Zhu Xiaoyu, Zou Leilei, Yu Manrong, Qiu Chen, Chen Minjie, Dai Jinhui
Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, People's Republic of China.
Key Laboratory of Myopia, Ministry of Health, Shanghai, People's Republic of China.
PLoS One. 2017 Aug 3;12(8):e0182251. doi: 10.1371/journal.pone.0182251. eCollection 2017.
To compare the 1-year outcome of visual quality after laser-assisted subepithelial keratomileusis (LASEK) and femtosecond laser-assisted small incision lenticule extraction (SMILE) for high myopia correction.
This prospective, comparative study included 24 eyes of 24 patients in the LASEK group, with a mean spherical equivalent (SE) of -7.59 ± 1.32 diopters, and 26 eyes of 26 patients in the SMILE group, with a mean SE of -7.91 ± 1.08 diopters. Visual acuity, corneal topography, contrast sensitivity (CS), and wavefront aberrations were recorded preoperatively and compared with postoperative measurements. Objective scatter index (OSI) and modulation transfer function (MTF) cut-off frequency were measured 1 year postoperatively.
One year postoperatively, the two groups demonstrated no significant difference in the CS at all spatial frequencies. The increments of higher-order aberrations (HOAs) (HOA = 0.583 ± 0.210 μm), including spherical aberration (SA) (SA = 0.546 ± 0.249 μm), were higher (P < 0.05) in the LASEK group than those in the SMILE group (HOA = 0.451 ± 0.143 μm; SA = 0.450 ± 0.340 μm) after surgery. There were no significant differences in the increments of coma and trefoil aberrations between the two groups. The OSI and MTF cut-off frequency exhibited no significant differences between the two groups postoperatively. No vision-threatening complications were noted at any stage in either group.
Both LASEK and SMILE are safe and effective surgical options for the correction of high myopia. SMILE has a lower HOAs and SA induction rate 1 year postoperatively.
比较准分子激光上皮下角膜磨镶术（LASEK）和飞秒激光小切口基质透镜切除术（SMILE）矫正高度近视后1年的视觉质量结果。
这项前瞻性比较研究纳入了LASEK组的24例患者的24只眼，平均等效球镜度（SE）为-7.59±1.32屈光度，以及SMILE组的26例患者的26只眼，平均SE为-7.91±1.08屈光度。术前记录视力、角膜地形图、对比敏感度（CS）和波前像差，并与术后测量值进行比较。术后1年测量客观散射指数（OSI）和调制传递函数（MTF）截止频率。
术后1年，两组在所有空间频率的CS方面均无显著差异。LASEK组术后高阶像差（HOA）（HOA = 0.583±0.210μm）的增加，包括球差（SA）（SA = 0.546±0.249μm），高于SMILE组（HOA = 0.451±0.143μm；SA = 0.450±0.340μm）（P < 0.05）。两组之间彗差和三叶草像差的增加无显著差异。术后两组的OSI和MTF截止频率无显著差异。两组在任何阶段均未发现威胁视力的并发症。
LASEK和SMILE都是矫正高度近视的安全有效的手术选择。SMILE术后1年的高阶像差和球差诱导率较低。
