目的：分析并比较飞秒激光制瓣联合准分子激光原位角膜磨镶术(FS-LASIK)与飞秒激光小切口角膜基质透镜取出术(SMILE)对角膜前表面非球面性的影响。

方法：选取2016-11/2017-09在我院行FS-LASIK手术(FS-LASIK组)和SMILE手术(SMILE组)的近视患者各60例60眼，术前和术后3mo使用Pentacam眼前节分析系统测量角膜前表面6、7、8、9mm直径范围Q值和角膜前表面像差。

结果：术前，两组患者角膜前表面各直径范围Q值均无差异； 术后3mo，均明显高于术前，且FS-LASIK组患者角膜前表面6mm直径范围Q值明显高于SMILE组(0.89±0.43 vs 0.47±0.32，P<0.05)。术前，两组患者角膜总高阶像差和角膜球差均无差异； 术后3mo，两组患者角膜总高阶像差也无差异，但FS-LASIK组患者角膜球差高于SMILE组(0.43±0.23μm vs 0.31±0.11μm，P<0.05)。

结论：FS-LASIK和SMILE术均改变了角膜前表面非球面性，术后角膜前表面Q值均向正值方向变化，且SMILE术对角膜前表面Q值和角膜像差的改变均小于FS-LASIK术。

METHODS: There were sixty eyes of 60 patients in FS-LASIK and SMILE group respectively from November 2016 to September 2017. The Q-values of anterior corneal surface for different diameters(6, 7, 8 and 9mm)and corneal aberrations were measured with Pentacam before and 3mo after operation.

RESULTS: The Q-values of anterior corneal surface between FS-LASIK and SMILE were no significant differences. After 3mo operation, the values increased significantly; and the post-operative Q-values of 6mm in group SMILE was significant lower than group FS-LASIK(0.47±0.32 vs 0.89±0.43,P<0.05). The higher aberration and spherical aberration in FS-LASIK and SMILE were no significant differences before surgery; after 3mo operation,there were no significant difference between them. However, group FS-LASIK had significant higher spherical aberration than group SMILE(0.43±0.23μm vs 0.31±0.11μm, P<0.05).

CONCLUSION: FS-LASIK and SMILE cause significant changes of anterior corneal asphericity, Q-values all increased to positive values after surgeries; and there have less changes of Q-value and corneal aberration in SMILE than in FS-LASIK surgery.