[1]高萌蔓,时钟,马月磊,等.矢量分析法比较SMILE与波前像差引导的FS-LASIK矫正中高度散光的临床效果[J].眼科新进展,2020,40(11):1079-1083.[doi:10.13389/j.cnki.rao.2020.0241]
 GAO Mengman,SHI Zhong,MA Yuelei,et al.Comparison of clinical effects of moderate to high astigmatism in SMILE and wavefront aberration-guided FS-LASIK correction by vector analysis[J].Recent Advances in Ophthalmology,2020,40(11):1079-1083.[doi:10.13389/j.cnki.rao.2020.0241]
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矢量分析法比较SMILE与波前像差引导的FS-LASIK矫正中高度散光的临床效果/HTML
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
40卷
期数:
2020年11期
页码:
1079-1083
栏目:
应用研究
出版日期:
2020-11-05

文章信息/Info

Title:
Comparison of clinical effects of moderate to high astigmatism in SMILE and wavefront aberration-guided FS-LASIK correction by vector analysis
作者:
高萌蔓时钟马月磊刘超敏李向品董盈盈侯献琪郭秀瑾
050000 河北省石家庄市,河北医科大学第二医院眼科
Author(s):
GAO MengmanSHI ZhongMA YueleiLIU ChaominLI XiangpinDONG YingyingHOU XianqiGUO Xiujin
Department of Ophthalmology,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,Hebei Province,China
关键词:
中高度散光角膜标记的SMILE波前像差引导的FS-LASIK矢量分析
Keywords:
moderate to high astigmatismcorneal-marked SMILEwavefront aberration-guided FS-LASIKvector analysis
分类号:
R778.1
DOI:
10.13389/j.cnki.rao.2020.0241
文献标志码:
A
摘要:
目的 应用矢量分析法比较角膜标记的飞秒激光小切口角膜基质透镜取出术(SMILE)、未角膜标记的SMILE以及波前像差引导的飞秒激光制瓣准分子激光原位角膜磨镶术(FS-LASIK)矫正中高度散光的临床效果。方法 采用前瞻性非随机对照研究。选择2018年12月至2019年10月于我院近视激光治疗中心行SMILE及波前像差引导的FS-LASIK的中高度近视散光患者(球镜≥-1.0 D、柱镜≥-1.5 D)41例(82眼),按照手术方式分为3组:角膜标记的SMILE组17例(34眼)、未角膜标记的SMILE组12例(24眼)和波前像差引导的FS-LASIK组12例(24眼)。三组患者术前及术后3个月均行裸眼视力(UCVA)、最佳矫正视力、屈光度、眼压、裂隙灯显微镜等检查;利用Alpins矢量分析方法计算目标矫正散光量(TIA)、手术矫正散光量(SIA)、差异矢量、矫正指数、成功指数、误差角度(AofE)、变平指数等指标。结果 角膜标记的SMILE组术后UCVA、等效球镜度、残余散光度分别为(-0.040±0.020)logMAR、(-0.02±0.51)D、(-0.06±0.35)D,未角膜标记的SMILE组分别为(-0.062±0.043)logMAR、(-0.07±0.38)D、(-0.07±0.44)D,波前像差引导的FS-LASIK组分别为(-0.054±0.038)logMAR、(-0.06±0.48)D、(-0.25±0.56)D,三组间两两对比差异均无统计学意义(均为P>0.05)。角膜标记的SMILE组、未角膜标记的SMILE组、波前像差引导的FS-LASIK组误差角度绝对值(|AofE|)分别为1.39±3.03、2.24±4.13、-1.81±4.88,未角膜标记的SMILE组大于角膜标记的SMILE组、波前像差引导的FS-LASIK组,差异均有统计学意义(均为P<0.05);角膜标记的SMILE组与波前像差引导的FS-LASIK组差异无统计学意义(P>0.05)。术后3个月矫正指数、成功指数、变平指数三组之间两两对比差异均无统计学意义(均为P>0.05)。三组中各组的|SIA|与|TIA|均呈正相关(均为P<0.001),术后3个月三组的成功指数与|AofE|、差异矢量与|AofE|均存在明显正相关(均为P<0.05)。结论 角膜标记及未角膜标记的SMILE和波前像差引导的FS-LASIK矫正中高度散光均具有安全性、有效性。角膜标记的SMILE和波前像差引导的FS-LASIK比未角膜标记的SMILE在控制散光轴向误差方面的准确性更好,可提高散光的矫正效果。
Abstract:
Objective To evaluate and compare the clinical effect of marking on corneal in small incision lenticule extraction (SMILE) operation, unmarking on corneal in SMILE operation and wavefront aberration guided femtosecond laser assisted laser-assisted in situ keratomileusis (FS-LASIK) surgery in the treatment of moderate to high myopia astigmatism using vector analysis.Methods  A prospective non-randomized control method was conducted on 41 patients (82 eyes) of moderate to high myopia astigmatism (spherical mirror ≥ 1.0 D and cylindrical mirror ≥ 1.5 D) intends to SMILE operation and wavefront aberration guided FS-LASIK surgery in laser treatment center of our myopia between December 2018 to October 2019 were collected, and were divided into 3 groups according to the surgical treatment: 17 patients (34 eyes) treated with SMILE of corneal marker (corneal-marked SMILE group), 12 patients (24 eyes) treated with SMILE of non-corneal marker (SMILE without corneal marking), and 12 patients (24 eyes) treated with wavefront aberration guided FS-LASIK (wavefront aberration guided FS-LASIK group). Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), diopter, intraocular pressure, slit lamp microscope were examined before and 3 months after the surgery, and the differences among the three groups were compared. Alpins’s vector analysis was used to calculated the target induced astigmatism (TIA), surgically induced astigmatism (SIA), difference vector (DV), correction index (CI), index of success (IOS), angle of error (AofE), and flattening index (FI).Results The UCVA, equivalent spherical mirror, residual astigmatism in the corneal-marked SMILE group were (-0.040±0.020)logMAR, (-0.02±0.51) D, and (-0.06±0.35) D, and (-0.062±0.043)logMAR, (-0.07±0.38) D, and (-0.07±0.44) D in the SMILE without corneal marking group, as well as (-0.054±0.038) logMAR, (-0.06±0.48) D, and (-0.25±0.56) D in the wavefront aberration guided FS-LASIK group, and there was no statistically significant differences between the three groups (all P> 0.05). The|AofE|was 1.39±3.03 in the corneal-marked SMILE group, 2.24±4.13 in the SMILE without corneal marking group and 1.81 ± 4.88 in the wavefront aberration guided FS-LASIK group. The SMILE without corneal marking group was higher than the corneal-marked SMILE group and the wavefront aberration guided FS-LASIK group (both P<0.05). There was no significant difference between the corneal-marked SMILE group and the wavefront aberration guided FS-LASIK group (P>0.05). There was no significant difference in CI, IOS and FI between the three groups 3 months after operation (all P>0.05). In each of the three groups, | SIA | and | TIA | were positively correlated (all P<0.001). There were significant positive correlations between IOS and|AofE|, DV and|AofE| (both P<0.05).Conclusion Corneal-marked and uncorneal-marked SMILE surgery and wavefront aberration guide FS-LASIK surgery are all safe and effective in correcting moderate to high astigmatism. Corneal-marked SMILE surgery and wavefront aberration guided FS-LASIK surgery have better accuracy in controlling the axial error of astigmatism than uncorneal marked SMILE surgery, and can improve the correction effect of astigmatism.

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备注/Memo

备注/Memo:
N/A
更新日期/Last Update: 2020-11-05