He Miao, Huang Wenyong, Zhong Xingwu
Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, 54SXianlie Road, Guangzhou, 510060, China.
Hainan Eye Hospital, Zhongshan Ophthalmic Center, Sun Yat-sen University, Haikou, 570311, China.
BMC Ophthalmol. 2015 Oct 24;15:141. doi: 10.1186/s12886-015-0129-5.
The aim of this study was to evaluate central corneal sensitivity after small incision lenticule extraction (SMILE) versus femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) for myopia.
Eligible studies were identified by systematically searching PubMed, the Cochrane Library, Embase and the Chinese Biomedicine Database. Central corneal sensitivity after SMILE versus FS-LASIK was assessed by the pooled weighted mean differences (WMDs) of the reduction from pre-operation levels to 1 week, 1, 3 and 6 months following the operation. The quality of the included literature was assessed by the Quality Index. Data were synthesized by Stata 12.0 SE for Windows.
Five studies involving 245 patients (363 eyes; 189 eyes in the FS-LASIK group and 174 eyes in the SMILE group) were included in the meta-analysis. The pooled results showed that there were no significant differences in central corneal sensitivity between FS-LASIK and SMILE before surgery (WMD = 0 mm, 95 % CI: -0.23 to -0.23, p = 0.998). At 1 week, 1 and 3 months after surgery, the central corneal sensitivity after FS-LASIK was lower than with SMILE (WMD = -17.35 mm, 95 % CI: -26.54 to -8.16, p <0.001; WMD = -17.52 mm, 95 % CI: -25.10 to -9.94, p <0.001; WMD = -14.64 mm, 95 % CI: -20.08 to -9.21, p <0.001, respectively). However, central corneal sensitivity after FS-LASIK was similar with SMILE 6 months after surgery (WMD = -2.02 mm, 95 % CI: -4.23 to 0.19, p = 0.074).
Central corneal sensitivity exhibited a small decrease and a faster recovery after the SMILE procedure compared to FS-LASIK during the first three postoperative months. Corneal sensitivity after SMILE and FS-LASIK was similar at 6 months after surgery. However, these results should be interpreted with caution due to the limited number of studies.
本研究旨在评估飞秒激光小切口基质透镜切除术（SMILE）与飞秒激光制瓣准分子原位角膜磨镶术（FS-LASIK）治疗近视后中央角膜敏感性。
通过系统检索PubMed、Cochrane图书馆、Embase和中国生物医学数据库来确定符合条件的研究。通过手术前水平至术后1周、1、3和6个月降低程度的合并加权平均差（WMD）来评估SMILE与FS-LASIK术后的中央角膜敏感性。采用质量指数评估纳入文献的质量。使用Windows版Stata 12.0 SE对数据进行综合分析。
五项研究共纳入245例患者（363只眼；FS-LASIK组189只眼，SMILE组174只眼）进行荟萃分析。汇总结果显示，术前FS-LASIK与SMILE的中央角膜敏感性无显著差异（WMD = 0 mm，95%CI：-0.23至-0.23，p = 0.998）。术后1周、1个月和3个月，FS-LASIK术后的中央角膜敏感性低于SMILE（WMD = -17.35 mm，95%CI：-26.54至-8.16，p <0.001；WMD = -17.52 mm，95%CI：-25.10至-9.94，p <0.001；WMD = -14.64 mm，95%CI：-20.08至-9.21，p <0.001）。然而，FS-LASIK术后6个月的中央角膜敏感性与SMILE相似（WMD = -2.02 mm，95%CI：-4.23至0.19，p = 0.074）。
与FS-LASIK相比，术后前三个月SMILE手术中央角膜敏感性下降较小且恢复较快。SMILE和FS-LASIK术后6个月角膜敏感性相似。然而，由于研究数量有限，这些结果应谨慎解读。
