Wang Xinlin, Jiao Yexuan, Liu Pan, Ye Xinqi, Zhou Yuhang, Wang Qi, Xiu Xiaoqing, Shao Zhengbo
Department of Ophthalmology, Second Affiliated Hospital of Harbin Medical University, Harbin, China.
Future Medical Laboratory, Second Affiliated Hospital of Harbin Medical University, Harbin, China.
Lasers Med Sci. 2025 Aug 9;40(1):331. doi: 10.1007/s10103-025-04586-6.
To investigate changes in the Effective Optical Zone (EOZ) using a novel method, evaluate visual outcomes within six months following Small Incision Lenticule Extraction (SMILE), and analyze the changes in postoperative visual outcomes. This retrospective study evaluated patients who underwent SMILE and were assessed during a 6-month follow-up. 95 eyes were divided into two groups: low to moderate myopia (LM, SE ranging from - 0.50D to -6.00D) and high myopia (HM, SE ranging from - 6.00D to -9.00D). Postoperative EOZ was automatically distinguished by custom software on the tangential curvature difference map. Higher-order aberrations (HOAs), Q-values, and Strehl ratios (SR) were analyzed for the central 4 mm and 6 mm corneal zones. Changes in EOZ (△-OZ) and other parameters were monitored and compared between the two groups. The EOZ was significantly larger in LM group than in HM group (25.45 ± 2.19 vs. 23.88 ± 1.53mm), and the changes in vertical diameter exceeded those in horizontal diameter in both groups (P < 0.01). All patients showed increased HOAs, spherical aberration (SA), and coma compared to preoperative values (all P < 0.01), with higher values in HM group. The changes in Q-value, HOAs, and SA were positively correlated with △-OZ (r = 0.640, r = 0.534, r = 0.680, all P < 0.01). No significant differences in SR, visual acuity, or refractive error between the two groups. EOZ stabilized by 3 months postoperatively while Visual Outcomes at 1 month. Following SMILE surgery, the EOZ decreased and stabilized at around 3 months. Higher preoperative myopia was associated with increased corneal remodeling, larger HOA changes, and greater EOZ reduction, without significantly affecting visual outcomes.
为了使用一种新方法研究有效光学区（EOZ）的变化，评估小切口透镜切除术（SMILE）后6个月内的视觉效果，并分析术后视觉效果的变化。这项回顾性研究评估了接受SMILE手术并在6个月随访期间接受评估的患者。95只眼睛分为两组：低度至中度近视（LM，球镜等效度范围为-0.50D至-6.00D）和高度近视（HM，球镜等效度范围为-6.00D至-9.00D）。术后EOZ通过切线曲率差图上的定制软件自动识别。分析了中央4mm和6mm角膜区域的高阶像差（HOAs）、Q值和斯特列尔比（SR）。监测并比较两组之间EOZ（△-OZ）和其他参数的变化。LM组的EOZ明显大于HM组（25.45±2.19 vs. 23.88±1.53mm），两组垂直直径的变化均超过水平直径的变化（P<0.01）。与术前值相比，所有患者的HOAs、球差（SA）和彗差均增加（均P<0.01），HM组的值更高。Q值、HOAs和SA的变化与△-OZ呈正相关（r=0.640，r=0.534，r=0.680，均P<0.01）。两组之间的SR、视力或屈光不正无显著差异。术后3个月EOZ稳定，而1个月时视觉效果稳定。SMILE手术后，EOZ下降并在3个月左右稳定。术前近视程度越高，角膜重塑增加、HOA变化越大、EOZ减少越明显，但对视觉效果无显著影响。
