SMILE与FS-LASIK治疗低中度近视的偏心情况

Comparison of Optical Zone Decentration after SMILE and FS-LASIK for Low and Moderate Myopia

目的:比较飞秒激光小切口角膜基质透镜取出术(SMILE)与飞秒激光制瓣准分子激光原位角膜磨镶术(FS-LASIK)的术后偏心量,分析偏心量与术后角膜高阶像差、Kappa角、等效球镜度(SE)、主导眼的相关性。方法:回顾性研究。选取2018年1-10月在广州爱尔眼科医院行SMILE的患者62例(124眼),行FS-LASIK的患者44例(88眼)。在Pentacam术后3个月的切线曲率图(Tangentialcurvature[front])上,用自制的透明同心圆环拟合6mm左右光学区边界,圆心距角膜顶点的距离记为偏心量。应用独立样本t检验、Pearson线性相关分析、卡方检验处理数据。结果:术后3个月SMILE组偏心量为(0.27±0.14)mm,FS-LASIK组为(0.25±0.13)mm,组间差异无统计学意义;FS-LASIK组偏心量与术后彗差有相关性(r=0.288,P=0.009),SMILE组偏心量与术后彗差、球差及FS-LASIK组偏心量与术后球差均无相关性。2组偏心量与Kappa角、SE均无相关性。组内主导眼与非主导眼偏心量差异无统计学意义。结论:SMILE的手动切削中心定位方式与FS-LASIK的自动化切削中心定位方式精确度相仿;偏心量会影响FS-LASIK术后彗差,对SMILE无影响;且2种术式偏心量均不受Kappa角、SE、主导眼的影响。

Objective: To compare the optical zone decentration between small incision lenticule extraction (SMILE) and femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) in treating myopia and astigmatism, and to analyze the correlation between the decentration distance and corneal higher-order aberrations (HOAs), angle kappa, spherical equivalent (SE), and the dominant eye. Methods: This research was based on the retrospective analysis of 62 patients (124 eyes) who had undergone SMILE and 44 patients (88 eyes) who had undergone FS-LASIK in Guangzhou Aier Eye Hospital between January 2018 and October 2018. Based on the 3-month postoperative tangent curvature [front] map of Pentacam, the 6 mm cutting boundary was fitted with a self-made concentric circle and the distance from the center to the top of the cornea was recorded as decentration. Independent t-tests, Pearson correlation coefficient analysis, and a chi-square test were used to analyze the collected data. Results: The decentration was 0.27±0.14 mm for SMILE and 0.25±0.13 mm for FS-LASIK, and there was no statistically significant difference between the groups. There was a correlation between decentration distance and coma (r=0.288, P=0.009) for FS-LASIK but not for SMILE. There was no correlation between decentration distance and angle kappa or SE for both groups. There was no significant difference in eccentricity between the dominant and non-dominant eye in both groups. Conclusions: The accuracy of the manual centration location of SMILE is similar to that of the automatic centration location of FS-LASIK. There is a correlation between decentration distance and coma for FS-LASIK, but not for SMILE. There is no correlation between decentration distance and angle kappa, SE, or the dominant eye.