15-Month Visual Outcomes and Corneal Power Changes of SMILE in Treating High Myopia With Maximum Myopic Meridian Exceeding 10.00 D
15-Month Visual Outcomes and Corneal Power Changes of SMILE in Treating High Myopia With Maximum Myopic Meridian Exceeding 10.00 D
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SMILE治疗最大近视子午线超过10.00D高度近视15个月视力结果及角膜屈光力变化
DOI：
10.3928/1081597x-20181126-01
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发表时间：
2019-01-01
影响因子：
2.4
通讯作者：
Lin, Haiqin
中科院分区：
文献类型：
--
作者：
Yang, Xiaonan;Liu, Fang;Lin, Haiqin
目得：评价最大近视子午线超过10.00屈光度（D）的高度近视患者行小切口小梁切除术（SMILE）后的长期视力和屈光结果、光学质量、角膜稳定性和眼轴长度。通过一项前瞻性队列研究，最大近视子午线超过10.00 D的患者（53例）使用VisuMax飞秒激光进行矫正（版本3.0; Carl Zeiss Meditec AG，Jena，德国）在中山大学中山眼科中心进行。术前和术后1、3和15个月评价屈光结果、像差、眼轴长度和角膜曲率。结果：术后15个月，有效性和安全性指数分别为0.91 +/- 0.25和1.15 +/- 0.18。分别有72%的眼睛在尝试等效球镜的+/- 0.50 D范围内，89%在+/- 1.00 D范围内。从术后1到15个月，明显屈光度的回归值为-0.24 +/- 0.28 D（P < .001），前角膜曲率的回归值为-0.43 +/- 0.54 D（P < .001）。此外，观察到球面像差显著增加0.20 μ m（P = 0.016）。角膜后曲率无明显变化（P > .999），包括术后1 - 15个月的平均角膜曲率或散光，或眼轴长度（分别为26.82 ± 0.93和26.82 ± 0.95 mm，P > 0.99）。SMILE在治疗最大近视子午线超过10.00 D的高度近视时具有长期安全性、有效性和可预测性。术后1 ~ 15个月，由于前角膜曲率增加，观察到明显屈光回退为-0.24 D，球面像差显著增加0.20 μ m。
PURPOSE: To evaluate the long-term visual and refractive outcomes, optical quality, and stability of the cornea and axial length after small incision lenticule extraction (SMILE) for the correction of high myopia with a maximum myopic meridian exceeding 10.00 diopters (D).METHODS: Via a prospective cohort study, 53 eyes (53 patients) with a maximum myopic meridian exceeding 10.00 D were corrected with a VisuMax femtosecond laser (version 3.0; Carl Zeiss Meditec AG, Jena, Germany) at the Zhongshan Ophthalmic Center of Sun Yat-sen University. Refractive outcomes, aberrations, axial length, and corneal curvature were evaluated preoperatively and at 1, 3, and 15 months postoperatively.RESULTS: At 15 months postoperatively, the efficacy and safety indexes were 0.91 +/- 0.25 and 1.15 +/- 0.18, respectively. A total of 72% of eyes were within +/- 0.50 D and 89% were within +/- 1.00 D of the attempted spherical equivalent, respectively. From 1 to 15 months postoperatively, the significant regression was -0.24 +/- 0.28 D (P < .001) on manifest refraction and -0.43 +/- 0.54 D (P < .001) on anterior corneal curvature. In addition, a significant increase of 0.20 mu m (P = .016) was observed in the spherical aberration. No significant change was observed in posterior corneal curvature (P > .999), including mean keratometry or astigmatism, or in the ocular axis length from 1 to 15 months postoperatively (26.82 +/- 0.93 and 26.82 +/- 0.95 mm, respectively, P > .99).CONCLUSIONS: SMILE had long-term safety, efficacy, and predictability when treating high myopia with a maximum myopic meridian exceeding 10.00 D. Both a manifest refraction regression of -0.24 D and a significant spherical aberration increase of 0.20 mu m were observed between 1 and 15 months postoperatively, due to the increased anterior corneal curvature.