Xu Zhirong, Dong Songguo, Yu Sejie, Wu Yuxiao, Deng Hongwei, Zhao Jun
Department of Medical Technology, Bijie Medical College, Bijie, China.
Shenzhen Eye Hospital, Jinan University, Shenzhen, China.
Semin Ophthalmol. 2025 Apr;40(3):196-203. doi: 10.1080/08820538.2024.2403439. Epub 2024 Sep 18.
The aim of this study is to assess the changes and differences in early postoperative binocular accommodative function following femtosecond laser-assisted in situ keratomileusis (FS-LASIK) and small incision lenticule extraction (SMILE).
In this retrospective study, 120 patients (240 eyes) diagnosed with low-to-moderate and high myopia, who underwent either FS-LASIK or SMILE procedures were included. The assessment encompassed measurements of accommodative facility, accommodation time, relaxation time, and accommodation-to-relaxation ratio using a smart flipper. Measurements were taken preoperatively, as well as at 1 day, 1 week, and 1 month postoperatively. Additionally, the visual fatigue scale score was assessed and compared at the 1 month mark post-surgery. Changes in parameters were quantified by calculating the difference between preoperative values and those recorded at each postoperative time point.
At 1 month post-surgery, both FS-LASIK and SMILE procedures demonstrated potential for recovery or even improvement in accommodative facility, accommodation time, relaxation time, and accommodation-to-relaxation ratio compared to preoperative levels. The FS-LASIK group exhibited a greater magnitude of change in accommodative facility postoperatively compared to the SMILE group. In the low-to-moderate myopia subgroup, the FS-LASIK group exhibited lower changes in accommodation time and visual fatigue scale score at 1 month post-surgery compared to the SMILE group, with all associated -values <0.05.
Early postoperative recovery of accommodation function was slower following SMILE compared to FS-LASIK. Additionally, the severity of visual fatigue at 1 month post-surgery was greater in the SMILE group than in the FS-LASIK group. This difference in visual fatigue levels may be attributed to the delayed recovery observed in postoperative SMILE procedures.
本研究旨在评估飞秒激光原位角膜磨镶术（FS-LASIK）和小切口透镜切除术（SMILE）术后早期双眼调节功能的变化和差异。
在这项回顾性研究中，纳入了120例（240只眼）诊断为中低度和高度近视并接受FS-LASIK或SMILE手术的患者。使用智能翻转器对调节灵活度、调节时间、放松时间和调节与放松比进行测量评估。在术前、术后1天、1周和1个月进行测量。此外，在术后1个月时评估并比较视觉疲劳量表评分。通过计算术前值与每个术后时间点记录值之间的差异来量化参数变化。
术后1个月时，与术前水平相比，FS-LASIK和SMILE手术在调节灵活度、调节时间、放松时间和调节与放松比方面均显示出恢复甚至改善的潜力。与SMILE组相比，FS-LASIK组术后调节灵活度的变化幅度更大。在中低度近视亚组中，与SMILE组相比，FS-LASIK组在术后1个月时调节时间和视觉疲劳量表评分的变化较小，所有相关P值<0.05。
与FS-LASIK相比，SMILE术后早期调节功能的恢复较慢。此外，SMILE组术后1个月时的视觉疲劳严重程度高于FS-LASIK组。视觉疲劳水平的这种差异可能归因于SMILE术后观察到的恢复延迟。
