Observation of peripheral refraction in myopic anisometropia in young adults

AIM:To investigate the differences in retinal refraction difference values(RDVs)of adult patients with myopic anisometropia compared with those without myopic anisometropia,and to investigate the relationship between ocular biometric measurements and relative peripheral refraction.METHODS:This clinical observation study included 130 patients with myopia(-0.25 to-10.00 D)between October 2022 and January 2023 aged between 18 and 40y.The patients were divided into anisometropia(n=63;difference in binocular anisometropia≥1.00 D)and non-anisometropia(n=67;difference in binocular anisometropia<1.00 D)groups accordingly.Ocular biometric measurements were performed by optical biometrics and corneal topography to assess the steep keratometry(Ks),flap keratometry(Kf),axial length(AL),corneal astigmatism(CYL;Ks-Kf),surface regularity index(SRI),surface asymmetry index(SAI),and central corneal thickness(CCT).The RDV was measured at five retinal areas from the fovea to 53 degrees(RDV-0-10,RDV-10-20,RDV-20-30,RDV-30-40,and RDV-40-53),the total RDV(TRDV)of 53 degrees,and four regions,including RDV-superior,RDV-inferior,RDV-temporal,and RDV-nasal.An analysis of Spearman correlation was carried out to examine the correlation between RDV and the spherical equivalent(SE)and ocular biological parameters.RESULTS:Within RDV-20-53,both groups showed relative hyperopic defocus,and the increase in RDV corresponds to the increase in eccentricity.In the myopic anisometropia group,the TRDV,RDV-20-53,RDV-superior,and more myopic eyes had significantly higher RDVtemporal values than less myopic eyes.(P<0.05).In the non-anisometropia group,there was no significant difference in the RDV between the more and less myopic eyes at different eccentricities(P>0.05).There was a negative correlation between SE and TRDV(r=-0.205,P=0.001),RDV-20-53(r=-0.281,-0.183,-0.176,P<0.05),RDV-superior(r=-0.251,P<0.001),and RDV-temporal(r=-0.230,P<0.001),a negative correlation between CYL and RDV-10-30(r=-0.147,-0.180,P<0.05),and a negative correlation between SRI and RDV-0-20(r=-0.190,-0.170,P<0.05).AL had a positive correlation with RDV-20-30(r=0.164,P=0.008)and RDV-temporal(r=0.160,P=0.010).CONCLUSION:More myopic eyes in patients with myopic anisometropia show more peripheral hyperopic defocus.Diopter and corneal morphology may affect peripheral retinal defocus.

配戴角膜塑形镜后光学治疗区偏心对视网膜离焦量的影响

目的:观察配戴角膜塑形镜12mo后光学治疗区偏心对视网膜离焦量的影响。方法:病例对照研究。选取2021-03/09在我院完成验配并坚持配戴角膜塑形镜12mo的近视患者120例120眼,根据戴镜12mo后偏心量分为低度偏心组(<0.5mm,58例58眼)和中高度偏心组(≥0.5mm,62例62眼)。评估配戴角膜塑形镜12mo后光学治疗区直径(OTZD)和偏心量、眼轴长度(AL)、基线瞳孔直径(PD)及视网膜离焦量(RDV),分析视网膜离焦量与偏心量的相关性。结果:配戴角膜塑形镜12mo后,中高度偏心组AL增长量、距黄斑30°~40°和40°~53°范围RDV明显低于低度偏心组(均P<0.05)。纳入患者距黄斑40°~53°范围RDV与AL增长量、OTZD呈正相关(r s=0.544、0.333,均P<0.01),与偏心量呈负相关(r s=-0.224,P=0.014)。结论:配戴角膜塑形镜后周边视网膜离焦与偏心量、OTZD相关,一定范围内偏心量越大、OTZD越小可诱导更多周边视网膜近视性离焦,控制眼轴增长效果越好。

FS-LASIK与SMILE手术前后视网膜周边屈光状态及像差的变化

目的:观察比较飞秒激光制瓣准分子激光原位角膜磨镶术(FS-LASIK)与飞秒激光小切口角膜基质透镜取出术(SMILE)矫正近视术后视网膜周边屈光和像差的改变。方法:选取2022-10/2023-04来院行FS-LASIK的近视患者71例71眼作为FS-LASIK组,行SMILE的近视患者80例80眼作为SMILE组。所有患者于术前,术后3mo均行角膜像差检查和多光谱地形图检查,检查黄斑周围0°~10°、10°~20°、20°~30°、30°~40°、40°~53°环形视网膜相对离焦值(RDV),并记录为RDV-(0°~10°)、RDV-(10°~20°)、RDV-(20°~30°)、RDV-(30°~40°)、RDV-(40°~53°)。对两组患者检查结果进行比较。结果:术后3mo,两组患者RDV-(0°~10°)、RDV-(10°~20°)、RDV-(20°~30°)、RDV-(30°~40°)、RDV-(40°~53°)比较均无差异(均P>0.05)。两组术后3mo的RDV-(20°~30°)、RDV-(30°~40°)、RDV-(40°~53°)均显著低于术前(均P<0.05)。SMILE组患者术后3mo时的彗差(水平)及球差(SA)分别为0.106(0.056,0.171)、0.115(0.081,0.182)μm,均显著低于FS-LASIK组[0.206(0.104,0.355)、0.197(0.128,0.254)μm](Z=-4.170、-5.016,均P<0.05)。术后SA与术后RDV-(10°~53°)呈负相关(rs=-0.205、-0.181、-0.226、-0.244,均P<0.05)。结论:FS-LASIK与SMILE均能减少黄斑周围20°~53°离心率范围的视网膜远视离焦,且SMILE术后彗差(水平)和SA的改变比FS-LASIK小。术后SA与术后的周边视网膜离焦存在一定的相关性。