Reinstein Dan Z, Pradhan Kishore R, Carp Glenn I, Archer Timothy J, Gobbe Marine, Sekundo Walter, Khan Raynan, Dhungana Purushottam
J Refract Surg. 2017 Jun 1;33(6):370-376. doi: 10.3928/1081597X-20170331-01.
To evaluate optical zone diameter efficacy and spherical aberration change in hyperopic small incision lenticule extraction (SMILE).
Prospective study of 60 consecutive hyperopic SMILE procedures using the VisuMax femtosecond laser (Carl Zeiss Meditec, Jena, Germany) and matched LASIK procedures with the VisuMax and MEL 80 excimer (Carl Zeiss Meditec) lasers. Inclusion criteria were maximum attempted hyperopic meridian of between +1.00 and +7.00 diopters (D). For SMILE, the transition zone was 2 mm and the mean optical programmed zone was 6.37 mm (range: 6.3 to 6.7 mm). Two LASIK control groups (6.5- and 7-mm optical zone) matched for spherical equivalent treated were generated. Both tangential and axial curvature difference maps were generated for each eye at 3 months. A fixed grid and set of concentric circles were superimposed on the difference map to measure the achieved optical zone diameter.
Mean attempted spherical equivalent refraction was +5.58 ± 0.95 D (range: +3.20 to +6.50 D) in the SMILE group. By tangential mapping, SMILE programmed at a mean optical zone of 6.37 mm achieved a diameter of 5.03 ± 0.30 mm, similar to 7-mm LASIK (4.96 ± 0.25 mm, P = 0.33) but larger than 6.5-mm LASIK (4.53 ± 0.25 mm, P < .001). By axial mapping, the achieved optical zone diameter was 6.75 ± 0.31 mm for 6.37-mm SMILE, larger than for both 6.5-mm (6.61 ± 0.21 mm) and 7-mm (6.92 ± 0.14 mm) LASIK (P < .01). Spherical aberration changed on average by -0.45 ± 0.22 μm for 6.37-mm SMILE, similar to 7-mm LASIK (-0.50 ± 0.21 μm, P = .29) and less than for 6.5-mm LASIK (-0.69 ± 0.22 μm, P < .001).
The mean achieved optical zone diameter of hyperopic SMILE was found to be larger than the mean achieved optical zone diameter of hyperopic LASIK. Consequently, spherical aberration induction was similar for 6.37-mm SMILE and 7-mm LASIK. [J Refract Surg. 2017;33(6):370-376.].
评估远视性小切口透镜切除术（SMILE）中光学区直径的有效性及球差变化。
对连续60例使用VisuMax飞秒激光（德国耶拿卡尔蔡司医疗科技公司）进行的远视性SMILE手术以及使用VisuMax和MEL 80准分子激光（德国耶拿卡尔蔡司医疗科技公司）进行的匹配LASIK手术进行前瞻性研究。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。对于SMILE，过渡区为2mm，平均光学编程区为6.37mm（范围：6.3至6.7mm）。生成两个等效球镜度数匹配的LASIK对照组（光学区分别为6.5mm和7mm）。在术后3个月为每只眼睛生成切向和轴向曲率差图。在差图上叠加固定网格和一组同心圆以测量实际获得的光学区直径。
SMILE组平均尝试等效球镜度数为+5.58±0.95D（范围：+3.20至+6.50D）。通过切向映射，平均光学区为6.37mm的SMILE实际获得的直径为5.03±0.30mm，与7mm LASIK（4.96±0.25mm，P = 0.33）相似，但大于6.5mm LASIK（4.53±0.25mm，P <.001）。通过轴向映射，6.37mm SMILE实际获得的光学区直径为6.75±0.31mm，大于6.5mm（6.61±0.21mm）和7mm（6.92±0.14mm）LASIK（P <.01）。6.37mm SMILE的球差平均变化为-0.45±0.22μm，与7mm LASIK（-0.50±0.21μm，P =.29）相似，且小于6.5mm LASIK（-0.69±0.22μm，P <.001）。
远视性SMILE实际获得的平均光学区直径大于远视性LASIK实际获得的平均光学区直径。因此，6.37mm SMILE和7mm LASIK的球差诱导相似。[《屈光手术杂志》。2017；33(6)：370 - 376。]
