比较有晶状体眼人工晶状体植入术与SMILE术对高度近视眼表的影响

Comparison of the effect between implantable collamer lens implantation and SMILE on ocular surface in high myopia

目的比较有晶状体眼人工晶状体(ICL)植入术及飞秒激光小切口角膜基质透镜取出术(SMILE)对高度近视受术者眼表的影响。方法前瞻性研究。随机选择郑州大学第一附属医院2021年3月至12月拟行屈光手术者60例(60眼)。随机分为两组:A组(30眼)行有晶状体眼人工晶状体植入术。B组(30眼)行飞秒激光小切口角膜基质透镜取出术。术后随访3个月,比较两组间术前及术后各时间点的泪膜破裂时间、泪河高度、泪液分泌试验I、眼红指数、眼表疾病指数(OSDI)评分、睑板腺面积及脂质层分级。结果A组术后1个月及3个月泪膜破裂时间为(12.99±3.85)s、(14.96±4.26)s,均明显高于B组的(11.09±2.80)s及(12.75±3.68)s(t=2.18、2.16,P=0.033、0.035)。A组术后1个月眼红指数为1.16±0.32明显高于B组的0.93±0.24(t=4.15,P<0.001)。A组术后1个月及3个月OSDI评分为(3.60±2.22)分、(2.83±2.21)分显著低于B组的(5.53±2.74)分及(3.97±2.25)分(t=3.00、2.50,P<0.001、0.036)。结论与ICL手术相比,SMILE术后OSDI评分增高,泪膜破裂时间短,眼红指数降低。

Objective To compare the effects of implantable collamer lens(ICL)implantation and small-incision lenticule extraction(SMILE)on the ocular surface in high myopia.Methods This was a prospective study.The data of 60 eyes of 60 cases who were scheduled for refractive surgery from Mar.2021 to Dec.2021 in the First Affiliated Hospital of Zhengzhou University were selected.And they were randomly divided into two groups.In group A,30 eyes of 30 cases underwent ICL implantation and in group B 30 eyes of 30 cases underwent SMILE.They were followed up for 3 months.The tear film rupture time,tear river height,schirmer I test,hyperemia index,the ocular surface disease index(OSDI)score,meibomian gland area and lipid layer grade were compared between the two groups before and at each time point after operation.Results During the postoperative follow-up period,non-invasive tear break up time in group A was(12.99±3.85)s,(14.96±4.26)s at 1 and 3 months after operation,which were significantly higher than those of group B(11.09±2.80)s,(12.75±3.68)s(t=2.18,2.16;P=0.033,0.035).Hyperemia index at group A was 1.16±0.32 at 1 month after operation,which was higher than the 0.93±0.24 of group B(t=4.15,P<0.001).The OSDI scores of group A[(3.60±2.22)points and(2.83±2.21)points]at 1 and 3 months after operation were significantly lower than those of group B[(5.53±2.74)points and(3.97±2.25)points](t=3.00,2.50;P<0.001,0.036).Conclusion Compared with ICL,the OSDI score increases,and the tear film rupture time is shorter while the hyperemia index after SMILE decreases.