Xia Lei, Zhang Jing, Wu Junshu, Yu Keming
a State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center , Sun Yat-sen University , Guangzhou , People's Republic of China.
b Department of Ophthalmology, the East Area of Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital , Chengdu , People's Republic of China.
Curr Eye Res. 2016 Sep;41(9):1202-8. doi: 10.3109/02713683.2015.1107590. Epub 2016 Feb 1.
To assess and compare the dry-eye-associated parameters and corneal biomechanical status after small-incision lenticule extraction (SMILE) and femtosecond laser-assisted in situ keratomileusis (FS-LASIK).
Sixty-five patients' (128 eyes) were collected between November 2012 and April 2013. Thirty-five (69 eyes) underwent SMILE and thirty (59 eyes) underwent FS-LASIK. Visual acuity, manifest refraction, tear break-up time (TBUT), Schirmer's test (ST), corneal sensitivity, Ocular Surface Disease Index (OSDI), corneal hysteresis (CH) and corneal resistance factor (CRF) were evaluated preoperatively and 1 day, 1 week, 1 month, 3 and 6 months postoperatively.
There was no significant difference in visual outcomes of SMILE and FS-LASIK (p = 0.208). TBUT, ST, CH and CRF decreased significantly after surgery in both groups (all p < 0.05); however, the decrease of TBUT, ST and CRF in the SMILE group was not as significant as that in the FS-LASIK group (all p < 0.05) and the change of CH value was comparable in both groups (p = 0.052).Corneal sensitivity was significantly decreased in the FS-LASIK group postoperatively (p < 0.05), but not significantly changed in the SMILE group (p > 0.05). OSDI scores were significantly increased after surgery for the two groups (all p < 0.05), and the scores were much higher in the FS-LASIK group than in the SMILE group (p = 0.000).
The corneal biological healing of SMILE surgery was superior to FS-LASIK in the early period.
评估并比较小切口基质透镜切除术(SMILE)和飞秒激光原位角膜磨镶术(FS-LASIK)后干眼相关参数及角膜生物力学状态。
收集2012年11月至2013年4月期间65例患者(128只眼)。35例(69只眼)接受SMILE手术,30例(59只眼)接受FS-LASIK手术。术前及术后1天、1周、1个月、3个月和6个月评估视力、显验光、泪膜破裂时间(TBUT)、泪液分泌试验(ST)、角膜敏感性、眼表疾病指数(OSDI)、角膜滞后(CH)和角膜阻力因子(CRF)。
SMILE和FS-LASIK的视觉效果无显著差异(p = 0.208)。两组术后TBUT、ST、CH和CRF均显著下降(均p < 0.05);然而,SMILE组TBUT、ST和CRF的下降不如FS-LASIK组显著(均p < 0.05),且两组CH值变化相当(p = 0.052)。FS-LASIK组术后角膜敏感性显著下降(p < 0.05),而SMILE组无显著变化(p > 0.05)。两组术后OSDI评分均显著升高(均p < 0.05),且FS-LASIK组评分远高于SMILE组(p = 0.000)。
SMILE手术早期角膜生物愈合优于FS-LASIK。