From the Department of Ophthalmology, The Eye and ENT Hospital of Fudan University China (Han, Shang, Xueyi Zhou, Xu, Xingtao Zhou), Shanghai, NHC Key Laboratory of Myopia, Fudan University, Chinese Academy of Medical Sciences (Han, Shang, Xueyi Zhou, Xu, Xingtao Zhou), Beijing, Research Center of Ophthalmology and Optometry (Han, Xu, Xingtao Zhou), Shanghai, China; Cornea and Refractive Service, Singapore National Eye Centre (Ang); and Ophthalmology and Visual Sciences, DUKE-National University of Singapore (Ang), Singapore.
J Cataract Refract Surg. 2020 Mar;46(3):419-427. doi: 10.1097/j.jcrs.0000000000000075.
To compare the long-term refractive effects of small-incision lenticule extraction (SMILE) and femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) on the correction of high myopia and astigmatism.
The Eye and ENT Hospital of Fudan University, Shanghai, China.
Retrospective case series.
Patients had SMILE or FS-LASIK for high myopia. Subgroup analyses of high myopia (-6.00 to -8.75 diopters [D]) and extremely high myopia (≥-9.00 D) were performed. The main outcome measure was refractive predictability, compared between SMILE and FS-LASIK groups. Secondary outcomes included efficacy, safety, and residual astigmatism.
This study included 121 patients (121 eyes: 75 in the SMILE group and 46 in the FS-LASIK group). No differences were found in terms of refractive predictability between SMILE and FS-LASIK in eyes with high myopia: 56% vs 58.7% achieved ± 0.50 D of attempted correction (P = .771) and 81.3% vs 76.1% achieved ± 1.00 D of attempted correction (P = .489). Efficacy indices of the SMILE and FS-LASIK groups were 1.02 ± 0.24 and 1.03 ± 0.24 (P = .742), respectively; safety indices were 1.23 ± 0.22 and 1.20 ± 0.24 (P = .324), respectively. Logarithm of the minimum angle of resolution uncorrected distance visual acuity and spherical equivalent in the high myopia subgroup were better than in the extremely high myopia subgroup after both SMILE and FS-LASIK (P < .01).
SMILE and FS-LASIK were both effective in correcting high myopia and myopic astigmatism. However, both techniques may require further nomogram adjustments when treating eyes with extremely high myopia.
比较小切口微透镜切除术（SMILE）和飞秒激光辅助准分子激光原位角膜磨镶术（FS-LASIK）治疗高度近视和散光的长期屈光效果。
中国上海复旦大学眼耳鼻喉科医院。
回顾性病例系列。
患者接受高度近视 SMILE 或 FS-LASIK 手术。对高度近视（-6.00 至-8.75 屈光度 [D]）和超高度近视（≥-9.00 D）进行亚组分析。主要观察指标为 SMILE 组和 FS-LASIK 组之间的屈光预测值。次要观察指标包括疗效、安全性和残余散光。
本研究共纳入 121 例患者（121 只眼：SMILE 组 75 只眼，FS-LASIK 组 46 只眼）。在高度近视患者中，SMILE 和 FS-LASIK 的屈光预测值无差异：56%的患者达到了±0.50 D 的目标矫正值，而 58.7%的患者达到了±1.00 D 的目标矫正值（P =.771）；81.3%的患者达到了±0.50 D 的目标矫正值，而 76.1%的患者达到了±1.00 D 的目标矫正值（P =.489）。SMILE 和 FS-LASIK 组的疗效指数分别为 1.02 ± 0.24 和 1.03 ± 0.24（P =.742），安全性指数分别为 1.23 ± 0.22 和 1.20 ± 0.24（P =.324）。SMILE 和 FS-LASIK 术后，高度近视亚组的最小分辨角对数视力和等效球镜的 logMAR 未矫正距离视力优于超高度近视亚组（P <.01）。
SMILE 和 FS-LASIK 均能有效治疗高度近视和近视散光，但治疗超高度近视时，两种技术可能需要进一步调整列线图。
