飞秒激光微小切口角膜基质透镜取出术后早期视觉质量的观察

Observation of Early Visual Quality after Femtosecond Laser Small Incision Lenticule Extraction

目的:探讨40岁以上人群飞秒激光微小切口角膜基质透镜取出术(SMILE)后早期的视觉质量。方法:选取2020年11个月至2021年12月在肇庆市第一人民医院眼科行SMILE的中低度近视患者28例(56眼)进行前瞻性研究,所有患者分别在术前及术后1 d、1周、1个月、3个月测量未矫正视力(UCVA)、球镜度数、柱镜度数、眼压、散光、慧差、三叶草差、球面像差、高阶像差、波前像差和斯特列尔,并评估患者手术前后视觉质量。结果:术后1 d、1周、1个月、3个月的UCVA高于术前,球镜度数、柱镜度数、眼压低于术前,差异具有统计学意义(P<0.05);术后1个月、3个月的散光小于术前,慧差、球面像差、高阶像差、波前像差大于术前,差异具有统计学意义(P<0.05);术后3个月的环境触发因素、视觉功能、眼部症状以及视觉质量问卷总分均低于术前,差异具有统计学意义(P<0.05)。结论:40岁以上人群行SMILE是安全有效的,调节力会影响视近满意度,术前充分沟通是提高满意度的关键。

Objective To investigate the early visual quality of femtosecond laser small incision lenticule extraction(SMILE) in patients over 40 years of age.Methods A prospective study was conducted on 28 patients(56 eyes)with moderate and low degree myopia who received SMILE in the ophthalmology department of The First People’s Hospital of Zhaoqing from November 2020 to December 2021.Uncorrected visual acuity(UCVA),spherical lens degree,column lens degree,intraocular pressure,astigmatism,coma,clover difference,spherical aberration,high-order aberration,wavefront aberration,and Steller were measured in all patients before and after surgery at 1 day,1 week,1 month,and 3 months,respectively,and visual quality was assessed before and after surgery.Results After surgery,the UCVA at 1 day,1 week,1 month and 3 months was higher than before surgery,and the bulb degree,column degree and intraocular pressure were lower than those before surgery,the differences were statistically significant(P<0.05).After surgery,the astigmatism at 1 month and 3 months was lower than before surgery,and the difference of coma,spherical aberration,high-order aberration and wavefront aberration were higher than those before surgery,the differences were statistically significant(P<0.05).3 months after surgery,the total scores of environmental triggers,visual function,ocular symptoms and visual quality questionnaire were lower than those before surgery,the differences were statistically significant(P<0.05).Conclusion SMILE surgery is safe and effective for people over 40 years old,and the adjustment will affect the satisfaction of near vision.Adequate preoperative communication is the key to improve satisfaction.