J Refract Surg. 2022 Aug;38(8):488-496. doi: 10.3928/1081597X-20220623-01. Epub 2022 Aug 1.
To evaluate the outcomes of small incision lenticule extraction (SMILE) for myopia in a large population of young adults.
In this retrospective case series, the patient population consisted of the first 4,138 consecutive SMILE treatments using the VisuMax femtosecond laser (Carl Zeiss Meditec) between 2012 and 2018 at the London Vision Clinic. Inclusion criteria were myopic spherical equivalent up to -9.00 diopters (D), cylinder up to 6.00 D, corrected distance visual acuity of 20/20 or better, age younger than 40 years, and follow-up of 12 months. Outcomes analysis was performed using the Standard Graphs for Reporting Refractive Surgery.
Data were available at 12 months in 3,722 eyes (90%), and 416 eyes (10%) were lost to follow-up. Mean attempted spherical equivalent refraction (SEQ) was -4.61 ± 1.84 D (range: -1.12 to -9.00 D). Mean cylinder was -0.78 ± 0.66 D (range: 0.00 to -6.00 D). Postoperatively, the mean SEQ relative to target was -0.13 ± 0.30 D (range: -1.35 to +1.25 D) and was within ±0.50 D in 88.1% and ±1.00 D in 99.6% of eyes. Uncorrected distance visual acuity was 20/20 or better in 95.4% of eyes and 20/25 or better in 98.7% of eyes. One line of CDVA was lost in 3.0% of eyes, and 0.08% (n = 3) lost two or more lines of CDVA, for which CDVA was restored following phototherapeutic keratectomy treatment. There was a statistically significant improvement of 0.05, 0.06, 0.07, and 0.07 log units for contrast sensitivity at 3, 6, 12, and 18 cycles per degree, respectively ( < .001).
SMILE achieved excellent outcomes for myopia up to -9.00 D with cylinder up to -5.50 D for a large population in patients without presbyopia. .
评估小切口微透镜提取术（SMILE）治疗近视的效果，该研究纳入了大量年轻成年人患者。
本回顾性病例系列研究纳入 2012 年至 2018 年期间在伦敦视力诊所接受 VisuMax 飞秒激光（卡尔蔡司医学技术公司）治疗的 4138 例连续 SMILE 治疗的患者人群。纳入标准为近视球镜等效值最高达-9.00 屈光度（D），柱镜最高达 6.00 D，矫正远视力 20/20 或更好，年龄小于 40 岁，随访时间 12 个月。使用标准视力矫正手术报告图表进行结果分析。
3722 只眼（90%）在 12 个月时可获取数据，416 只眼（10%）失访。平均目标球镜等效值（SEQ）为-4.61 ± 1.84 D（范围：-1.12 至-9.00 D）。平均柱镜为-0.78 ± 0.66 D（范围：0.00 至-6.00 D）。术后，平均 SEQ 与目标值的相对值为-0.13 ± 0.30 D（范围：-1.35 至+1.25 D），88.1%的眼在±0.50 D 以内，99.6%的眼在±1.00 D 以内。95.4%的眼未矫正远视力为 20/20 或更好，98.7%的眼为 20/25 或更好。3.0%的眼视力下降一行，0.08%（n = 3）的眼视力下降两行或更多，经光动力角膜切削术治疗后视力恢复。对比敏感度分别提高了 0.05、0.06、0.07 和 0.07 个对数单位，分别在 3、6、12 和 18 个周期/度时具有统计学意义（<.001）。
SMILE 治疗近视效果极佳，可矫正最高至-9.00 D 的近视和最高至-5.50 D 的散光，适用于大多数无老视的年轻患者。
