[关键词]
[摘要]
目的：观察准分子激光原位角膜磨镶术(LASIK)、波前像差引导的LASIK(WF-LASIK)术与飞秒激光小切口角膜基质透镜取出术(SMILE)治疗屈光不正患者的疗效。
方法：回顾性分析。选取2020-03/2021-03本院收治的屈光不正患者97例194眼，依据手术方式分为LASIK组28例56眼、WF-LASIK组32例64眼与SMILE组37例74眼，观察手术前后裸眼视力(UCVA)、屈光度、角膜高阶像差、泪膜破裂时间(BUT)、泪液分泌试验(SⅠt)，记录相关并发症发生情况。
结果：三组患者术后1、3mo UCVA、球镜、柱镜、等效球镜比较均无差异(均P>0.05)； LASIK组术后1、3mo球差大于其余两组(均P<0.05)，WF-LASIK组大于SMILE组(均P<0.05)； LASIK组、SMILE组术后1、3mo水平彗差、垂直彗差大于WF-LASIK组(均P<0.05)； LASIK组术后1、3mo总高阶像差大于其余两组(均P<0.05)； SMILE组术后1、3mo BUT和SⅠt优于其余两组(均P<0.05)，WF-LASIK组与LASIK组比较无差异(均P>0.05)； 三组患者并发症总发生率比较无差异(P>0.05)。
结论：LASIK术、WF-LASIK术、SMILE术治疗屈光不正均可获得良好视力效果，WF-LASIK术后患者视觉质量最好，SMILE术后泪膜稳定性更好。
[Key word]
[Abstract]
AIM:To observe the therapeutic effects of standard laser
in situ keratomileusis(LASIK), wavefront-guided LASIK(WF-LASIK)and small incision lenticule extraction(SMILE)on refractive errors.
METHODS: This study retrospectively analyzed 97 patients(194 eyes)with refractive errors admitted to the hospital between March 2020 and March 2021. They were divided into LASIK group(28 cases, 56 eyes), WF-LASIK group(32 cases, 64 eyes)and SMILE group(37 cases, 74 eyes)according to the surgical method. The uncorrected visual acuity(UCVA), diopter, high-order aberrations, tear film break-up time(BUT)and tear secretion function(SⅠt)were observed before and after operation, and related complications were recorded.
RESULTS: The UCVA, spherical diopter, cylindrical lens diopter and spherical equivalent were similar in the 3 groups at 1 and 3mo after operation(all P>0.05). The spherical aberrations of LASIK group, WF-LASIK group, and SMILE group at 1 and 3mo after operation decreased in order(all P<0.05). The horizontal coma and vertical coma of LASIK group and SMILE group at 1 and 3mo after operation were greater than those of WF-LASIK group(all P<0.05). The total high order aberrations of LASIK group at 1 and 3mo after operation were significantly greater than those of the other two groups(all P<0.05). BUT and SⅠt of SMILE group at 1 and 3mo after operation were significantly better than those of the other two groups(all P<0.05), without significant difference between WF-LASIK group and LASIK group(all P>0.05). The total incidence rates of complications in the 3 groups were close(P>0.05).
CONCLUSION: All of LASIK, WF-LASIK and SMILE can improve vision of patients with refractive errors. However, patients treated with WF-LASIK have the best visual quality after operation, and those treated with SMILE can obtained better tear film stability after operation.
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