Comparison of outcome between small incision lenticule extraction and FS-LASIK in eyes having refractive error greater than negative 10 diopters
Comparison of outcome between small incision lenticule extraction and FS-LASIK in eyes having refractive error greater than negative 10 diopters
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屈光不正大于负10屈光度的眼睛小切口晶状体摘除术与FS-LASIK的结果比较
DOI：
10.1016/j.jcrs.2019.08.038
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发表时间：
2020-01-01
影响因子：
2.8
通讯作者：
Xie, Yi
中科院分区：
文献类型：
--
作者：
Yang, Xiaonan;Liu, Quan;Xie, Yi
目的：比较小切口晶状体摘除（SMILE）和飞秒激光辅助激光原位角膜磨磨术（FS-LASIK）在矫正最大近视经络超过10屈光度(D)的近视中的安全性、屈光效果、视觉质量和生物力学反应。单位：中山大学中山眼科中心。设计：前瞻性、随机、比较研究。方法：选取60只眼（60例），最大近视眼经络超过10d；30眼采用SMILE矫正，30眼采用FS-LASIK矫正。患者接受术前和术后6个月的检查，包括屈光结果、角膜曲线、对比敏感度、眼差测量和角膜生物力学反应。结果：术后6个月，SMILE组和LASIK组未矫正距离视力分别为-0.01 +/- 0.06和-0.05 +/- 0.10 （P = 0.08）。矫正距离视力分别为-0.07 +/- 0.07和-0.08 +/- 0.08 （P = .624）。术后球形当量（SE）分别为-0.20 +/- 0.25 D和-0.03 +/- 0.20 D （P = 0.008）。SMILE和FS-LASIK术后角膜后曲率无明显变化（P < 0.05）。角膜厚度分别减少137.40 +/- 15.01 μ m和155.06 +/- 17.43 μ m （P < 0.001）。与1周相比，SE的变化分别为-0.01 +/- 0.26和-0.13 +/- 0.30 （P = 0.103）。只有峰值距离（未变形角膜部分最高点之间的距离）在两组之间存在差异（1.06 +/- 1.44 mm vs -0.26 +/- 1.16 mm, P = .007）。SMILE患者高阶像差（P = 0.018）和球差（P = 0.011）的变化小于LASIK患者。结论：与LASIK相比，SMILE矫正超过10 d的最大近视眼经络的安全性和客观视觉质量更高，稳定性和有效性相当，但可预测性略差
Purpose: To compare small incision lenticule extraction (SMILE) and femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) in terms of safety, refractive outcomes, visual quality, and biomechanical responses in correcting myopia with maximum myopic meridian exceeding 10 diopters (D).Setting: Zhongshan Ophthalmic Center, Sun Yat-sen University.Design: Prospective, randomized, comparative study.Methods: The study comprised 60 eyes (60 patients) with a maximum myopic meridian exceeding 10 D; 30 eyes were corrected using SMILE and 30 eyes were corrected using FS-LASIK. Patients received preoperative and 6-month postoperative examinations, including refractive outcomes, corneal curve, contrast sensitivity, ocular aberrometry, and corneal biomechanical responses.Results: At 6 months postoperatively, the uncorrected distance visual acuity was -0.01 +/- 0.06 and -0.05 +/- 0.10 in the SMILE and LASIK eyes, respectively (P = .08). The corrected distance visual acuity was -0.07 +/- 0.07 and -0.08 +/- 0.08 (P = .624), respectively. The postoperative spherical equivalent (SE) was -0.20 +/- 0.25 D and -0.03 +/- 0.20 D, respectively (P = .008). The posterior corneal curvature was unchanged after SMILE and FS-LASIK (P > .05). The measured corneal thickness was reduced by 137.40 +/- 15.01 mu m and 155.06 +/- 17.43 mu m (P < .001). The change in the SE was -0.01 +/- 0.26 and -0.13 +/- 0.30 from 1 week (P = .103). Only the peak distance (the distance between the highest points of the nondeformed corneal parts) differed between the groups (1.06 +/- 1.44 mm vs -0.26 +/- 1.16 mm, P = .007). In the SMILE patients, changes in higher-order aberration (P = .018) and spherical aberration (P = .011) were smaller than in LASIK patients.Conclusions: Compared with LASIK, SMILE might offer superior safety and objective visual quality, comparable stability and efficacy, and a little inferior predictability in correcting maximum myopic meridian exceeding 10 D. Copyright (C) 2019 Published by Wolters Kluwer on behalf of ASCRS and ESCRS