Yu Manrong, Chen Minjie, Liu Wangyuan, Dai Jinhui
Department of Ophthalmology, Eye and ENT Hospital, Fudan University, No. 83 Fenyang Road, Shanghai, 200031, China.
NHC Key Laboratory of Myopia (Fudan University) and Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.
BMC Ophthalmol. 2019 Mar 20;19(1):80. doi: 10.1186/s12886-019-1084-3.
The study compares the wave-front aberration and corneal asphericity from multiple perspectives after Small Incision Lenticule Extraction and Laser-assisted Subepithelial Keratomileusis for mild to moderate myopia in a short and long time period.
This prospective and comparative study included 32 eyes in the SMILE group, with a mean spherical equivalent (SE) of - 4.1 ± 0.9D and 32 eyes in the LASEK group, with a mean SE of - 3.7 ± 1.0D. Visual acuity, refractive error, wave-front aberration, corneal Q value and corneal refractive power were analyzed pre-, 3 months and 3 years post-operatively.
There was no significant difference in refractive error, wave-front aberration, corneal Q value and corneal refractive power before treatment. Three months postoperative, Q value within 6 mm (SMILE: 0.46 ± 0.27, LASEK: 0.63 ± 0.28, p = 0.02), the relative peripheral corneal power (5-8 mm: p < 0.05), change of higher order aberration (SMILE: 0.10 ± 0.16, LASEK: 0.24 ± 0.20, p = 0.004) and spherical aberration (SA, SMILE: -0.07 ± 0.30, LASEK: -0.41 ± 0.40, p < 0.001) were significantly lower in the SMILE than in LASEK group. The visual acuity, refractive error, coma, peripheral Q value, central corneal power had no significant difference between the two groups. Three years post-operation, the corneal power distribution results and SA were similar to that of 3-month, while the Q value had no significant difference between the two groups.
In the early stage after SMILE, the HOAs was lower, the corneal refractive power from central to periphery was more uniform than after LASEK; and in the long-term run, SMILE still preceded LASEK in the corneal asphericity and aberration.
本研究从多个角度比较了小切口透镜切除术(Small Incision Lenticule Extraction,SMILE)和准分子激光上皮下角膜磨镶术(Laser-assisted Subepithelial Keratomileusis,LASEK)治疗轻中度近视术后短期和长期的波前像差及角膜非球面性。
本前瞻性对照研究纳入了SMILE组32眼,等效球镜度(SE)均值为-4.1±0.9D;LASEK组32眼,SE均值为-3.7±1.0D。分析术前、术后3个月和3年的视力、屈光不正、波前像差、角膜Q值及角膜屈光力。
治疗前两组的屈光不正、波前像差、角膜Q值及角膜屈光力无显著差异。术后3个月,SMILE组6mm范围内的Q值(SMILE:0.46±0.27,LASEK:0.63±0.28,p=0.02)、相对周边角膜屈光力(5-8mm:p<0.05)、高阶像差变化(SMILE:0.10±0.16,LASEK:0.24±0.20,p=0.004)及球差(SA,SMILE:-0.07±0.30,LASEK:-0.41±0.40,p<0.001)均显著低于LASEK组。两组的视力、屈光不正、彗差、周边Q值、中央角膜屈光力无显著差异。术后3年,角膜屈光力分布结果及SA与术后3个月相似,而两组的Q值无显著差异。
SMILE术后早期,高阶像差较低,角膜中央到周边的屈光力比LASEK术后更均匀;长期来看,SMILE在角膜非球面性和像差方面仍优于LASEK。