SMILE、FS-LASIK术治疗高度近视对角膜和泪膜稳定性的影响

Effects of SMILE and FSLASIK on corneal and tear membrane stability in the treatment of high myopia

目的对高度近视患者分别应用飞秒激光小切口角膜基质透镜取出术(SMILE)、半飞秒激光近视手术(FS-LASIK)治疗,并分析其对角膜和泪膜稳定性的影响.方法抽取2017年1月至2019年1月在南阳市第二人民医院治疗的85例高度近视患者(共170眼),将其分为SMILE组45例(90眼)、FS-LASIK组40例(80眼),分别采取SMILE、FS-LASIK术治疗.术后随访3个月,对比两组患者视力、屈光度、泪膜稳定性、角膜稳定性相关指标.视力指标包括裸眼视力(UCVA)、术前最佳矫正视力(BCVA);泪膜稳定性指标包括泪膜破裂时间(BUT)、泪液分泌功能检测(SIt);角膜稳定性包括角膜最薄点高度、角膜后表面高度.结果术后1个月、3个月,两组患者的UCVA、BCVA、屈光度比较,差异未见统计学意义(P>0.05);术后3个月,两组患者角膜最薄点高度、角膜后表面高度比较,差异未见统计学意义(P>0.05),SMILE组患者的BUT、SIt均明显大于FS-LASIK组(P<0.05).结论SMILE、FS-LASIK术对患者视力、屈光度、角膜稳定性影响未见差异,SMILE术泪膜稳定性更佳.

Objective To analyze the effects of femtosecond laser corneal stroma with small incision lens remoral(SMILE),semi-femtosecond laser for my opia operation(FS-LASIK)on corneal and tear film stability in patients with high myopia.Methods A total of 85 patients(170 eyes)with high myopia from January 2017 to January 2019 treated in the Second People’s Hospital of Nanyang were divided into SMILE group(45 cases,90 eyes)and FS-LASIK group(40 cases,80 eyes).The patients were treated with SMILE,and FS-LASIK correspondingly.Postoperative follow-up was conducted for 3 months.The vision,power,tear film stability and corneal stability were compared between the two groups.Visual indicators included naked eye vision(UCVA)and preoperative best corrected visual acuityand preoperative best corrected visual acuity,BCVA.Tear film stability indicators included break up time of tear film(BUT),detection of tear secretion function(SIt).Corneal stability indicators included the thickness of the cornea at the thinnest point of the cornea and the height of the posterior surface of the cornea.Results One month and three months after operation,UCVA,BCVA and Diopter were significantly different between the two groups(P>0.05).Three months after operation,corneal thinnest point height had no significant difference and corneal posterior surface height had no significant difference between the two groups(P>0.05),and the BUT and SⅠt of the patients in the SMILE group were significantly higher than those of the FS-LASIK group(P<0.05).Conclusions SMILE and FS-LASIK have no difference in the effects on the patient’s vision,power and corneal stability.Tear film stability of the patients treated by SMILE group are higher than that of patients treated by FS-LASIKp.