,1个月、3个月、6个月定期随访观察裸眼远视力、屈光度、角膜地形图,前节OCT观察角膜基质对合面愈合情况。结果飞秒激光透镜切除术中顺利。术后无感染。末次随访裸眼远视力提高至0.8-1.2,最佳矫正视力0.8-1.2,其中较术前最佳矫正远视力提高2行及以上者4只眼,提高1行者10只眼,不变者26只眼,无最佳矫正视力下降者。术后眼屈光度数与目标屈光度数的差值平均为（0.27±0.21）D。角膜地形图显示无偏心,OCT显示手术后基质面对合良好。结论 VisuMax全飞秒激光微小切口角膜基质透镜切除术矫正近视及近视散光的安全性及稳定性良好。

Objective To investigate the clinical outcomes of femtosecond laser small incision lenticule extraction（SMILE） in 40 myopic eyes. Methods SMILE surgery was performed in 40 eyes of 20 patients with myopia or myopic astigmatism. The primary outcome included uncorrected distance visual acuity（UCVA）,spherical equivalence of the subjective manifest refraction,corneal topography,and healing of corneal stroma determined by AS-OCT at postoperative 1day,1 week,1 month,3 months and 6 months. Results SMILE procedureswereperformedsmoothly in all patients. No surgery related infection happened. Atthe last follow-up visits（6 months postoperative）,average UCVA improved to 0. 8 -1. 2 and average BCVA improved to 0. 8 - 1. 2,respectively. Specifically,BCVA increased more than 2 lines in 4 eyes,1line in 10 eyes,and remained same in other 26 eyes. Mean spherical refraction was 0. 27 ± 0. 21D（range ？ 0. 75 D to ＋0. 75 D）. Corneal topography showed no eccentricity. AS-OCT showed good alignment of stroma bed. Conclusion Small incision lenticule extraction（SMILE） is a safe and effective procedure for surgical correction of myopia or myopic astigmatism with predictable outcomes.