目的：探讨0.05 D(屈光度)间隔球镜片验光引导下飞秒激光小切口角膜基质透镜取出术(SMILE)矫正不同程度近视术后的早期视觉质量。

方法：回顾性研究。选取2023-05/09于联勤保障部队第九八九医院接受SMILE的患者200例200眼，均为右眼。采用0.05 D验光方法进行屈光度测定。根据术前等效球镜度数分为低中度近视组(>-6.0 D)和高度近视组(≤-6.0 D)，每组各100眼。比较两组术前及术后6 mo角膜总高阶像差(HOA)、球差、彗差、三叶草差，并填写视觉质量调查问卷。

结果：术后6 mo两组患者角膜总HOA、球差、垂直彗差均较术前显著增大(均P<0.05)； 术后6 mo低中度近视组HOA、球差、垂直彗差均低于高度近视组(均P<0.05)。低中度近视组视觉质量调查问卷综合评分、近视力、夜视力、夜间眩光及视疲劳评分均高于高度近视组(均P<0.05)。

结论：0.05 D间隔球镜片验光引导下SMILE在矫正低中度近视和高度近视虽然均有视觉症状发生，但术后早期能获得良好的视觉质量。

METHODS: Retrospective study. A total of 200 cases(200 eyes)that underwent SMILE at the 989th Hospital of Joint Logistic Support Force from May to September 2023 were selected. The 0.05 D optometry was used to measure diopter. According to the preoperative spherical equivalent(SE), they were divided into low-to-moderate myopic group(>-6.0 D)and high myopic group(≤-6.0 D), with 100 eyes in each group. The total high-order corneal aberration(HOA), spherical aberration, coma and trefoil aberration were compared between the two groups preoperatively and at 6 mo postoperatively, and the quality of vision questionnaire was completed.

RESULTS: The HOA, spherical aberration and vertical coma aberration in the two groups at 6 mo after operation were significantly higher than those before operation(all P<0.05). At 6 mo postoperatively, the HOA, spherical aberration and vertical coma aberration in the low-to-moderate myopic group were lower than those in the high myopic group(all P<0.05). The scores of the quality of vision questionnaire, near vision, night vision, night glare and visual fatigue in the low-to-moderate myopic group were all higher than those in the high myopic group(all P<0.05).

CONCLUSION: Both low-to-moderate myopia and high myopia after the 0.05 D interval spherical lens optometry-guided SMILE had some visual symptoms, but great visual quality can be obtained after surgery.