目的：对比角膜板层刀制瓣的前弹力层下准分子激光角膜磨镶术(SBK)、飞秒激光制瓣的SBK术(FS-SBK)与飞秒激光小切口角膜基质透镜取出术(SMILE)对近视中央角膜内皮细胞的短期及长期影响。

方法：我院近视34例34眼行SBK术； 41例41眼行FS-SBK术； 49例49眼行SMILE术，术前和术后1wk，1a利用SP-1P型非接触角膜内皮显微镜检查角膜内皮细胞，统计分析各组中央角膜内皮细胞密度(ECD)、内皮细胞面积的变异系数(CV)和六边形内皮细胞百分比。

结果：三组间术前、术后1wk，1a裸眼视力及屈光度均无差异(P>0.05)。术后1wk三组中央ECD均较术前减少(P<0.01)，术后1a各组均较术前无差异(P>0.05)； 术前及术后各随访时间点，三组间中央角膜内皮细胞面积CV及六边形内皮细胞百分比均无差异(P>0.05)； 不同组内，术前及术后各随访时间点结果均无差异(P>0.05)。

结论：SBK、FS-SBK和SMILE手术对近视内皮细胞的安全性确切，术后早期各组中央角膜ECD均轻度降低，1a后恢复； 术后各组中央角膜内皮细胞面积CV及六边形内皮细胞百分比较术前无明显改变。

METHODS: Thirty-four myopia patients(34 eyes)were performed with SBK, and 41 patients(41 eyes)underwent FS-SBK, 49 patients(49 eyes)underwent SMILE. The corneal endothelial cells, in terms of central corneal ECD, the coefficient of variation(CV)and the percentage of hexagonal endothelial cells, were measured by non-contact corneal endothelial microscope(Topcon SP-1P )at 1wk and 1a preoperative, and postoperative, separately.

RESULTS:There were no significant differences in the visual acuity and diopter among three groups at preoperative, 1wk and at 1a postoperative, separately(all P>0.05). The central corneal ECDs statistically decreased at 1wk postoperative in three groups, compared to preoperatively(all P<0.01), while the ECDs recovered at 1a postoperative. The changes of CVs and the percentage of hexagonal endothelial cells at 1wk,1a after operation were not statistically significantly different compared with preoperative results in the three groups(all P>0.05).The differences of ECD, CVs, and the percentage of hexagonal endothelial cells among three groups at preoperatively and postoperatively were not statistically significant(all P>0.05).

CONCLUSION: The SBK, FS-SBK and SMILE used to treat myopia were safe for the corneal endothelium. The central corneal ECDs decreased slightly at early period after operation, and recovered 1a later in all groups. The CVs and percentages of hexagonal endothelial cells in three groups do not change at short-term and long-term postoperatively. The differences of ECD, CVs, and the percentage of hexagonal endothelial cells among three groups were not found at postoperative.