Wu Yan, Huang Zhenping
Department of Ophthalmology, Jinling Hospital, No.305 East Zhongshan Road, Nanjing, 210002, Jiangsu Province, People's Republic of China.
BMC Ophthalmol. 2021 Jan 19;21(1):46. doi: 10.1186/s12886-020-01798-y.
The early visual qualities of patients with moderate myopia were evaluated after small incision lenticule extraction (SMILE) using different optical zones.
In this retrospective case study, 27 cases (51 eyes) were selected, including 10 cases in Group A (19 eyes), 6.6-6.8 mm in the optical zone, 10 cases in Group B (19 eyes), 6.4-6.5 mm in the optical zone, and 7 cases in Group C (13 eyes),6.1-6.3 mm in the optical zone. The following items were examined preoperatively and 1 month postoperatively: uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), spherical, cylinder, central corneal thickness (CCT), corneal mean curvature (CMC), total ocular aberrations (TA), total low order aberrations (tLOAs), defocus, astigmatism and total high order aberrations (tHOAs), spherical, coma, trefoil, modulation transfer function (MTF), MTF, SR, objective scatter index (OSI), point scatter function at 50 and 10% (PSF50%, PSF10%), and contrast visual acuity of 100, 20, and 9% (VA100%, VA20%, and VA9%). We compared the three groups by Kruskal-Wallis test. Wilcoxon signed ranks test was used for each group before and 1 month after surgeries. P< 0.05 was considered statistically significant.
There was no significant difference in UCVA, BCVA, CCT, cylinder, and CMC in three groups preoperatively and 1 month postoperatively (P> 0.05). Comparison of the aberrations of the three groups showed statistically significant difference only in TA, tLOA, defocus, astigmatism and SA preoperatively, and trefoil 1 month postoperatively(P< 0.05). The postoperative TA, tLOAs, defocus, astigmatism and trefoil of the three groups were lower than those before surgeries (P< 0.05). The postoperative tHOAs of Group B and C was lower than those before surgeries (P< 0.05). The MTF results showed that before surgeries, there were significant differences in three groups (P< 0.05) in spatial frequencies 515 cycles per degree (cpd), and no differences in 2030 cpd(P> 0.05), while no difference were observed in all spatial frequencies postoperatively (P> 0.05). Comparing the preoperative and postoperative MTF values for each group, the results showed that there was a significant difference in Group C at 5~20 cpd after surgeries(P< 0.05). There was no significant difference in MTF, SR, OSI, PSF50%, PSF10%, VA100%, VA20%, and VA9% in the three groups preoperatively (P> 0.05). One month after surgeries, higher VA9% values were measured for Group C compared to Group A and B (P < 0.05). There was no significant difference in each group before and after surgeries (P> 0.05).
SMILE could improve the visual qualities of patients with moderate myopia. Reducing the surgical optical zone will only affect night vision slightly.
采用不同光学区的小切口透镜切除术（SMILE）后，对中度近视患者的早期视觉质量进行评估。
在这项回顾性病例研究中，选取27例（51只眼），其中A组10例（19只眼），光学区为6.6 - 6.8毫米；B组10例（19只眼），光学区为6.4 - 6.5毫米；C组7例（13只眼），光学区为6.1 - 6.3毫米。术前及术后1个月检查以下项目：裸眼视力（UCVA）、最佳矫正视力（BCVA）、球镜、柱镜、中央角膜厚度（CCT）、角膜平均曲率（CMC）、总眼像差（TA）、总低阶像差（tLOAs）、离焦、散光和总高阶像差（tHOAs）、球差、彗差、三叶草像差、调制传递函数（MTF）、SR、客观散射指数（OSI）、50%和10%处的点扩散函数（PSF50%，PSF10%）以及100%、20%和9%的对比视力（VA100%，VA20%，VA9%）。采用Kruskal - Wallis检验对三组进行比较。每组手术前后采用Wilcoxon符号秩检验。P < 0.05被认为具有统计学意义。
三组术前及术后1个月的UCVA、BCVA、CCT、柱镜和CMC无显著差异（P > 0.05）。三组像差比较显示，术前仅TA、tLOA、离焦、散光和球差有统计学显著差异，术后1个月三叶草像差有统计学显著差异（P < 0.05）。三组术后的TA、tLOAs、离焦、散光和三叶草像差低于手术前（P < 0.05）。B组和C组术后的tHOAs低于手术前（P < 0.05）。MTF结果显示，术前三组在每度5~15周/度（cpd）的空间频率上有显著差异（P <
