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[飞秒激光辅助准分子原位角膜磨镶术、波前引导飞秒激光原位角膜磨镶术和小切口基质透镜切除术治疗近视及散光后1年视觉质量的比较]

[Comparison of the visual quality at 1 year following femtosecond laser-assisted LASIK, wavefront-guided femtosecond LASIK and small incision lenticule extraction for myopia and astigmatism].

作者信息

Zheng Y, Zhou Y H, Zhang J, Zhang L, Zhai C B, Hu Y B, Liu J, Wang Y

机构信息

Ophthalmic Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Lab., Beijing, China 100730.

Ophthalmic Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Lab., Beijing, China 100730 (Zhou Yuehua is now working at Beijing Ming Vision and Ophthalmology, The Academy of Ophthalmology, Chengdu University of TCM, Beijing 100060, China).

出版信息

Zhonghua Yan Ke Za Zhi. 2020 Feb 11;56(2):118-125. doi: 10.3760/cma.j.issn.0412-4081.2020.02.007.

DOI:10.3760/cma.j.issn.0412-4081.2020.02.007
PMID:32074822
Abstract

To investigate mesopic contrast sensitivity (CS) and high-order aberrations after femtosecond laser-assisted LASIK (FS-LASIK), wavefront-guided femtosecond LASIK (WF-LASIK) and small incision lenticule extraction (SMILE) for myopia and astigmatism. In this case-control study, 212 eyes of 108 patients with myopia and astigmatism from September 2014 to September 2016 were treated by refractive surgery. There were 34 males (66 eyes) and 74 females (146 = eyes), aged 27 (24, 32) years. They were divided into 3 groups, with 37 patients (71 eyes), 35 patients (69 eyes) and 36 patients (72 eyes) treated by FS-LASIK, WF-LASIK and SMILE, respectively. Refraction diopters, corneal tomography, wavefront aberrations and contrast sensitivity were evaluated before and at 12 months after surgery. The results of different groups were compared by rank sum test. At 12 = months of follow-up, 69 eyes (97.18%) treated by FS-LASIK, 67 eyes (97.10%) by WF-LASIK and 69 eyes (95.83%) by SMILE had the uncorrected distance visual acuity of 20/20 or better. Fifty-nine eyes (83.10%) treated by FS-LASIK, 60 eyes (86.96%) by WF-LASIK and 61 eyes (84.72%) by SMILE had better postoperative uncorrected distance visual acuity than preoperative corrected distance visual acuity. Surface regularity index of the WF-LASIK group decreased from 0.11 (0.07, 0.28) to 0.07 (0.06, 0.20) (-2.662, 0.008), which was less than that of the FS-LASIK and SMILE groups (-3.236, -3.118, 0.001, 0.000). Surface asymmetry index of the WF-LASIK group increased from 0.34 (0.25, 0.43) to 0.38 (0.30, 0.52) (-2.140, 0.032), which was less than that of the FS-LASIK and SMILE groups (-2.910, -3.779, 0.004, 0.000). The root mean square of high-order of the FS-LASIK group increased from 0.32 (0.27, 0.41) to 0.53 (0.40, 0.65) (-6.228, 0.000), which was more than that of the WF-LASIK and SMILE groups (-3.595, -4.806, 0.000, 0.000). Coma of the WF-LASIK group increased from 0.16 (0.11, 0.24) to 0.26 (0.15, 0.37) (-3.816, 0.000), which was less than that of the FS-LASIK group (-3.528, 0.000). Spherical aberration of the FS-LASIK and WF-LASIK groups increased from 0.10 (0.05, 0.21) and 0.08 (0.04, 0.12) to 0.24 (0.13, 0.34) and 0.15 (0.09, 0.26), respectively (-5.141, -4.864, 0.000, 0.000), which were more than that of the SMILE group (-2.549, -4.682, 0.011, 0.000). CS of the WF-LASIK group at 12 cycles per degree (c/d) increased from 1.34 (1.18, 1.48) to 1.48 (1.34, 1.63) (-2.985, 0.003), which was more than that of the FS-LASIK and SMILE groups (-3.194, -2.977, 0.001, 0.003). CS with glare of the WF-LASIK group at 12.0 c/d increased from 1.26 (1.18, 1.34) to 1.34 (1.34, 1.63) (-3.608, 0.000), which was more than that of the FS-LASIK and SMILE groups (-4.033, -2.913, 0.000, 0.004). FS-LASIK, WF-LASIK and SMILE achieved ideal visual outcomes at 12 months postoperatively. WF-LASIK treated eyes showed the best corneal symmetry, the least increase of high-order aberrations and the best visual quality among three kinds of surgeries. .

摘要

为研究飞秒激光制瓣准分子原位角膜磨镶术(FS-LASIK)、波前引导飞秒激光制瓣准分子原位角膜磨镶术(WF-LASIK)和小切口基质透镜切除术(SMILE)治疗近视及散光后的中视对比敏感度(CS)和高阶像差。在这项病例对照研究中,2014年9月至2016年9月期间,108例近视及散光患者的212只眼接受了屈光手术。其中男性34例(66只眼),女性74例(146只眼),年龄27(24,32)岁。他们被分为3组,分别有37例患者(71只眼)、35例患者(69只眼)和36例患者(72只眼)接受FS-LASIK、WF-LASIK和SMILE治疗。在手术前及术后12个月评估屈光度数、角膜地形图、波前像差和对比敏感度。采用秩和检验比较不同组的结果。随访12个月时,FS-LASIK治疗的69只眼(97.18%)、WF-LASIK治疗的67只眼(97.10%)和SMILE治疗的69只眼(95.83%)的裸眼远视力达到20/20或更好。FS-LASIK治疗的59只眼(83.10%)、WF-LASIK治疗的60只眼(86.96%)和SMILE治疗的61只眼(84.72%)术后裸眼远视力优于术前矫正远视力。WF-LASIK组的表面规则性指数从0.11(0.07,0.28)降至0.07(0.06,0.20)(-2.662,0.008),低于FS-LASIK组和SMILE组(-3.236,-3.118,0.001,0.000)。WF-LASIK组的表面非对称性指数从0.34(0.25,0.43)增至0.38(0.30,0.52)(-2.140,0.032),低于FS-LASIK组和SMILE组(-2.910,-3.7

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