小切口微透镜切除术联合与不联合预防性角膜交联术的比较研究：1 年随访结果。

Comparative study of small-incision lenticule extraction with and without prophylactic corneal crosslinking: 1-year outcomes.

机构信息

From the Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China (Liu, Zhao, Zou, Y. Wang); Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Hospital, Tianjin, China (Liu, Zhao, Zou, Y. Wang); Aier School of Ophthalmology, Shenyang Aier Eye Hospital, Central South University, Shenyang, Liaoning, China (Liu, Fang); Aier School of Ophthalmology, Guangzhou Aier Eye Hospital, Central South University, Guangzhou, Guangdong, China (Z. Wang); Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (Jhanji).

出版信息

J Cataract Refract Surg. 2021 Sep 1;47(9):1196-1204. doi: 10.1097/j.jcrs.0000000000000594.

DOI:10.1097/j.jcrs.0000000000000594

PMID:34468458

Abstract

PURPOSE

To compare myopia and astigmatic correction after small-incision lenticule extraction (SMILE) with or without prophylactic crosslinking (SMILE Xtra).

SETTING

Shenyang Aier Eye Hospital, Central South University, China.

DESIGN

Retrospective study.

METHODS

Patients with comparable manifest sphere and cylinder undergoing SMILE Xtra or SMILE were enrolled. The crosslinking (CXL) energy was 2.7 J/cm2. Only right eyes were selected. Visual and refractive changes were evaluated for 1 year. Astigmatic correction was analyzed using Alpins method.

RESULTS

Thirty-six eyes undergoing SMILE Xtra and 40 eyes undergoing SMILE were enrolled. The uncorrected distance visual acuity at 1-day visit was lower after SMILE Xtra than that after SMILE (P = .01). At 12 months, the mean manifest refraction spherical equivalent (MRSE) and manifest cylinder were 0.08 ± 0.32 diopters (D) and -0.29 ± 0.23 D in SMILE Xtra group, whereas -0.25 ± 0.29 D and -0.22 ± 0.19 D in SMILE group (P < .01 and P = .135), respectively. Thirty-four eyes (94%) and 32 eyes (89%) in SMILE Xtra group and 36 eyes (91%) and 39 eyes (98%) in SMILE group exhibited target MRSE and manifest cylinder within ±0.50 D (P = .771 and P = .294), respectively. Compared with SMILE group, spherical correction index (SCI), correction index (CI), and difference vector were higher in SMILE Xtra group since 1-week follow-up (all P < .05). SCI and CI were slightly more than 1.0 after SMILE Xtra even at postoperative 12-month follow-up.

CONCLUSIONS

With CXL protocol of 30 mW/cm2 for 90 seconds, SMILE Xtra exhibited comparable astigmatic correction with SMILE up to 1-year follow-up, although slight spherical equivalent and astigmatic overcorrection were evident after SMILE Xtra.

摘要

目的

比较小切口微透镜提取术（SMILE）联合或不联合预防性交联（SMILE Xtra）术后的近视和散光矫正效果。

设置

中国中南大学湘雅爱尔眼科医院。

设计

回顾性研究。

方法

招募接受 SMILE Xtra 或 SMILE 治疗、等效球镜和柱镜相近的患者。交联（CXL）能量为 2.7 J/cm2。仅选择右眼。术后 1 年评估视力和屈光变化。使用 Alpins 法分析散光矫正情况。

结果

纳入 36 只眼行 SMILE Xtra 和 40 只眼行 SMILE。SMILE Xtra 术后第 1 天未矫正远视力低于 SMILE（P =.01）。12 个月时，SMILE Xtra 组平均表现屈光球镜等效值（MRSE）和表现柱镜分别为 0.08 ± 0.32 屈光度（D）和-0.29 ± 0.23 D，SMILE 组分别为-0.25 ± 0.29 D 和-0.22 ± 0.19 D（P <.01 和 P =.135）。SMILE Xtra 组 34 只眼（94%）和 32 只眼（89%）、SMILE 组 36 只眼（91%）和 39 只眼（98%）的目标 MRSE 和表现柱镜均在±0.50 D 以内（P =.771 和 P =.294）。SMILE Xtra 组自术后 1 周起，球镜矫正指数（SCI）、矫正指数（CI）和差异向量均高于 SMILE 组（均 P <.05）。SMILE Xtra 术后 12 个月时，SCI 和 CI 略大于 1.0。