Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China.
Tianjin Eye Hospital, Tianjin Eye Institute, Tianjin Key Laboratory of Ophthalmology and Visual Science, Nankai University, Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China.
Cornea. 2020 May;39(5):609-614. doi: 10.1097/ICO.0000000000002274.
To compare higher-order aberrations (HOAs) after small incision lenticule extraction (SMILE) in patients with and without intraoperative angle kappa adjustments.
This is a retrospective case series. One hundred six eyes of 106 patients who underwent SMILE at Tianjin Eye Hospital (Tianjin Medical University, Tianjin, China) for correction of myopia and myopic astigmatism were divided into 2 groups. The first group consisted of eyes with intraoperative angle kappa adjustment and the second group consisted of eyes without adjustment. Preoperative and postoperative visual outcome, refraction, and HOA measurements at 1 and 3 months were compared.
At the pupil size of 6 mm, vertical coma at 1 and 3 months after SMILE for the angle kappa-adjusted group was 0.153 ± 0.107 and 0.157 ± 0.094 μm, which were significantly lower than those of the nonadjusted group (0.204 ± 0.117 and 0.203 ± 0.113 μm, respectively) (P = 0.026 at 1 mo, P = 0.047 at 3 mo). The change in vertical coma between preoperative and postoperative measurements was 0.011 ± 0.136 and 0.023 ± 0.129 μm at 1 and 3 months postoperatively for the angle kappa-adjusted group, which were lower than those of the nonadjusted group (0.082 ± 0.165 and 0.085 ± 0.150 μm, respectively) (P = 0.023 at 1 mo, P = 0.045 at 3 mo). Subgroup analysis for eyes with large angle kappa demonstrated that the vertical coma was significantly less in the angle kappa-adjusted group at both 1 and 3 months (P = 0.009, P = 0.043, respectively). No significant correlation was observed between angle kappa and HOAs in the angle kappa-adjusted group.
Adjustment of angle kappa during SMILE resulted in less HOAs. It would provide more insight on how to optimize treatment centration in SMILE.
比较小切口透镜切除术（SMILE）中进行和不进行术中角度kappa 调整的患者的高阶像差（HOAs）。
这是一项回顾性病例系列研究。106 名近视和近视散光患者的 106 只眼在天津医科大学天津眼科医院接受了 SMILE 手术，将其分为两组。第一组为术中进行角度kappa 调整的眼，第二组为未调整的眼。比较术前和术后 1 个月和 3 个月的视力结果、屈光度和 HOA 测量值。
在瞳孔直径为 6mm 时，进行角度 kappa 调整的 SMILE 术后 1 个月和 3 个月的垂直彗差分别为 0.153±0.107μm 和 0.157±0.094μm，显著低于未调整组的 0.204±0.117μm 和 0.203±0.113μm（P=0.026，1 个月时；P=0.047，3 个月时）。进行角度 kappa 调整的组术后 1 个月和 3 个月的垂直彗差变化分别为 0.011±0.136μm 和 0.023±0.129μm，低于未调整组的 0.082±0.165μm 和 0.085±0.150μm（P=0.023，1 个月时；P=0.045，3 个月时）。对于大角度 kappa 的眼进行亚组分析，发现调整角度 kappa 后，两组在 1 个月和 3 个月时的垂直彗差均显著减少（P=0.009，P=0.043）。在进行角度 kappa 调整的组中，角度 kappa 与 HOAs 之间没有观察到显著相关性。
在 SMILE 中调整角度 kappa 可导致较少的 HOAs。这将为如何优化 SMILE 中的治疗中心定位提供更多的见解。
