SMILE和FS-LASIK术治疗高度近视的疗效及对角膜和泪膜稳定性的影响

Clinical effect of SMILE and FS-LASIK and the effect on the stability of cornea and tear film

目的:探讨飞秒激光小切口角膜基质透镜取出术(SMILE)和飞秒激光制瓣的准分子激光角膜原位磨镶术(FSASIK)矫正高度近视的临床效果和对角膜、泪膜稳定性的影响。方法:选取2016-08/2017-02我院收治的高度近视患者20例240眼作为研究对象,按照手术方式分为SMILE组67例134眼)和FS-LASIK组(53例106眼)。SMILE组患者行SMILE术治疗,FS-LASIK组患者行FS-LASIK术治疗,比较两组患者术后视力和屈光度情况,分析手术对角膜和泪膜稳定性的影响。结果:术后1、3mo,两组患者UCVA、BCVA和屈光度比较,差异均无统计学意义(P>0. 05)。术前、术后1mo,两组患者BUT和SⅠt比较,差异均无统计学意义(P>0. 05);术后3mo,两组患者BUT和SⅠt比较,差异均有统计学意义P<0. 001),且SMILE组明显优于FS-LASIK组。术前和术后1、3mo,两组患者角膜最薄点高度和角膜后表面高度比较,差异均无统计学意义(P>0. 05)。结论:SMILE和FS-LASIK术治疗高度近视均安全有效,有很好的可预测性和稳定性,但SMILE术后泪膜稳定性优于FS-LASIK术,两种术式在角膜生物力学稳定性方面无明显差异。

AIM： To explore the clinical effect of small incision lenticule extraction（ SMILE） and femtosecond laser in situ keratomileusis（ FS-LASIK） in correcting high myopia and the effect on cornea and tear film stability. METHODS： Totally 120 patients with high myopia treated in the hospital from August 2016 to February 2017 were selected as the research subjects. According to the surgical methods,the patients were divided into SMILE group and FS-LASIK group,67 cases 134 eyes in SMILE group and,and 53 cases 106 eyes in FS-LASIK group.Group SMILE was treated with SMILE,and group FS-LASIK was treated by FS-LASIK. The influence of normal vision and stability of cornea and tear film. RESULTS： There was no significant difference in uncorrected visual acuity（ UCVA）,best corrected visual acuity（ BCVA） and diopter between two groups after 1 mo and 3 mo（ P0.05）. There was no significant difference in BUT and SⅠt between the two groups of patients before and 1 mo after operation（ P〉0.05）. After 3 mo between the two groups,BUT and S Ⅰ t in the two groups were statistically different, and the SMILE group was significantly better than the FS-LASIK group（ P〈0.001）.There was no significant difference between the two groups of corneal thinning point height and posterior vertex height at preoperative and postoperative 1 and 3 mo（ P〉0. 05）.CONCLUSION： SMILE and FS-LASIK are equally safe and effective and have good predictability and stability.The postoperative tear film stability is superior to FS-LASIK, and there is no significant difference in the biomechanical stability of the two kinds of methods.