Fang Zhi, Li Yan, Song Dejuan, He Xiaoying, Zhang Kai, Zhu Tiepei, Han Wei
Eye Center, The Second Affiliated Hospital of Zhejiang University School of Medicine; Zhejiang Provincial Key Laboratory of Ophthalmology; Zhejiang Provincial Clinical Research Center for Eye Diseases; Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, China.
Adv Ophthalmol Pract Res. 2025 Jan 2;5(2):149-155. doi: 10.1016/j.aopr.2025.01.001. eCollection 2025 May-Jun.
To evaluate the impact of coronavirus disease 2019 (COVID-19) on postoperative visual acuity, optical quality, and severity of dry eye disease in patients after small incision lenticule extraction (SMILE).
This is a retrospective, comparative study. Patients who underwent SMILE were included and divided into two groups according to the period at the eye center of the Second Affiliated Hospital of Zhejiang University. The first group included patients who underwent SMILE before the large-scale COVID-19 pandemic in China (Group 1). The second group comprised patients who underwent SMILE during the pandemic with a confirmed infection of COVID-19 (Group 2). The visual acuity, the severity of dry eye, ocular surface disease index (OSDI), oculus keratography analysis, and individual Zernike coefficients were evaluated and compared between the 2 groups.
A total of 43 eyes of 23 patients and 45 eyes of 26 patients were included in Groups 1 and 2, respectively. The OSDI score in Group 2 was significantly higher than Group 1 ( < 0.01). The corrected distance visual acuity (CDVA, logMAR) at 3 months postoperatively in Group 1 was better than in Group 2 ( < 0.001). Despite the improvement over 1 month after the COVID-19 infection, the OSDI score was still higher in Group 2 than in Group 1 ( < 0.01). The bulbar and limbal redness were significantly higher in Group 2 than in Group 1 at both 1 month and 3 months ( < 0.05), while no significant differences were found in tear breakup time or tear meniscus height. Spherical aberration (SA) at the 4 mm zone was significantly higher in Group 2 than in Group 1 both at 1 month and 3 months ( < 0.001), while no significant changes were observed in corneal total higher-order aberrations. No significant correlation was found between the bulbar/limbal redness index and SA.
COVID-19 infection impaired visual outcomes and aggravated dry eye severity among postoperative SMILE patients.
评估2019冠状病毒病(COVID-19)对小切口透镜切除术(SMILE)患者术后视力、光学质量和干眼疾病严重程度的影响。
这是一项回顾性比较研究。纳入接受SMILE手术的患者,并根据浙江大学医学院附属第二医院眼科中心的时间分为两组。第一组包括在中国大规模COVID-19疫情之前接受SMILE手术的患者(第1组)。第二组包括在疫情期间确诊感染COVID-19并接受SMILE手术的患者(第2组)。评估并比较两组患者的视力、干眼严重程度、眼表疾病指数(OSDI)、角膜地形图分析和各泽尼克系数。
第1组和第2组分别纳入了23例患者的43只眼和26例患者的45只眼。第2组的OSDI评分显著高于第1组(<0.01)。第1组术后3个月的矫正远视力(CDVA,logMAR)优于第2组(<0.001)。尽管在COVID-19感染后1个月有所改善,但第2组的OSDI评分仍高于第1组(<0.01)。第2组在1个月和3个月时的球结膜和角膜缘充血均显著高于第1组(<0.05),而泪膜破裂时间或泪河高度无显著差异。第2组在1个月和3个月时4mm区域的球差(SA)均显著高于第1组(<0.001),而角膜总高阶像差无显著变化。球结膜/角膜缘充血指数与SA之间未发现显著相关性。
COVID-19感染损害了SMILE术后患者的视力预后,并加重了干眼严重程度。