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[摘要]
目的:观察飞秒激光小切口角膜基质透镜取出术(SMILE)和飞秒激光制瓣的准分子激光原位角膜磨镶术(FS-LASIK)治疗近视术后24h内视力变化情况。
方法:回顾性分析2017-08/2018-03于我院行角膜屈光手术的近视患者80例160眼,根据手术方式不同分为两组,其中SMILE组40例80眼接受SMILE手术,FS-LASIK组40例80眼接受FS-LASIK手术。观察两组患者术后24h内裸眼视力情况,手术前后眼压和角膜内皮细胞情况,术中及术后并发症情况。
结果:两组患者手术过程均顺利完成。SMILE组与FS-LASIK组患者术后2、4、6、8、12、24h裸眼视力呈逐渐改善趋势。术后2、4、6、8、12、24h,FS-LASIK组患者裸眼视力均优于SMILE组,差异均有统计学意义(P<0.05)。SMILE组患者裸眼视力在术后12、24h最优,FS-LASIK组患者裸眼视力在术后6、24h最优。术后24h,两组患者眼压均低于术前,角膜内皮细胞密度、变异系数均较术前显著下降,角膜内皮细胞面积、六角形细胞比例均较术前显著升高,差异均具有统计学意义(P<0.01),但两组患者之间眼压和角膜内皮细胞相关指标比较,差异均无统计学意义(P>0.05)。两组术中及术后均未发生严重并发症。
结论:SMILE和FS-LASIK术后24h内视力均发生较大变化,术后均能获得良好的视力。
[Key word]
[Abstract]
AIM: To observe the visual acuity changes within 24h after femtosecond laser small incision lenticule extraction(SMILE)and femtosecond laser
in situ keratomileusis(FS-LASIK)for myopia.
METHODS: A retrospective analysis was made of 80 myopic patients(160 eyes)who underwent corneal refractive surgery in our hospital from August 2017 to March 2018. They were divided into two groups according to different surgical methods, 40 cases(80 eyes)in SMILE group and 40 cases(80 eyes)in FS-LASIK group. The visual acuity, intraocular pressure, corneal endothelial cells, intraoperative and postoperative complications were observed within 24h.
RESULTS: The operation was successfully completed in both groups. The uncorrected visual acuity(UCVA)of SMILE group and FS-LASIK group improved gradually at 2, 4, 6, 8, 12 and 24h after operation. At 2, 4, 6, 8, 12, 24h after operation, the UCVA of FS-LASIK group was better than that of SMILE group, and the difference was statistically significant(P<0.05). The UCVA of SMILE group was the best 12 and 24h after operation, and that of FS-LASIK group was the best 6 and 24h after operation. The results of intragroup comparison before and after operation showed that the intraocular pressure(IOP)of the two groups was lower than that before operation, the density of corneal endothelial cells, the coefficient of variation were significantly decreased, the area of corneal endothelial cells and the proportion of hexagonal cells were significantly increased; the difference was statistically significant(P<0.01). The results of comparison between groups after operation showed that there was no significant difference in intraocular pressure and corneal endothelial cell related indexes between the two groups(P>0.05). No serious complications occurred during and after operation in both groups.
CONCLUSION: Within 24h after SMILE and FS-LASIK, the visual acuity changed greatly, and good visual acuity was obtained.
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