J Refract Surg. 2013 Oct;29(10):668-74. doi: 10.3928/1081597X-20130806-01.
To study microdistortions in Bowman's layer after femtosecond laser small incision lenticule extraction (SMILE) using Fourier-domain optical coherence tomography (OCT) and to investigate possible sources and potential visual impacts.
A nonrandomized controlled prospective study enrolled 52 eyes of 29 consecutive patients undergoing SMILE, with spherical equivalent of -6.33 ± 1.88 diopters and 4.2 mm superior incision. The microdistortions in Bowman’s layer were counted at 1 day, 1 week, and 1 month postoperatively and at long-term follow-up. Another 38 eyes of 20 patients undergoing femtosecond laser-assisted LASIK (FS-LASIK) were examined at 1 day and long-term postoperatively as the control group.
Microdistortions in Bowman’s layer were observed by OCT, with no clinically significant corneal striae under slit-lamp microscopy, in 46 eyes (88.5%) on day 1 after SMILE and in 16 eyes (42.1%) after FS-LASIK, with more in SMILE eyes than in FS-LASIK eyes. The amount decreased at 1 week and then remained stable. There were more microdistortions in the center area than in the periphery in both groups. Microdistortions were more in the inferior than the superior quadrant on the first day after SMILE but there was no difference at long-term follow-up. Microdistortions after SMILE were associated with the refractive lenticule thickness and surgery order but had no significant impact on long-term visual outcomes or wavefront aberrations.
Microdistortions in Bowman's layer after SMILE were associated with the refractive lenticule thickness and surgery order. The microdistortions remained stable after 1 week and had no impact on long-term visual performance.
应用傅里叶域光学相干断层扫描（OCT）研究飞秒激光小切口角膜基质透镜取出术（SMILE）后Bowman 层的微观扭曲，并探讨可能的来源和潜在的视觉影响。
一项非随机对照前瞻性研究纳入了 29 例连续患者的 52 只眼，这些患者均行 SMILE 手术，等效球镜屈光度为-6.33±1.88 屈光度，切口位于上方 4.2mm。术后 1 天、1 周和 1 个月以及长期随访时，计数 Bowman 层的微观扭曲。另将 20 例患者的 38 只眼行飞秒激光辅助 LASIK（FS-LASIK）作为对照组，于术后 1 天和长期随访时进行检查。
OCT 观察到 Bowman 层有微观扭曲，但在 SMILE 术后 1 天的 46 只眼（88.5%）和 FS-LASIK 术后的 16 只眼（42.1%）中，裂隙灯显微镜下均未见明显的角膜条纹。SMILE 眼的微观扭曲比 FS-LASIK 眼多。数量在 1 周后减少，然后保持稳定。两组的中心区的微观扭曲比周边区多。SMILE 术后第 1 天，下方象限的微观扭曲比上方象限多，但长期随访时无差异。SMILE 术后的微观扭曲与屈光性透镜厚度和手术顺序有关，但对长期视觉结果或波前像差无显著影响。
SMILE 后 Bowman 层的微观扭曲与屈光性透镜厚度和手术顺序有关。1 周后，微观扭曲保持稳定，对长期视觉性能无影响。
