SMILE与EVO-ICL植入术矫正中度近视的短期视觉质量观察

Short-term visual quality observation of femtosecond laser small incision lenticule extraction and evolution implantable collamer lens implantation in the correction of moderate myopia

目的:探讨飞秒激光小切口角膜基质透镜取出术(SMILE)与中央孔型有晶状体眼后房型人工晶状体(EVO-ICL)植入术矫正中度近视术后短期视觉质量表现。方法:前瞻性对照研究。选取2021-04/2022-02在潍坊眼科医院行SMILE和EVO-ICL植入术的中度近视患者51例51眼,根据手术方式分为SMILE组(30例30眼)和EVO-ICL组(21例21眼)。分别于术前、术后1wk,1、3mo观察两组患者视力[裸眼远视力(UDVA)、矫正远视力(CDVA)]、屈光度[等效球镜度(SE)]及双通道客观视觉质量分析系统(OQASⅡ)相关参数的变化,并填写视觉质量(QoV)调查问卷。结果:术后3mo,SMILE组和EVO-ICL组安全性指数(术后CDVA/术前CDVA)分别为1.20(1.00,1.20)和1.20(1.00,1.38),有效性指数(术后UDVA/术前CDVA)分别为1.00(1.00,1.20)和1.00(1.00,1.20);SE在±0.50D以内的比例分别为87%和100%。SMILE组术后客观散射指数(OSI)值增加,术后1wk,1mo调制传递函数截止频率(MTF cutoff)、对比度视力(VA)100%、VA20%及术后各时间点斯特列尔比(SR)、VA9%均较术前降低(均P<0.05);EVO-ICL组术后各时间点OSI、MTF cutoff、SR、VA与术前相比均无差异(均P>0.05)。SMILE和EVO-ICL植入术后最常见的视觉症状分别为视觉朦胧和光晕。结论:SMILE和EVO-ICL植入术矫正中度近视术后短期均有良好的安全性、有效性及可预测性,两种手术术后均有视觉症状的发生,但患者总体满意度高,且EVO-ICL植入术后具有更好的客观视觉质量表现。

English_abstract AIM:To investigate the short-term visual quality outcomes after femtosecond laser small incision lenticule extraction(SMILE)and evolution implantable collamer lens(EVO-ICL)implantation for the correction of moderate myopia.METHODS:Prospective control study.A total of 51 cases(51 eyes)with moderate myopia who underwent SMILE or EVO-ICL implantation surgery at Weifang Eye Hospital from April 2021 to February 2022 were selected.They were divided into SMILE group(30 patients,30 eyes)and EVO-ICL group(21 patients,21 eyes)according to the surgical methods.The changes of visual acuity[uncorrected distance visual acuity(UDVA),corrected distance visual acuity(CDVA)],diopter[spherical equivalent(SE)]and related parameters of optical quality analysis system(OQASⅡ)were observed before surgery and at 1wk,1 and 3mo after surgery,and the quality of vision(QoV)questionnaire was completed.RESULTS:At 3mo after surgery,the safety index(postoperative CDVA/preoperative CDVA)of SMILE gruop and EVO-ICL group were 1.20(1.00,1.20)and 1.20(1.00,1.38),respectively,the efficacy index(postoperative UDVA/preoperative CDVA)were 1.00(1.00,1.20)and 1.00(1.00,1.20),respectively,and the percentage of SE within±0.50D was 87%and 100%,respectively.In SMILE group,the objective scattering index(OSI)was increased after surgery,while modulation transfer function cutoff frequency(MTF cutoff),contrast visual acuity(VA)100%,and VA20%at 1wk and 1mo after surgery,and Strehl ratio(SR)and VA9%at each time point after surgery were all decreased compared with those before surgery(all P<0.05).The OSI,MTF cutoff,SR and VA of EVO-ICL group showed no difference at each time point after surgery compared with those before surgery(all P>0.05).The most common visual symptoms after SMILE and EVO-ICL implantation were visual haze and halos,respectively.CONCLUSION:Both SMILE and EVO-ICL implantation have good safety,efficacy and predictability in the short term after the correction of moderate myopia.Both groups had visual symptoms after surgery,but the overall satisfaction of patients was high.Furthermore,EVO-ICL implantation has better objective visual quality performance.