摘要
目的探讨微小切口角膜基质透镜取出术(SMILE)不同大小光学区对术后3个月内视力及高阶像差的影响。设计前瞻性比较病例系列。研究对象31例行SMILE手术的患者所有患者。均选择右眼做为研究对象。方法全部患者由同一位医生采用相同设备行SMILE手术,手术序号单号的患者术中光学区大小为6.0 mm进行切削,双号患者术中光学区大小为6.5mm进行切削。观察3个月,检查术后裸眼视力、等效球镜度数和像差变化。主要指标术后视力、屈光度、高阶像差,包括均方根值(RMSh)、慧差(Coma)、三叶草(Trefoil)、球差(Sphere)。结果术后3个月,6.0 mm组和6.5 mm组平均视力分别为1.20±0.23和1.24±0.20(P=0.534);平均等效球镜分别为(-0.45±0.32)D和(-0.29±0.42)D(P=0.235);RMSh分别为(0.683±0.324)μm和(0.621±0.252)μm(P=0.646);Coma分别为(0.124±0.080)μm和(0.100±0.052)μm(P=0.057);Trefoil分别为(0.060±0.033)μm和(0.061±0.041)μm(P=0.147);Sphere分别为(0.007±0.040)μm和(-0.002±0.032)μm(P=0.223)。6.5 mm组术后Coma与术前Coma(0.073±0.050μm)相比略增加(P=0.065),而6.0 mm组术后Coma与术前(0.075±0.050μm)相比显著增加(P=0.004)。结论6.0 mm和6.5 mm光学区SMILE术均安全有效,虽然较小光学区(6.0 mm)可能导致慧差增加,但不会引起其他高阶像差的增加。
Objective To study the effect on the wavefront aberration using different optical zone in small incision lenticule extraction(SMILE).Design Prospective comparative case series.Participants Thirty-one patients performed SMILE operation.The right eyes were the study eyes.Methods All the operation were undergone by the same surgeon and with the same laser machine.According to the operative serial number,the patients of the singular number choose 6.0 mm optic zone,and the patients of the even number choose 6.5 mm optic zone during the surgery.The visual acurity,the equivalent spherical diopter,and the wavefront aberration before and after the operation in the two group were recorded and compared.Main Outcome Measures The visual acurity,the spherical diopter,the high order wavefront aberration(RMSh,Coma,Trefoil,Sphere).Results Three months after the surgery,the mean visual acuity of the 6.0 mm group and the 6.5 mm group was 1.20±0.23 and 1.24±0.20,respectively(P=0.534);the mean equivalent spherical diopter was(-0.45±0.32) D and(-0.29±0.42) D,respectively(P=0.235);RMSh was(0.683±0.324) μm and(0.621±0.252) μm(P=0.646),respectively;Coma was(0.124±0.080) μm and(0.100±0.052) μm(P=0.057);Trefoil was(0.060±0.033)μm and(0.061±0.041) μm(P=0.147),respectively;Sphere was(0.007±0.040) μm and(-0.002±0.032) μm(P=0.223),respectively.Compared with the preoperative Coma(0.073±0.050 μm),the post-operation Coma was slightly increased in the 6.5 mm group(P=0.065).The post-operation Coma was significantly increased in the 6.0 mm group compared with the preoperative group(0.075±0.050 μm,P=0.004).Conclusion Operation with 6.0 mm and 6.5 mm optical zone in SMILE both are safe and effective.Although 6.0 mm optical zone may result in the increase of Coma,but it could not result in the increase of other high order aberration.
作者
齐颖
翟长斌
郑燕
付彩云
胡雅斌
Qi Ying;Zhai Changbin;Zheng Yan;Fu Caiyun;Hu Yobin(Beijing Tongren Eye Center,Beijing Key Laboratory of Ophthalmology and Visual Sciences,Beijing Tongren Hospital,Capital Medical University,Bejing 100730,China)
出处
《眼科》
CAS
2020年第6期438-441,共4页
Ophthalmology in China
关键词
微小切口角膜基质透镜取出术
光学区
像差
small incision lenticule extraction
optic zone
wavefront aberration
