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微笑-角膜环切术后眼内散射和Bowman层微畸变的短期观察

Short-term Observation of Intraocular Scattering and Bowman's Layer Microdistortions After SMILE-CCL.

作者信息

Miao Huamao, Liu Xiu, Tian Mi, Zhao Jing, Fang Xuejun, Zhou Xingtao

出版信息

J Refract Surg. 2018 Jun 1;34(6):387-392. doi: 10.3928/1081597X-20180426-02.

Abstract

PURPOSE

To investigate changes in intraocular scattering and Bowman's layer microdistortions after femtosecond laser small incision lenticule extraction using the continuous curvilinear lenticulerhexis technique (SMILE-CCL).

METHODS

In this prospective study, 93 eyes of 93 patients (44 women, 49 men) were treated with SMILE-CCL. Mean age was 26.09 ± 4.39 years and mean spherical equivalent was -6.31 ± 2.16 diopters. The Objective Scatter Index (OSI) was examined with an objective optical quality analysis system. Bowman's layer microdistortions in the central 4-mm optical zone were measured using Fourier-domain optical coherence tomography.

RESULTS

The mean OSI value increased from 0.67 preoperatively to 1.09 at 20 days, and then decreased to 0.84 at 3 months (P < .05). Microdistortions were observed in 62.37% of the eyes at 20 days and 48.39% at 3 months postoperatively (P < .05). The width of the microdistortions per meridian was 283.18 ± 197.19 μm at 20 days; this decreased to 156.00 ± 159.86 μm at 3 months (P < 0.05). Regression analysis models revealed that older age (b = 0.02, P = .03) and higher preoperative spherical equivalent (b = -0.09, P < .05) resulted in higher postoperative OSI values; no significant association was found between postoperative OSI values and microdistortion-related parameters (P > .05). Higher preoperative spherical equivalent (b = -0.28, P = .01) and thinner preoperative corneal thickness (b = -0.02, P = .01) were associated with more microdistortions.

CONCLUSIONS

SMILE induced a temporary increase in OSI values and Bowman's layer microdistortions. The microdistortions did not influence intraocular scattering. [J Refract Surg. 2018;34(6):387-392.].

摘要

目的

研究使用连续曲线晶状体囊膜切开技术(SMILE-CCL)的飞秒激光小切口基质透镜切除术(SMILE)后眼内散射和Bowman层微变形的变化。

方法

在这项前瞻性研究中,对93例患者(44例女性,49例男性)的93只眼进行了SMILE-CCL治疗。平均年龄为26.09±4.39岁,平均等效球镜度为-6.31±2.16屈光度。使用客观光学质量分析系统检查客观散射指数(OSI)。使用傅里叶域光学相干断层扫描测量中央4mm光学区的Bowman层微变形。

结果

平均OSI值从术前的0.67增加到术后20天时的1.09,然后在3个月时降至0.84(P<.05)。术后20天时,62.37%的眼观察到微变形,术后3个月时为48.39%(P<.05)。每条子午线的微变形宽度在术后20天时为283.18±197.19μm;在3个月时降至156.00±159.86μm(P<0.05)。回归分析模型显示,年龄较大(b=0.02,P=.03)和术前等效球镜度较高(b=-0.09,P<.05)导致术后OSI值较高;术后OSI值与微变形相关参数之间未发现显著相关性(P>.05)。术前等效球镜度较高(b=-0.28,P=.01)和术前角膜厚度较薄(b=-0.02,P=.01)与更多的微变形相关。

结论

SMILE导致OSI值和Bowman层微变形暂时增加。微变形不影响眼内散射。[《屈光手术杂志》。2018;34(6):387-392。]

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