Reinstein Dan Z, Pradhan Kishore R, Carp Glenn I, Archer Timothy J, Gobbe Marine, Sekundo Walter, Khan Raynan, Citron Kim, Dhungana Purushottam
J Refract Surg. 2017 Mar 1;33(3):150-156. doi: 10.3928/1081597X-20161220-01.
To evaluate optical zone centration of hyperopic small incision lenticule extraction (SMILE).
This prospective study of 60 consecutive hyperopic SMILE procedures used the VisuMax femtosecond laser and matched LASIK procedures with the VisuMax and MEL 80 excimer lasers (Carl Zeiss Meditec AG, Jena, Germany). Inclusion criteria were maximum attempted hyperopic meridian of between +1.00 and +7.00 diopters (D) and astigmatism up to 6.00 D. For SMILE, the optical zone was between 6.3 and 6.7 mm, with a 2-mm transition zone. Two LASIK control groups (6.5- and 7-mm optical zone) were generated matched for spherical equivalent treated. In SMILE, the corneal vertex of the coaxially fixating eye was aligned with the vertex of the curved contact glass. In LASIK, the treatment was centered on the coaxially sighted corneal light reflex (first Purkinje image) with the contralateral eye (Seiler method). A tangential (instantaneous) curvature preoperative to 3 months postoperative difference map was generated for each eye. A fixed grid and set of concentric circles were superimposed on the difference map to measure the offset between the optical zone center and corneal vertex (0,0), and vector analysis was used for comparative analysis.
Mean attempted spherical equivalent was +5.61 ± 0.96 D (range: +3.20 to +6.50 D) and mean cylinder was -0.96 ± 0.62 D (range: 0.00 to -2.75 D) in the SMILE group. Mean age was 29 ± 7 years (range: 19 to 52 years) in the SMILE group. Mean centration offset was 0.23 ± 0.15 mm (range: 0 to 0.61 mm) for the SMILE group, 0.33 ± 0.14 mm (range: 0.14 to 0.85 mm) for the 6.5-mm LASIK group, and 0.31 ± 0.19 mm (range: 0.05 to 0.85 mm) for the 7-mm LASIK group. The mean centration offset for SMILE was less than that of both LASIK groups (P < .05).
Optical zone centration of hyperopic SMILE was found to be similar to eye-tracker-centered hyperopic LASIK with the MEL 80 laser. [J Refract Surg. 2017;33(3):150-156.].
评估远视性小切口透镜切除术（SMILE）的光学区对中情况。
这项前瞻性研究连续纳入60例远视性SMILE手术，使用VisuMax飞秒激光，并将其与使用VisuMax和MEL 80准分子激光（德国耶拿卡尔蔡司医疗技术公司）的LASIK手术进行匹配。纳入标准为最大尝试远视子午线在+1.00至+7.00屈光度（D）之间，散光达6.00 D。对于SMILE，光学区在6.3至6.7 mm之间，有一个2 mm的过渡区。生成两个LASIK对照组（光学区分别为6.5 mm和7 mm），使其与治疗的等效球镜度相匹配。在SMILE中，同轴注视眼的角膜顶点与弯曲接触镜的顶点对齐。在LASIK中，治疗以对侧眼同轴注视的角膜光反射（第一普尔钦耶像）为中心（塞勒法）。为每只眼睛生成术前至术后3个月的切向（瞬时）曲率差异图。在差异图上叠加一个固定网格和一组同心圆，以测量光学区中心与角膜顶点（0,0）之间的偏移，并使用矢量分析进行比较分析。
SMILE组平均尝试等效球镜度为+5.61±0.96 D（范围：+3.20至+6.50 D），平均柱镜度为-0.96±0.62 D（范围：0.00至-2.75 D）。SMILE组平均年龄为29±7岁（范围：19至52岁）。SMILE组平均对中偏移为0.23±0.15 mm（范围：0至0.61 mm），6.5 mm LASIK组为0.33±0.14 mm（范围：0.14至0.85 mm），7 mm LASIK组为0.31±0.19 mm（范围：0.05至0.85 mm）。SMILE的平均对中偏移小于两个LASIK组（P <.05）。
发现远视性SMILE的光学区对中情况与使用MEL 80激光且以眼动仪为中心的远视性LASIK相似。[《屈光手术杂志》。2017；33(3):150 - 156。]
