Jiao Xiaohang, Xue Wenxin, Zhou Ziyu, Yang Jing, Wang Weiqun, Bai Yanhui
The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450000, China.
BMC Ophthalmol. 2025 Jul 1;25(1):388. doi: 10.1186/s12886-025-04209-2.
We evaluated the efficacy of small incision lenticule extraction (SMILE), femtosecond-assisted laser in situ keratomileusis (FS-LASIK), and toric implantable collamer lens (TICL) implantation for correcting myopia with high astigmatism by vector analysis.
This retrospective study included 155 patients (155 eyes) with myopia and high astigmatism who underwent SMILE, FS-LASIK, or TICL implantation at our hospital. Patients were selected and divided into three groups based on the surgical procedure. The safety and effectiveness of three methods in correcting high astigmatism were compared, and the efficacy on high astigmatism were compared using Alpins' vector analysis.
Six months after surgery, operative safety and effectiveness did not differ significantly among the implantation types. Postoperative cylinder and SE were higher in the SMILE and FS-LASIK groups compared to the TICL group (P < 0.05). Among the three groups, significant differences were observed in surgically-induced astigmatism (1.91 ± 0.46D vs. 2.14 ± 0.56D vs. 1.89 ± 0.63D), difference vector (0.43 ± 0.28 vs. 0.34 ± 0.24 vs. 0.80 ± 0.52), correction index (0.96 ± 0.15 vs. 1.02 ± 0.15 vs. 0.87 ± 0.21), angle of error (-3.38 ± 5.87°vs. -0.54 ± 4.04° vs. -7.23 ± 10.09°), flattening effect (1.87 ± 0.47 vs. 2.13 ± 0.57 vs. 1.74 ± 0.64), flattening index (0.93 ± 0.14 vs. 1.01 ± 0.15 vs. 0.80 ± 0.22), and index of success (0.23 ± 0.16 vs. 0.16 ± 0.12 vs. 0.38 ± 0.24) (P < 0.05).
SMILE, FS-LASIK, and TICL implantation are all safe and effective for correcting myopia with high astigmatism. FS-LASIK demonstrated the best correction effect on high astigmatism, followed by SMILE and TICL implantation.
我们通过矢量分析评估了小切口飞秒透镜切除术（SMILE）、飞秒激光制瓣准分子原位角膜磨镶术（FS-LASIK）和可植入式散光矫正人工晶状体（TICL）植入术矫正高度散光近视的疗效。
这项回顾性研究纳入了155例（155眼）在我院接受SMILE、FS-LASIK或TICL植入术的高度散光近视患者。根据手术方式将患者选择并分为三组。比较三种方法矫正高度散光的安全性和有效性，并使用阿尔平斯矢量分析比较对高度散光的疗效。
术后6个月，不同植入方式的手术安全性和有效性无显著差异。与TICL组相比，SMILE组和FS-LASIK组的术后柱镜度数和等效球镜度数更高（P < 0.05）。三组之间，在手术源性散光（1.91±0.46D vs. 2.14±0.56D vs. 1.89±0.63D）、差异矢量（0.43±0.28 vs. 0.34±0.24 vs. 0.80±0.52）、矫正指数（0.96±0.15 vs. 1.02±0.15 vs. 0.87±0.21）、误差角度（-3.38±5.87° vs. -0.54±4.04° vs. -7.23±10.09°）、 flattening效应（1.87±0.47 vs. 2.13±0.57 vs. 1.74±0.64）、 flattening指数（0.93±0.14 vs. 1.01±0.15 vs. 0.80±0.22）和成功指数（0.23±0.16 vs. 0.16±0.12 vs. 0.38±0.24）方面观察到显著差异（P < 0.05）。
SMILE、FS-LASIK和TICL植入术矫正高度散光近视均安全有效。FS-LASIK对高度散光的矫正效果最佳，其次是SMILE和TICL植入术。
