Wu Wenjing, Wang Yan, Zhang Hui, Zhang Jiamei, Li Hua, Dou Rui
Tianjin Ophthalmology and Visual Science Key Laboratory, Tianjin Eye Hospital & Eye Institute, Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China.
BMJ Open. 2016 Sep 21;6(9):e010993. doi: 10.1136/bmjopen-2015-010993.
To determine whether the long-term visual outcome of small incision lenticule extraction (SMILE) surgery is consistent with the short-term results in high myopic eyes.
Retrospective cohort study; data collected from 8 August 2011 to 31 August 2015.
Single refractive surgery centre.
A total of 156 eyes were studied: 65 eyes of 39 subjects (22 female/17 male) in the high myopic group (manifest refraction spherical equivalent (MRSE) ≥-6.0 D), and 91 eyes of 54 subjects (29 female/25 male) in the control group (MRSE <-6.0 D). The inclusion criteria were subjects who had follow-ups after 1 day, 1 week, 1 month, 3, 6 months and 1 year with the manifest refraction, uncorrected and corrected distance visual acuity (UDVA/CDVA). There were no statistically significant differences between the two groups in the subjects' gender, age, or cylindrical dioptre, preoperatively (p=0.835, p=0.055, p=0.341, respectively).
UDVA, refractive stability, safety index (postoperative CDVA/preoperative CDVA), and predictability (the percentage of eyes within ±0.50 D).
In both groups, the 1-year UDVA and safety index were significantly better than results at 1 day (high myopic group: p=0.035, p<0.001; control group: p<0.016, p<0.001); the 1-year predictability showed no significant difference with the short-term results (p=1.00 in both groups). In the high myopic eyes, the 1-year MRSE was significantly worse than the short-term result (p=0.048). To correct it, the added magnitude (D) for the high myopic eyes may equal 0.13×Attempted SE (D)-0.66 D. However, the postoperative MRSE showed no differences from 1 day to 1 year (p=0.612) in the control group.
The 1-year visual outcomes were better than the short-term results after the SMILE surgery on the visual acuity and safety. However, the high myopic eyes suffered a significant regression at 1 year, which may be corrected by adding additional magnitude to the SE for high myopic eyes.
确定小切口透镜切除术（SMILE）治疗高度近视的长期视觉效果是否与短期结果一致。
回顾性队列研究；数据收集时间为2011年8月8日至2015年8月31日。
单一屈光手术中心。
共研究156只眼：高度近视组（明显屈光球镜等效度（MRSE）≥-6.0 D）39例受试者的65只眼（22例女性/17例男性），对照组（MRSE＜-6.0 D）54例受试者的91只眼（29例女性/25例男性）。纳入标准为术后1天、1周、1个月、3个月、6个月和1年进行明显屈光、未矫正和矫正远视力（UDVA/CDVA）随访的受试者。两组受试者术前的性别、年龄或柱镜度数差异均无统计学意义（分别为p=0.835、p=0.055、p=0.341）。
UDVA、屈光稳定性、安全指数（术后CDVA/术前CDVA）和可预测性（±0.50 D范围内的眼数百分比）。
两组1年时的UDVA和安全指数均显著优于术后1天（高度近视组：p=0.035，p<0.001；对照组：p<0.016，p<0.001）；1年时的可预测性与短期结果无显著差异（两组p均=1.00）。高度近视眼中，1年时的MRSE显著差于短期结果（p=0.048）。为矫正此情况，高度近视眼的增加量（D）可能等于0.13×预期SE（D）-0.66 D。然而，对照组术后1天至1年的MRSE无差异（p=0.612）。
SMILE手术后1年的视力和安全性视觉效果优于短期结果。然而，高度近视眼在1年时出现显著回退，可通过增加高度近视眼的SE量来矫正。
