Chen Pei, Ye Yiming, Yu Na, Zhang Xiaoying, He Jiexu, Zheng Hua, Wei Han, Zhuang Jing, Yu Keming
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, PR China.
Cornea. 2019 Jun;38(6):723-729. doi: 10.1097/ICO.0000000000001937.
To evaluate the add-on effect of manual cyclotorsion error correction by the cornea-marking method over standard small incision lenticule extraction (SMILE) surgery in astigmatic eyes.
Consecutive patients (84) who had preoperative myopic astigmatism of -0.75 diopters (D) or more and were seeking surgical refractive correction by SMILE surgery during July 2017 to August 2017 were included in this study and randomized to treatment with standard SMILE surgery (S group: 30 eyes) or cyclotorsion compensated SMILE surgery (CC group: 54 eyes). The visual acuity and refractive outcomes were analyzed preoperatively and postoperatively. Refractive astigmatic changes were analyzed by the Alpins method.
The S and CC groups were comparable preoperatively regarding age, manifest spherical equivalent, and manifest refractive cylinder. The mean position-related cyclotorsion degree in the enrolled astigmatic eyes for the S and CC groups was 1.7 ± 2.2 degrees (ranging from 0 to 10 degrees) and 2.19 ± 1.74 degrees (ranging from 0 to 10 degrees), respectively. The mean cylinder was -1.67 ± 0.54 D versus -1.72 ± 0.71 D preoperatively. Six months after treatment, the surgical outcomes in the CC group were significantly better than those of the S group, with a postoperative corrected distance visual acuity of -0.07 ± 0.07 versus 0.016 ± 0.13. A vector analysis of astigmatism also yielded better outcomes in the CC group. However, these 2 groups were statistically similar in spherical equivalent.
SMILE surgery combined with cyclotorsion error compensation yielded a significant improvement in surgical outcomes regarding safety, efficiency, and predictability for patients with astigmatism.
评估角膜标记法手动矫正旋转性扭转误差对散光眼标准小切口透镜切除术（SMILE）手术的附加效果。
纳入2017年7月至2017年8月期间连续的84例术前近视散光-0.75屈光度（D）或更高且寻求通过SMILE手术进行手术屈光矫正的患者，随机分为标准SMILE手术治疗组（S组：30只眼）或旋转性扭转补偿SMILE手术组（CC组：54只眼）。术前和术后分析视力和屈光结果。采用阿尔平斯方法分析屈光性散光变化。
S组和CC组术前在年龄、明显球镜等效度和明显屈光柱镜方面具有可比性。S组和CC组纳入的散光眼中，平均位置相关旋转性扭转度数分别为1.7±2.2度（范围为0至10度）和2.19±1.74度（范围为0至10度）。术前平均柱镜分别为-1.67±0.54 D和-1.72±0.71 D。治疗6个月后，CC组的手术效果明显优于S组，术后矫正远视力为-0.07±0.07，而S组为0.016±0.13。散光的矢量分析在CC组也产生了更好的结果。然而，这两组在球镜等效度方面在统计学上相似。
对于散光患者，SMILE手术联合旋转性扭转误差补偿在手术安全性、效率和可预测性方面产生了显著改善。
