比较SMILE与有晶状体眼ICL矫正高度近视的效果

Comparison of the efficacy between SMILE and posterior chamber phakic intraocular lens in correcting high myopia

目的比较飞秒激光小切口角膜基质透镜取出术（SMILE）与有晶状体眼后房型人工晶状体植人术（ICL）矫正高度近视的效果。方法回顾性分析近视屈光度为-8．00D～10．00D者76例（152只眼），其中40例（80只眼）接受SMILE术，36例（72只眼）行ICLV4c植入术，对两组术后视力、高阶像差均方根值和对比敏感度进行比较分析。结果术后1、3、6和12个月裸眼视力、最佳矫正视力及残留屈光度两组之间差异均无统计学意义（P〉0．05）；球差（掣）均方根值和垂直彗差（Z3^-1）均方根值两组之间的差异有统计学意义（P〈0．05），但水平三叶草（Z3^3）和垂直三叶草（z3^-3）以及水平彗差（Z3^1）均方根值（RMS）两组之间的差异均无统计学意义（P〉0．05）。术后6个月，暗视对比敏感度在3．0c／d和6．0c／d频段ICLV4C组高于SMILE组（P〈0．05），其余各频段两组之间差异均无统计学意义（P〉0．05）。结论SMILE与ICL V4c均能使高度近视患者获得预期的矫正效果，但是ICL V4c术后视觉质量优于SMILE手术。

Objective To compare the efficacy between small incision lenticule extraction （SMILE） and posterior chamber phakic intraocular lens （ICL） implantation for correcting high myopia. Methods The data of 152 eyes of 76 patients with high myopia between - 8D - - 10D were analysed and all cases were divided into 2 groups. SMILE group, 80 eyes of 40 patients underwent SMILE, and ICL group,72 eyes of 36 patients recived ICL V4c implantation. The postoperative visual acuity, residual refraction, the root mean square of higher-order aberrations and contrast sensitivity were compared and analyzed between the two groups. Results The difference of BCVA, UCVA, and residual refraction was not statistically significant between two groups at 1,3,6 and 12 months postoperatively （ P 〉 0. 05 ）. The difference of root mean square of （RMS） of spherical aberration （ Z4^0 ） and vertical primary coma （ Z3^-1 ） were statistically significant between two groups （ P 〈 0.05 ）. The difference of RMS of horizontal clover （ Z3^3 ）, vertical clover （ Z3^-3 ） and horizontal primary coma （ Z13 ） were not statistically significant between two groups （P 〉 0.05 ）. Six months after surgery,in ICL V4c group the contrast sensitivity at 3.0c/d and 6.0c/ d spatial frequencies was better than that in SMILE group （ P 〈 0.05 ）, the difference was not siginificant between two groups in the other spatial frequencies （ P 〉 0.05 ）. Conclusion Both SMILE and ICL V4c achieve the anticipated effect for correcting high myopia,but the visual quality of ICL V4c is better than that of SMILE.