From the Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China; Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China.
J Cataract Refract Surg. 2021 Nov 1;47(11):1398-1402. doi: 10.1097/j.jcrs.0000000000000639.
To investigate the long-term changes in posterior corneal elevation in moderate and high myopia after small-incision lenticule extraction (SMILE).
Eye & ENT Hospital, Fudan University, Shanghai, China.
Prospective case series.
33 eyes of 20 patients (30.1 ± 9.5 years, 7 men and 13 women, spherical equivalent [SE] range -4.00 to -8.75 D, mean SE -6.25 ± 1.29 D) who underwent SMILE were included. Changes in the posterior corneal elevation at central points (PCE), the thinnest point (PTE), the maximal point (PME), and an additional 20 points within the 4 mm area of the best-fit sphere were evaluated with a Pentacam (Oculus Optikgeräte GmbH) during a 7-year follow-up period. Mixed linear models were used to evaluate changes with P values less than 0.05. Correlations of elevation changes and residual bed thickness (RBT) were also evaluated.
No ectasia was observed among the 33 eyes studied. The safety index was 1.08, and the efficacy index was 1.03. The mean change in PCE at 1 year, 3 years, 5 years, and 7 years was -1.42 ± 0.95 μm, -2.67 ± 0.98 μm, -2.44 ± 1.06 μm, and -1.91 ± 0.92 μm, respectively. Statistically significant differences were found at 3 years, 5 years, and 7 years (P = .007, .023, and .040, respectively). PTE reduced significantly at each time point compared with baseline. The mean change was -2.82 ± 1.19 μm, -3.55 ± 1.22 μm, -3.47 ± 1.32 μm, and -2.39 ± 1.15 μm, respectively (P = .019, .004, .010, and .039, respectively). PME changed in 2.45 ± 1.02 μm at 7 years compared with baseline (P = .017). The changes in PCE and PME negatively correlated with the RBT.
Long-term posterior corneal elevation was stable in moderate and high myopia after SMILE.
研究小切口角膜基质透镜取出术（SMILE）后中高度近视患者的后角膜高度的长期变化。
复旦大学眼耳鼻喉科医院，上海，中国。
前瞻性病例系列。
纳入 20 名患者（30.1±9.5 岁，7 名男性，13 名女性，球镜等效值范围-4.00 至-8.75 D，平均球镜等效值-6.25±1.29 D）的 33 只眼。在 7 年的随访期间，使用 Pentacam（Oculus Optikgeräte GmbH）评估中央点（PCE）、最薄点（PTE）、最大点（PME）和最佳拟合球内另外 20 个点的后角膜高度变化。使用混合线性模型评估 P 值小于 0.05 的变化。还评估了高度变化与残余床厚度（RBT）的相关性。
在研究的 33 只眼中，没有观察到扩张。安全指数为 1.08，疗效指数为 1.03。PCE 在 1 年、3 年、5 年和 7 年的平均变化分别为-1.42±0.95μm、-2.67±0.98μm、-2.44±1.06μm 和-1.91±0.92μm。在 3 年、5 年和 7 年时差异有统计学意义（P=0.007、0.023 和 0.040）。与基线相比，PTE 在每个时间点均显著降低。平均变化分别为-2.82±1.19μm、-3.55±1.22μm、-3.47±1.32μm 和-2.39±1.15μm（P=0.019、0.004、0.010 和 0.039）。PME 在 7 年时与基线相比变化了 2.45±1.02μm（P=0.017）。PCE 和 PME 的变化与 RBT 呈负相关。
SMILE 治疗中高度近视后，后角膜高度长期稳定。
