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小切口基质透镜切除术与飞秒激光原位角膜磨镶术矫正中高度远视的临床疗效比较。

Comparison of clinical outcome of small-incision lenticule intrastromal keratoplasty and FS-LASIK for correction of moderate and high hyperopia.

作者信息

Zhang Li, Zhou Yue-Hua, Zhai Chang-Bin, Zhang Jing, Zheng Yan

机构信息

Beijing Tongren Hospital Affiliated to Capital Medical University, Beijing Tongren Eye Center, Beijing Ophthalmology & Visual Science Key Lab, Beijing 100730, China.

Beijing Ming Vision & Ophthalmology, Beijing 100191, China.

出版信息

Int J Ophthalmol. 2022 May 18;15(5):780-785. doi: 10.18240/ijo.2022.05.14. eCollection 2022.

Abstract

AIM

To compare the clinical outcome of small-incision lenticule intrastromal keratoplasty (sLIKE) and femtosecond laser-assisted keratomileusis (FS-LASIK) for correction of moderate and high hyperopia.

METHODS

A case-controlled clinical study was performed. Twenty right eyes of 20 moderate and high hyperopia patients underwent sLIKE (sLIKE group) and 22 right eyes of 22 moderate and high hyperopia patients underwent FS-LASIK (FS-LASIK group) were enrolled in this study from October 2015 to October 2017. Visual acuity, refractive error, corneal thickness, and keratometry were compared between the groups before and 1y postoperatively.

RESULTS

The postoperative uncorrected near visual acuity (UNVA) and uncorrected distance visual acuity (UDVA) were improved in the two groups. The UNVA reached J1 in 15 eyes (75.0%) in the sLIKE group and 5 eyes (22.7%) in the FS-LASIK group 1y after surgery ( =11.476, =0.001). The UDVA was equal or better than the preoperative CDVA in 16 eyes (80.0%) in the sLIKE group and 8 eyes (36.4%) in the FS-LASIK group, respectively ( =8.145, =0.004). No eyes lost any line of best-corrected visual acuity (BCVA) in either group. The amount of postoperative residual hyperopia in the sLIKE group was significantly less than in the FS-LASIK group (=-2.841, =0.004). The postoperative keratometry and corneal thickness were significantly higher in the sLIKE group than in the FS-LASIK group (=4.411, 10.279, <0.001). The SRI and SAI of the sLIKE group were significantly higher than that in the FS-LASIK group. There was no statistically significant difference in mean decentration between the two groups.

CONCLUSION

sLIKE has better visual and refractive outcome than FS-LASIK for correction of moderate and high hyperopia.

摘要

目的

比较小切口基质透镜切除术(sLIKE)和飞秒激光制瓣准分子原位角膜磨镶术(FS-LASIK)矫正中高度远视的临床效果。

方法

进行一项病例对照临床研究。2015年10月至2017年10月,纳入20例中高度远视患者的20只右眼行sLIKE(sLIKE组),22例中高度远视患者的22只右眼行FS-LASIK(FS-LASIK组)。比较两组术前及术后1年的视力、屈光不正、角膜厚度和角膜曲率计测量值。

结果

两组术后未矫正近视力(UNVA)和未矫正远视力(UDVA)均有改善。术后1年,sLIKE组15只眼(75.0%)的UNVA达到J1级(卡方检验值= =11.476,P =0.001);FS-LASIK组5只眼(22.7%)的UNVA达到J1级。sLIKE组16只眼(80.0%)的UDVA等于或优于术前最佳矫正视力(BCVA),FS-LASIK组8只眼(36.4%)的UDVA等于或优于术前最佳矫正视力(卡方检验值= =8.145,P =0.004)。两组均无眼最佳矫正视力(BCVA)下降。sLIKE组术后残余远视量显著低于FS-LASIK组(t检验值= -2.841,P =0.004)。sLIKE组术后角膜曲率计测量值和角膜厚度显著高于FS-LASIK组(t检验值=4.411,卡方检验值=10.279,P均<0.001)。sLIKE组的手术稳定性指数(SRI)和手术可预测性指数(SAI)显著高于FS-LASIK组。两组平均偏心量差异无统计学意义。

结论

对于矫正中高度远视,sLIKE比FS-LASIK具有更好的视觉和屈光效果。

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