Yang Xiaonan, Feng Qiting, Liu Quan, Chen Jianhui, Wan Pengxia
Department of Ophthalmology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, Guangdong, China.
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China.
J Ophthalmol. 2024 Jan 20;2024:8835585. doi: 10.1155/2024/8835585. eCollection 2024.
To investigate the long-term changes in visual quality and pupil size after small incision lenticule extraction (SMILE) for eyes without preoperative cylinder refraction.
Thirty-three myopic eyes (33 patients) without preoperative cylinder refraction were corrected using SMILE. Refractive outcomes, corneal curvature, aberrations, contrast sensitivity (CS), and pupil diameter were evaluated preoperatively, and 30 months postoperatively.
The 30-month postoperative uncorrected and corrected distance visual acuity (UDVA and CDVA, LogMAR) were -0.10 ± 0.09 and -0.14 ± 0.06, respectively, whereas the preoperative CDVA (LogMAR) was -0.07 ± 0.05. Cylinder refraction of -0.11 ± 0.21 D (ranging from -0.50 to 0.00) was observed at 30 months postoperatively, increasing from the preoperative cylinder refraction of 0.00 ± 0.00 D (=0.004). Moreover, the centroid coordinates , of corneal anterior astigmatic vectors were -0.19 ± 0.22, 0.81 ± 0.33 at 30 months postoperatively, and 0.02 ± 0.28, 0.76 ± 0.51 preoperatively ( < 0.001 and =0.810, respectively). Furthermore, a 15° axis change in the mean anterior corneal astigmatic vector was observed at 30 months postoperatively from the preoperative state, as measured by Pentacam. At 30 months postoperatively, the photopic Log CS reduced significantly with glare at three and six cycles/degrees ( < 0.001 and =0.015, respectively), a decreased photopic pupil diameter (3.27 ± 0.55 mm vs. 3.10 ± 0.66 mm, =0.030), and an increased Coma () and Trefoil () at 4 mm diameter area analysis. However, a significant linear regression relationship was only observed between changes in photopic pupil diameter and changes in photopic Log CS with glare at 12 cycles/degree (=0.038 and = 0.282).
Slight cylinder regression was observed with thicker corneal lenticular extraction after SMILE correction of nonastigmatic eyes 30 months postoperatively. This regression was mainly because of the axis changes in anterior corneal astigmatism power. Therefore, a cylinder nomogram modification of 0.25 to 0.50 D is considerable for correcting nonastigmatic myopic eyes with a predicted spherical lenticular thickness over 100 m.
研究对于术前无柱镜屈光的眼睛，小切口透镜切除术（SMILE）后视觉质量和瞳孔大小的长期变化。
对33只术前无柱镜屈光的近视眼睛（33例患者）采用SMILE进行矫正。术前及术后30个月评估屈光结果、角膜曲率、像差、对比敏感度（CS）和瞳孔直径。
术后30个月的未矫正和矫正远视力（UDVA和CDVA，LogMAR）分别为-0.10±0.09和-0.14±0.06，而术前CDVA（LogMAR）为-0.07±0.05。术后30个月观察到柱镜屈光为-0.11±0.21D（范围为-0.50至0.00），较术前柱镜屈光0.00±0.00D有所增加（=0.004）。此外，术后30个月角膜前散光矢量的质心坐标 、 分别为-0.19±0.22、0.81±0.33，术前为0.02±0.28、0.76±0.51（分别为<0.001和=0.810）。此外，通过Pentacam测量，术后30个月平均角膜前散光矢量的轴较术前状态有15°的变化。术后30个月，明视Log CS在3和6周/度眩光条件下显著降低（分别为<0.001和=0.015），明视瞳孔直径减小（3.27±0.55mm对3.10±0.66mm，=0.030），在4mm直径区域分析中彗差（）和三叶草像差（）增加。然而，仅在12周/度眩光条件下，明视瞳孔直径变化与明视Log CS变化之间观察到显著的线性回归关系（=0.038，=0.282）。
在对非散光眼进行SMILE矫正术后30个月，较厚角膜透镜切除术观察到轻微的柱镜回退。这种回退主要是由于角膜前散光度数的轴变化。因此，对于预测球形透镜厚度超过100μm的非散光近视眼睛，0.25至0.50D的柱镜列线图修正量是值得考虑的。
