Wu Yuan, Huang Yue, Wang Shu-Han, Wang Gui-Qin, Yu Ao-Miao, Zhao Shao-Zhen, Wei Rui-Hua, Yang Rui-Bo, Zhang Chen
Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin 300384, China.
Tianjin Branch of National Clinical Research Center for Ocular Disease, Tianjin 300384, China.
Int J Ophthalmol. 2022 Mar 18;15(3):502-509. doi: 10.18240/ijo.2022.03.20. eCollection 2022.
To compare the changes in the objective visual quality of patients with low and moderate myopia postoperatively after transepithelial photorefractive keratectomy using the smart pulse technology (SMART) and femtosecond laser keratomileusis (FS-LASIK).
Corneal higher-order aberrations (HOAs), horizontal coma, vertical coma and spherical aberration were measured using Pentacam, and cutoff for modulation transfer function (MTF cutoff), objective scatter index (OSI) and Strehl ratio (SR) was measured using an optical quality analysis system (OQAS-II), before and after operation at 1, 3, and 6mo, and data were analyzed by repeated measurement two-way analysis of variance.
The difference in uncorrected distance visual acuity between SMART and FS-LASIK was statistically significant only 1wk postoperatively. Approximately 86.36% and 80.69% of patients with spherical equivalent (SE) in ±0.50 D were observed in the SMART and FS-LASIK groups, respectively. No significant difference was observed in SE between the two groups (=0.509). The HOAs increased postoperatively compared with those before surgery in both groups (<0.05). No significant difference in HOA, corneal horizontal coma, spherical aberration, ΔHOA, Δhorizontal coma, and Δspherical aberration were observed between the two group (>0.05). Corneal vertical coma and Δcorneal vertical coma in the FS-LASIK group were higher than those in the SMART group (<0.05). The OSI of both groups at 1mo after surgery was higher than that before surgery (<0.05). At 3 and 6mo postoperatively, the OSI in the FS-LASIK group was slightly higher than that in the SMART group (=0.040 and 0.047, respectively). At 6mo after surgery, the MTF cutoff was statistically significant different between the two groups (=0.026). No significant difference in SR between the FS-LASIK and SMART groups was observed at 1, 3, and 6mo postoperatively (>0.05).
The HOAs increase and visual quality is delayed in both groups postoperatively, and the long-term objective visual quality after SMART is slightly better than that after FS-LASIK.
比较采用智能脉冲技术（SMART）的经上皮屈光性角膜切削术和飞秒激光制瓣准分子原位角膜磨镶术（FS-LASIK）术后低中度近视患者的客观视觉质量变化。
使用Pentacam测量角膜高阶像差（HOA）、水平彗差、垂直彗差和球差，使用光学质量分析系统（OQAS-II）测量调制传递函数截止频率（MTF截止）、客观散射指数（OSI）和斯特列尔比（SR），于术前及术后1、3和6个月进行测量，并采用重复测量双向方差分析对数据进行分析。
SMART组和FS-LASIK组术后仅1周时，未矫正远视力差异有统计学意义。SMART组和FS-LASIK组分别有大约86.36%和80.69%的等效球镜度（SE）在±0.50 D范围内。两组间SE差异无统计学意义（P = 0.509）。两组术后HOA均较术前增加（P < 0.05）。两组间HOA、角膜水平彗差、球差、ΔHOA、Δ水平彗差和Δ球差差异无统计学意义（P > 0.05）。FS-LASIK组的角膜垂直彗差和Δ角膜垂直彗差高于SMART组（P < 0.05）。两组术后1个月时的OSI均高于术前（P < 0.05）。术后3和6个月时，FS-LASIK组的OSI略高于SMART组（分别为P = 0.040和0.047）。术后6个月时，两组间MTF截止有统计学差异（P = 0.026）。FS-LASIK组和SMART组术后1、3和6个月时SR差异无统计学意义（P > 0.05）。
两组术后HOA均增加且视觉质量恢复延迟，SMART术后的长期客观视觉质量略优于FS-LASIK术后。
