全飞秒小切口角膜基质透镜取出术联合快速角膜交联治疗薄角膜中高度近视的临床价值

Clinical value of full femtosecond small incision lenticule extraction combined with rapid corneal crosslinking in the treatment of moderate and high myopia in thin cornea

目的探究全飞秒小切口角膜基质透镜取出术(SMILE)联合快速角膜交联治疗薄角膜中高度近视的临床价值。方法选取2019年1月至2020年1月本院收治的50例薄角膜中高度近视患者作为研究对象,均行SMILE,比较患者手术前后视力情况、手术效果。结果术后14个月,中高度近视患者切削厚度为(115.31±12.54)μm,剩余基质厚度为(285.32±4.32)μm,等效球镜大于术前,角膜曲率低于术前,角膜厚度薄于术前,差异有统计学意义(P<0.05)。术后30 d检查50例中高度近视患者角膜基质情况,6例可在角膜基质241~320μm处看见角膜交联线,但术后3个月6例患者均已恢复正常,角膜交联线并不明显,基本痊愈;术后14个月视力回退<0.50 D。结论SMILE联合快速角膜交联治疗中高度近视疗效确切,能促使患者视力尽快恢复,稳定性高,值得临床推广应用。

Objective To investigate the clinical value of full femtosecond small incision lenticule extraction(SMILE)combined with rapid corneal crosslinking in the treatment of moderate and high myopia in thin cornea.Methods 55 patients with moderate and high myopia in thin cornea admitted to our hospital from January 2019 to January 2020 were selected as the research subjects.All patients underwent full femtosecond SMILE,and the visual acuity and surgical effect were compared before and after surgery.Results 14 months after surgery,the cutting thickness of patients with moderate and high myopia was(115.31±12.54)μm,the remaining matrix thickness was(285.32±4.32)μm,the equivalent spherical lens was greater than before surgery,the corneal curvature was lower than before surgery,and the corneal thickness was thinner than before surgery,the differences were statistically significant(P<0.05).The corneal stroma of 50 patients with high myopia was examined 30 d after surgery,and the corneal crosslinking line could be seen in the corneal stroma of 241-320μm in 6 cases,but the corneal crosslinking line was not obvious in 6 cases after 3 months,and basically recovered;visual acuity decreased by less than 0.50 D 14 months after surgery.Conclusion SMILE combined with rapid corneal crosslinking in the treatment of moderate and high myopia is effective,can promote patients'vision recovery as soon as possible,high stability,which is worthy of clinical promotion and application.