全层散光角膜切开术联合小切口透镜切除术治疗高度和混合性散光

Full-Thickness Astigmatic Keratotomy Combined With Small-Incision Lenticule Extraction to Treat High-Level and Mixed Astigmatism.

作者信息

Kim Bu Ki, Mun Su Joung, Lee Dae Gyu, Kim Jae Ryun, Kim Hyun Seung, Chung Young Taek

机构信息

*Onnuri Smile Eye Clinic, Hyobong Building, 9F 1, Gangnam-daero 65 gil, Seocho-gu, Seoul, Korea; and †St. Mary's Hospital, Department of Ophthalmology and Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea.

出版信息

Cornea. 2015 Dec;34(12):1582-7. doi: 10.1097/ICO.0000000000000613.

DOI:10.1097/ICO.0000000000000613

PMID:26418429

Abstract

PURPOSE

To explore the clinical effects of combined full-thickness astigmatic keratotomy and small-incision lenticule extraction (SMILE) in patients who are inoperable using SMILE alone.

METHODS

We included 13 eyes of 9 patients with high-level or mixed astigmatism who underwent full-thickness astigmatic keratotomy followed by SMILE (secondarily) to correct the residual refractive error.

RESULTS

Six months after SMILE, the spherical equivalent was reduced from -4.83 ± 3.26 D to -0.17 ± 0.38 D (P < 0.001), and the astigmatism was reduced from 5.12 ± 0.96 D to 0.21 ± 0.22 D (P < 0.001). The uncorrected and corrected (CDVA) distance visual acuities improved from 1.07 ± 0.62 to 0.02 ± 0.13 (P < 0.001) and from 0.08 ± 0.14 to -0.01 ± 0.14 (P = 0.002), respectively. The CDVA improved by 1 or 2 Snellen lines in 8 cases (61.5%), and there was no loss in CDVA. All procedures were completed without intraoperative or postoperative complications.

CONCLUSIONS

This combined procedure was effective and safe for the treatment of high-level or mixed astigmatism.

摘要

目的

探讨全层散光角膜切开术联合小切口基质透镜切除术（SMILE）在单纯SMILE手术不可行的患者中的临床效果。

方法

我们纳入了9例患有高度或混合性散光的患者的13只眼，这些患者先接受了全层散光角膜切开术，随后（二期）接受SMILE手术以矫正残余屈光不正。

结果

SMILE术后6个月，等效球镜度从-4.83±3.26 D降至-0.17±0.38 D（P<0.001），散光从5.12±0.96 D降至0.21±0.22 D（P<0.001）。未矫正和矫正后（最佳矫正视力，CDVA）的远视力分别从1.07±0.62提高至0.02±0.13（P<0.001）和从0.08±0.14提高至-0.01±0.14（P=0.002）。8例（61.5%）患者的CDVA提高了1或2行Snellen视力表，且CDVA没有下降。所有手术均顺利完成，无术中或术后并发症。