全飞秒激光小切口角膜基质透镜取出术(SMILE)角膜帽与飞秒激光辅助的准分子激光角膜原位磨镶术(FS-LASIK)角膜瓣的对比

Characteristics of caps created with SMILE versus flaps created with FS-LASIK

目的对比全飞秒激光小切口角膜基质透镜取出术(small incision lenticule extraction,SMILE)制作的角膜帽和飞秒激光辅助的准分子激光角膜原位磨镶术(femtosecond laser in situ keratomileusis,FS-LASIK)制作的角膜瓣的特点。方法 100例200眼近视患者根据手术方式分为SMILE组、FS-LASIK组,每组各50例100眼。SMILE组角膜帽及FS-LASIK组角膜瓣厚度均设定为110μm,RTVue-OCT测量术眼角膜0°和90°两条子午线所在截面上特定7个点的角膜帽和角膜瓣厚度值,并对角膜帽和角膜瓣上14个测量点的厚度进行对比。结果术后1周,SMILE组中央区角膜帽厚度为(109.4±2.8)μm,低于FS-LASIK组中央区角膜瓣厚度[(111.2±3.6)μm],差异有统计学意义(t=-3.062,P<0.01)。SMILE组全角膜帽厚度值为(109.3±2.1)μm,亦低于FS-LASIK组全角膜瓣厚度[(111.1±1.8)μm],差异有统计学意义(t=-5.130,P<0.01)。两组在不同离心度的位置,角膜帽和角膜瓣厚度的变异均不大。两组角膜0°和90°经线所在截面的平均角膜帽和角膜瓣厚度差异均无统计学意义(均为P>0.05)。SMILE组中与预计值差值≤5μm的有1170个测量点,而FS-LASIK组中有1226个测量点。结论SMILE制作的角膜帽与FS-LASIK制作的角膜瓣同样具有良好的重现性,且形态均一、规整。

Objective To compare the features of caps created with small incision lenticule extraction （SMILE） versus flaps created with femtosecond laser-assisted in situ keratomileusis （femto-LASIK）.Methods Two hundreds eyes of 100 patients were collected in this study and divided into 2 groups according to the operation methodSMILE group （100 eyes,50 patients） and FS-LASIK group （100 eyes,50 patients）.The expected cap or flap thickness was 110 μm for both groups.Fourier-domain optical coherence tomography （RTVue OCT） was used to measure the cap and flap thicknesses of the 7 specified measurements in the 0° and 90° meridians on the corneas,and the thicknesses of 14 measurements on the caps and flaps were compared.Results At one week postoperatively,the central cap thickness of SMILE group [（109.4±2.8）μm] was thinner than central flap thickness of the FS-LASIK group[（111.2±3.6）μm]（ t =-3.062, P 〈0.01）.The mean whole cap thickness was（109.3±2.1）μm in the SMILE group,which was significant lower than the whole flap thickness in the FS-LASIK group[（111.1±1.8）μm]（ t =-5.130, P 〈0.01）.The caps and flaps morphology showed uniformity in both groups.There was no significant difference in the mean cap and flap thickness between 0° and 90° meridians （all P 〉0.05）.The amount of measurement points differ less than 5 μm was 1170 （83.57%） in the SMILE group,1226 （87.57%） in the FS-LASIK group.Conclusion The corneal caps made by SMILE and the corneal flaps made by FS-LASIK both have good reproducibility,and the shape is uniform and regular.