J Refract Surg. 2024 Jul;40(7):e490-e498. doi: 10.3928/1081597X-20240514-01. Epub 2024 Jul 1.
To compare the objective visual quality of moderate-to-high myopia corrected by small incision lenticule extraction (SMILE) and transepithelial photorefractive keratectomy (TransPRK) at a 1,050-Hz ablation frequency, assisted by Smart-Pulse technology (SCHWIND eye-tech-solutions).
This study involved 123 patients (123 eyes) with moderate-to-high myopia between July 2020 and January 2021. They were categorized into the SMILE group (67 patients, 67 eyes) and the TransPRK group (56 patients, 56 eyes). Follow-ups were conducted at 6 months postoperatively to record the logarithm of the minimum angle of resolution visual acuity, and the Strehl ratio and higher order aberrations were measured using the Sirius anterior segment analysis device (SCHWIND eye-tech-solutions) under a 6-mm pupil diameter at various postoperative intervals.
At 1 week and 1 month postoperatively, the uncorrected distance visual acuity (UDVA) in the SMILE group was superior to that in the TransPRK group ( < .05 for both). At 1 week and 1 month postoperatively, the Strehl ratio value in the SMILE group was higher than that in the TransPRK group ( < .05 for both). At 1, 3, and 6 months postoperatively, coma was greater in the SMILE group than in the TransPRK group ( < .05 for all). Spherical aberrations were lower in the SMILE group than in the TransPRK group at 3 and 6 months postoperatively ( < .05). At 6 months postoperatively, UDVA was -0.09 ± 0.08 and -0.11 ± 0.05 logMAR in the SMILE and TransPRK groups, respectively, which exceeded their preoperative corrected distance visual acuity of -0.05 ± 0.04 and -0.09 ± 0.08 logMAR (all < .001). Compared with preoperative values, the Strehl ratio, total higher order, coma, and spherical aberration differences were significantly increased postoperatively in both groups (all < .001).
Both surgical methods improved UDVA and each had its advantages. The visual quality of SMILE was superior at 1 week and 1 month postoperatively (Strehl ratio values were higher than those of the TransPRK group), and its spherical aberration was lower than that of the TransPRK group at 3 and 6 months; TransPRK with SmartPulse technology with a 1,050-Hz ablation frequency showed that coma was significantly lower than that of the SMILE group at 1, 3, and 6 months postoperatively. .
比较 1050Hz 频率消融时采用小切口微透镜提取术（SMILE）和经上皮准分子激光角膜切削术（TransPRK）治疗中高度近视的客观视觉质量，两种术式均采用 Smart-Pulse 技术（SCHWIND eye-tech-solutions）辅助。
本研究纳入 2020 年 7 月至 2021 年 1 月的 123 例（123 只眼）中高度近视患者，根据术式分为 SMILE 组（67 例，67 只眼）和 TransPRK 组（56 例，56 只眼）。术后 6 个月进行随访，记录最佳矫正视力的 logMAR 视力值，使用 Sirius 眼前节分析系统（SCHWIND eye-tech-solutions）在 6mm 瞳孔直径下测量 6 个月内各时间点的斯特列尔比和高阶像差。
术后 1 周和 1 个月时，SMILE 组的未矫正远视力（UDVA）优于 TransPRK 组（均<0.05）。术后 1 周和 1 个月时，SMILE 组的斯特列尔比均高于 TransPRK 组（均<0.05）。术后 1、3 和 6 个月时，SMILE 组的彗差均大于 TransPRK 组（均<0.05）。术后 3 和 6 个月时，SMILE 组的球差均低于 TransPRK 组（均<0.05）。术后 6 个月时，SMILE 组和 TransPRK 组的 UDVA 分别为-0.09±0.08 和-0.11±0.05 logMAR，均优于术前的-0.05±0.04 和-0.09±0.08 logMAR（均<0.001）。与术前相比，两组术后的斯特列尔比、总高阶像差、彗差和球差差值均显著增加（均<0.001）。
两种手术方式均改善了 UDVA，且各有优势。SMILE 组术后 1 周和 1 个月时视觉质量较好（斯特列尔比高于 TransPRK 组），术后 3 和 6 个月时球差低于 TransPRK 组；采用 SmartPulse 技术的 1050Hz 频率消融 TransPRK 组术后 1、3 和 6 个月时的彗差明显低于 SMILE 组。
