不同角膜表面处理方式在全飞秒SMILE手术中的应用效果分析

Application Effect Analysis of Different Corneal Surface Treatments in Femtosecond SMILE Surgery

目的:探讨不同角膜表面处理方式在全飞秒SMILE手术中的应用效果。方法:选择2021年10月至2022年9月来我院择期行全飞秒SMILE手术的患者50例,根据先右后左手术原则,观察眼与对照眼没有固定左右眼,观察眼25例选择右眼,25例选择左眼,对照眼反之选择另一眼,观察眼使用开睑器开睑后用三角海绵擦拭清洁角膜表。对照眼眼自净(眨眼)后使用开睑器开眼睑。对比观察眼与对照眼的角膜光密度、角膜表面颗粒物质计数、角膜表面湿度、术中负压吸引完成时间、失吸比例、OBL发生率,分析50例患者的舒适度。结果:观察眼的角膜光密度为16.33±2.12,对照组为16.85±2.58,组间对比无统计学意义(t=-1.101,P=0.274)。对照眼的表面颗粒物质计数明显较观察眼低,角膜表面湿度明显较观察眼高(P<0.05)。对照眼与观察组术中负压吸引完成时间、失吸比例对比无统计学意义(P>0.05)。观察眼中OBL发生率为6.00%,对照眼中OBL发生率为2.00%,组间对比无统计学意义(P=0.617>0.05)。50例患者中对三角海绵擦拭角膜感觉恐惧者占比32.00%(16/50),三角海绵擦拭角膜后对注视绿点存在影响者占比20.00%(10/50),手术中选择三角海绵擦拭角膜者20例,占比40.00%(20/50),选择眼自净(眨眼)者30例,占比60.00%(30/50)。结论:眼自净(眨眼)可以代替三角海绵擦拭角膜,用于全飞秒SMILE手术,提高患者舒适度。

Objective:To investigate the effect of different corneal surface treatments in full femtosecond SMILE surgery.Methods:Fifty patients who came to our hospital from October 2021 to September 2022 for full femtosecond SMILE surgery were selected.According to the principle of operation first on the right and then on the left,the left and right eyes were not fixed in the observation eye and the control eye.The observation eye was selected for 25 cases,the left eye was selected for 25 cases,and the other eye was selected for the control eye.After eyelid opening,clean the corneal surface with triangle sponge.The eyelid was opened with a blepharoscope after eye self-purification(blinking)in control eyes.The corneal optical density,corneal surface particulate matter count,corneal surface moisture,intraoperative negative pressure suction completion time,desorption ratio and OBL incidence were compared between the observation eyes and the control eyes,and the comfort level of 50 patients was analyzed.Results:The corneal optical density of the observation eye was 16.33±2.12 and that of the control group was 16.85±2.58,with no statistical significance between groups(t=-1.101,P=0.274).The count of particulate matter on the surface of the control eyes was lower than that of the observation eyes,and the surface moisture of the cornea was higher than that of the observation eyes(P<0.05).The time of negative pressure suction and the time between the control eyes and the observation group(P>0.05).The incidence of OBL in observation eyes was 6.00%,and that in control eyes was 2.00%.Tthere was no statistical significance between groups(P=0.617>0.05).Among the 50 patients,32.00%(16/50)felt afraid of wiping the cornea with triangle sponge,20.00%(10/50)of patients affected the green spot of fixation after wiping the cornea with triangle sponge,and 20 patients chose to wipe the cornea with triangle sponge during the operation,accounting for 40.00%(20/50).30 cases of eye self-purification(blinking)were selected,accounting for 60.00%(30/50).Conclusion:Eye self-purification(blink)can replace the triangular sponge to wipe the cornea,and be used for full femtosecond SMILE surgery to improve patient comfort.