SMILE术矫治中高度近视的疗效及对其角膜形态的影响

Efficacy of SMILE in the Correction of Moderate to High Myopia and the Effect on Its Corneal Morphology

目的探讨飞秒激光微小切口角膜基质透镜切除术(small incision lenticule extraction,SMILE)矫治中高度近视的疗效及对其角膜形态的影响。方法选择2021年1月—2022年12月于肇庆市第一人民医院行手术矫治的80例中高度近视患者为研究对象,依据不同的手术矫治方式将患者分为研究组与对照组,各40例。研究组应用SMILE术,对照组应用飞秒激光制瓣准分子激光原位角膜磨镶术(femtosecond assisted laser in situ keratomileusis,FS-LASIK)。对比两组最佳矫正视力、角膜非球面Q值、角膜曲率、角膜表面规则指数。结果与术前比较,两组术后1周、1个月、3个月、6个月的最佳矫正视力明显改善,差异有统计学意义(P<0.05),但两组对比差异无统计学意义(P>0.05);研究组术后3个月、6个月角膜非球面Q值低于对照组,差异有统计学意义(P<0.05);研究组术后1周、1个月、3个月、6个月的角膜曲率低于对照组,差异有统计学意义(P<0.05);研究组术后1周、1个月、3个月、6个月的角膜表面规则指数高于对照组,差异有统计学意义(P<0.05)。结论中高度近视患者应用SMILE术矫治的疗效与FS-LASIK术相当,且对角膜非球面Q值、角膜曲率的影响更小,有助于提高角膜表面规则指数。

Objective To investigate the efficacy of femtosecond laser small incision lenticule extraction(SMILE)in the treatment of moderate to high myopia and its effect on corneal morphology.Methods 80 patients with moderate high myopia who underwent surgical correction in Zhaoqing First People's Hospital from January 2021 to December 2022 were selected as the study objects.According to different surgical correction methods,the patients were divided into study group and control group,with 40 cases each.SMILE was used in the study group,and femtosecond assisted laser in situ keratomileusis(FS-LASIK)was used in the control group.The best corrected visual acuity,aspherical Q value,corneal curvature and corneal surface regularity index were compared between the two groups.Results Com-pared with pre-operation,the best corrected visual acuity of two groups was significantly improved at 1 week,1 month,3 months and 6 months after surgery,and the difference was statistically significant(P<0.05),but there was no statistically significant difference between 2 groups(P>0.05).The aspherical Q value of the study group were lower than those of the control group at 3 months and 6 months after surgery,and the difference was statistically significant(P<0.05).The corneal curvature of the study group at 1 week,1 month,3 months and 6 months after surgery were lower than those of the control group,and the difference was statistically significant(P<0.05).The corneal surface rule index of the study group at 1 week,1 month,3 months and 6 months after surgery were higher than those of the control group,and the difference was statistically significant(P<0.05).Conclusion The therapeutic effect of SMILE in pa-tients with moderate and high myopia is comparable to FS-LASIK,and the effect on Q value of aspherical cornea and corneal curvature is less,which is helpful to improve the corneal surface regularity index.