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小切口微透镜取出术矫正高度近视的中央角膜基质厚度减少的 3 年结果。

Three-year results of central corneal stromal thickness reduction in small-incision lenticule extraction for high myopia correction.

机构信息

The Affiliated Eye Hospital, Jiangxi Medical College, Nanchang University, No. 463 Bayi Avenue, Nanchang City, Nanchang, Jiangxi 330000, China.

Department of Ophthalmology and Optometry, Eye and ENT Hospital, Key Lab of Myopia, Ministry of Health, Fudan University, No. 83 Fenyang Road, Shanghai 200031, China.

出版信息

Photodiagnosis Photodyn Ther. 2024 Aug;48:104278. doi: 10.1016/j.pdpdt.2024.104278. Epub 2024 Jul 11.

Abstract

BACKGROUND

To investigate the long-term corneal stromal remodeling and central stromal thickness (CST) reduction accuracy after small-incision lenticule extraction (SMILE) for high myopia correction.

METHODS

This prospective study included 30 patients (50 eyes) who had undergone SMILE. Measurements of CST reduction using optical coherence tomography were performed at 1 month, 6 months, 1 year, and 3 years after surgery. Correlations were performed between planned and achieved CST reductions.

RESULTS

The study enrolled 50 eyes of 30 patients. The mean spherical equivalent was -9.25±1.52 D(diopters). The postoperative CST increased in the first month after surgery and remained stable for a year. Thereafter, it remained stable during follow-up from 1 to 3 years postoperatively. The predicted CST reduction was 146.4 ± 10.3 μm. The achieved CST reductions at 1 month, 6 months, 1 year, and 3 years after surgery were 135.3 ± 12.1 μm, 130.8 ± 10.6 μm, 125.9 ± 9.4 μm, and 122.2 ± 10.6 μm, respectively. An overestimation of CST reduction was observed three years after surgery. Correlation analysis revealed a strong correlation between planned and achieved CST reductions; however, no correlation was found between CST reductions predicted error and the planned CST reductions.

CONCLUSION

During long-term follow-up, our findings revealed a significant stromal remodeling following SMILE in patients with high myopia. Therefore, clinicians should consider it when screening patients with high myopia for SMILE.

摘要

背景

研究小切口透镜切除术(SMILE)治疗高度近视后长期角膜基质重塑和中央基质厚度(CST)减少的准确性。

方法

本前瞻性研究纳入了 30 名(50 只眼)接受 SMILE 的患者。术后 1 个月、6 个月、1 年和 3 年,使用光学相干断层扫描测量 CST 减少量。分析计划 CST 减少量与实际 CST 减少量之间的相关性。

结果

本研究纳入了 30 名患者的 50 只眼。平均等效球镜度数为-9.25±1.52 D。术后第 1 个月 CST 增加,术后 1 年保持稳定。此后,在术后 1 至 3 年的随访期间保持稳定。预测 CST 减少量为 146.4 ± 10.3 μm。术后 1 个月、6 个月、1 年和 3 年 CST 减少量分别为 135.3 ± 12.1 μm、130.8 ± 10.6 μm、125.9 ± 9.4 μm和 122.2 ± 10.6 μm。术后 3 年 CST 减少量出现高估。相关性分析显示,计划 CST 减少量与实际 CST 减少量之间存在很强的相关性;然而,CST 减少量预测误差与计划 CST 减少量之间无相关性。

结论

在长期随访中,我们发现高度近视患者接受 SMILE 治疗后基质重塑明显。因此,临床医生在对高度近视患者进行 SMILE 筛查时应考虑这一点。

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