Wei Sheng-sheng, Wang Yan, Geng Wei-li, Jin Ying, Zuo Tong, Wang Lu, Wu Di
Tianjin Eye Hospital, Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Institute, Clinical College of Ophthalmology, Tianjin Medical University, Tianjin 300020, China.
Zhonghua Yan Ke Za Zhi. 2013 Apr;49(4):299-304.
To evaluate and compare the recovery of central and peripheral corneal sensitivity in the early period after small incision lenticule extraction (SMILE) and femtosecond lenticule extraction (FLEx).
In this study, 47 cases (87 eyes) which underwent SMILE and FLEx were included. Central, superior, inferior, nasal and temporal corneal sensitivity was measured using a Cochet-Bonnet esthesiometer (Luneau Ophthalmologic) before and 1 week, 1 month, and 3 months after SMILE and FLEx. The results were analyzed with Mann-Whitney test by SPSS13.0 software.
There were statistical differences between SMILE and FLEx group in the central, inferior, nasal and temporal corneal sensitivity at 1 week, 1 month and 3 months postoperatively (Z = -5.219, -7.120, -6.735, -7.139, -5.945, -6.644, -7.006, -7.121, -5.262, -3.086, -4.140, -3.523. P < 0.01). However, the superior corneal sensitivity in the SMILE group did not show significant difference (Z = -1.807, P = 0.071) as compared to FLEx group (with exception of 1 week postoperatively). At 1 month and 3 months postoperatively, corneal sensitivity in the superior quadrant were (5.23 ± 0.62) and (5.57 ± 0.57) cm in the SMILE group, and were (4.43 ± 1.20) and (4.85 ± 1.11) cm in the FLEx group. There were statistical differences between these two groups (Z = -2.935, -2.678. P = 0.003, 0.007). In the SMILE group, corneal sensitivity in the central, superior, inferior, nasal and temporal quadrants at 3 months postoperatively was (5.74 ± 0.51), (5.57 ± 0.57), (5.70 ± 0.55), (5.83 ± 0.37), (5.84 ± 0.30) cm respectively, there were no significant differences as compared with preoperative data (Z = -1.255, -0.893, -0.570, -0.630, -0.935. P = 0.209, 0.440, 0.569, 0.529, 0.350). In the FLEx group, corneal sensitivity in the superior at 3 months postoperatively was 4.85 ± 1.11, there was not significant difference compared with preoperative data (Z = -1.095, P = 0.272). There were no correlations between the changes of central corneal sensitivity and central corneal ablation depth, central corneal thickness and preoperative spherical equivalent (SMILE group: r = 0.159, -0.202, 0.106, 0.060. P > 0.05. FLEx group: r = -0.156, -0.059, 0.058, -0.005. P > 0.05) after SMILE and FLEx surgery.
Corneal sensitivity decreases after SMILE and FLEx, and then returns to its original state over time. The decrease of corneal sensitivity after the SMILE was fewer and the recovery was faster as compared with FLEx.
评估并比较小切口飞秒透镜切除术（SMILE）和飞秒激光透镜切除术（FLEx）术后早期中央和周边角膜敏感性的恢复情况。
本研究纳入47例（87眼）接受SMILE和FLEx手术的患者。使用Cochet-Bonnet眼压计（Luneau Ophthalmologic）在SMILE和FLEx手术前以及术后1周、1个月和3个月测量中央、上方、下方、鼻侧和颞侧角膜敏感性。结果采用SPSS13.0软件进行Mann-Whitney检验分析。
SMILE组和FLEx组在术后1周、1个月和3个月时中央、下方、鼻侧和颞侧角膜敏感性存在统计学差异（Z = -5.219, -7.120, -6.735, -7.139, -5.945, -6.644, -7.006, -7.121, -5.262, -3.086, -4.140, -3.523。P < 0.01）。然而，SMILE组上方角膜敏感性与FLEx组相比差异无统计学意义（Z = -1.807, P = 0.071）（术后1周除外）。术后1个月和3个月时，SMILE组上方象限角膜敏感性分别为（5.23 ± 0.62）和（5.57 ± 0.57）cm，FLEx组分别为（4.43 ± 1.20）和（4.85 ± 1.11）cm。两组间存在统计学差异（Z = -2.935, -2.678。P = 0.003, 0.007）。在SMILE组，术后3个月中央、上方、下方、鼻侧和颞侧象限角膜敏感性分别为（5.74 ± 0.51）、（5.57 ± 0.57）、（5.70 ± 0.55）、（5.83 ± 0.37）、（5.84 ± 0.30）cm，与术前数据相比差异无统计学意义（Z = -1.255, -0.893, -0.570, -0.630, -0.935。P = 0.209, 0.440, 0.569, 0.529, 0.350）。在FLEx组，术后3个月上方角膜敏感性为4.85 ± 1.11，与术前数据相比差异无统计学意义（Z = -1.095, P = 0.272）。SMILE和FLEx手术后，中央角膜敏感性变化与中央角膜切削深度、中央角膜厚度和术前等效球镜度之间无相关性（SMILE组：r = 0.159, -0.202, 0.106, 0.060。P > 0.05。FLEx组：r = -0.156, -0.059, 0.058, -0.005。P > 0.05）。
SMILE和FLEx术后角膜敏感性降低，随后随时间恢复至原始状态。与FLEx相比，SMILE术后角膜敏感性降低较少且恢复较快。
