目的：探讨不同手术切口设计的SMILE术后角膜知觉的变化。

方法：选取2016-05-12/2018-01-18于我院行SMILE手术的近视及近视伴散光患者30例60眼，所有患者右眼手术切口设计在颞上方135°位置，左眼手术切口设计在正上方90°位置。分别于术前和术后1、7d，1、3mo采用角膜知觉计检测距角膜中央3mm位置3：00、6：00、9：00、12：00位及角膜中央的角膜知觉，并采用眼表疾病指数量表(OSDI)进行干眼症状评分。

结果：手术前后，本组患者左右眼之间5个位置的角膜知觉无明显差异(P>0.05)。术后1d，双眼5个位置的角膜知觉均较术前和术后1、3mo显著降低(P<0.05)，但术后1、3mo双眼5个位置的角膜知觉均与术前无明显差异(P>0.05)。术前和术后1、7d，1、3mo本组患者OSDI分值分别为10.739±7.576、15.003±11.296、16.357±14.467、14.020±10.128、11.968±7.586分，无明显差异(F=1.583，P=0.204)。

结论：不同手术切口设计的SMILE术后角膜知觉无明显差异，均在术后1d明显下降，至术后1mo基本恢复至术前水平。

METHODS: Totally 30 SMILE patients(60 eyes)were selected from 05/12/2016-01/18/2018. The incision in the right eye was designed at 135° while that in the left eye was designed at 90°. Cornea sensitivity were examined and noted by an experienced examiner preoperative, 1d, 7d,1mo and 3mo 3mm from central cornea postoperative at 3, 6, 9,12 o'clock and the central cornea. The eye surface disease index(ocular surface disease index, OSDI)was also noted at the same time.

RESULTS: The comparison of corneal sensitivity results from different eyes showed that there was no significant difference on all time points at different position(P>0.05). After further comparison, cornea sensitivity of both eyes was found to be lower on 1d postoperative than that preoperative, 1mo postoperative and 3mo postoperative(P<0.05), while restored to the level of preoperative at 1mo and 3mo(P>0.05). The OSDI scores on different time points are 10.739±7.576, 15.003±11.296, 16.357±14.467, 14.020±10.128, 11.968±7.586 respectively. The comparison showed no significant difference(F=1.583, P=0.204).

CONCLUSION: There is no significant difference on cornea sensitivity between two eyes after SMILE surgeries. The corneal sensitivity declined at 1d postoperative and the recovery was faster at about 1mo.