全飞秒激光小切口角膜基质透镜取出术在近视治疗中的应用效果

Application effect of full femtosecond laser small incision lenticule extraction in the treatment of myopia

目的探讨全飞秒激光小切口角膜基质透镜取出术(SMILE)在近视治疗中的应用效果。方法选取2020年5月至2021年5月桂林爱尔眼科医院诊治的120例(240眼)近视患者作为研究对象,按照治疗方式的不同分为对照组与观察组,每组60例(120眼)。对照组行飞秒激光角膜原位磨镶术(FS-LASIK),观察组行全飞秒激光SMILE。比较两组视力改善情况、非球面参数Q值、角膜切削深度变化及并发症发生情况。结果术前、术后3个月,两组裸眼视力(UCVA)、最佳矫正视力(BCVA)比较差异无统计学意义;术后3个月,两组UCVA、BCVA均高于术前,差异有统计学意义(P<0.05)。术前,两组非球面参数Q值比较差异无统计学意义;术后3个月,两组非球面参数Q值均高于术前,但观察组低于对照组,差异有统计学意义(P<0.05)。两组角膜实际切削深度比较差异无统计学意义;观察组角膜实际切削深度小于预测切削深度,切削误差大于对照组,差异有统计学意义(P<0.05)。两组并发症发生率比较差异无统计学意义。结论FS-LASIK与SMILE均能明显改善近视患者视力,且对非球面参数Q值影响较小,但SMILE与预测切削深度存有较大误差,临床需根据患者个体情况选择术式,以确保手术安全性。

Objective To explore the application effect of full femtosecond laser small incision lenticule extraction(SMILE)in the treatment of myopia.Methods 120 myopic patients(240 eyes)diagnosed and treated in Guilin Aier Eye Hospital from May 2020 to May 2021 were selected as the research subjects,and they were divided into the control group and the observation group according to the different treatment methods,with 60 cases(120 eyes)in each group.The control group underwent femtosecond laser in situ keratomileusis(FS-LASIK),while the observation group un-derwent full femtosecond laser SMILE.The improvement of vision,Q values of aspherical parameters,changes in corneal cutting depth,and inci-dence of complications were compared between the two groups.Results There was no statistically significant difference in uncorrected visual acuity(UCVA)and best corrected visual acuity(BCVA)between the two groups before and after surgery 3 months;after surgery 3 months,the UCVA and BCVA of the two groups were higher than those before operation,and the differences were statistically significant(P<0.05).Before surgery,there was no significant difference in the Q value of aspheric parameters between the two groups;after surgery 3 months,the Q values of aspheric parame-ters in the two groups were higher than those before surgery,but those in the observation group were lower than the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the actual corneal cutting depth between the two groups;the actual cut-ting depth of the cornea in the observation group was less than the predicted cutting depth,and the cutting error was greater than that in the control group,the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of complications be-tween the two groups.Conclusion Both FS-LASIK and SMILE can significantly improve the visual acuity of myopic patients,and have little effect on the aspheric parameter Q value,however,SMILE has the large error with the predicted cutting depth,clinically,the surgical procedure should be selected according to the individual condition of the patient to ensure the safety of the operation.