Comparison of Corneal Shape Changes and Aberrations Induced By FS-LASIK and SMILE for Myopia
Comparison of Corneal Shape Changes and Aberrations Induced By FS-LASIK and SMILE for Myopia
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DOI：
10.3928/1081597x-20150303-01
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发表时间：
2015-04-01
影响因子：
2.4
通讯作者：
Hjortdal, Jesper O.
中科院分区：
文献类型：
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作者：
Gyldenkerne, Anders;Ivarsen, Anders;Hjortdal, Jesper O.
目的：比较飞秒激光辅助准分子激光原位角膜磨镶术(FS-LASIK)和小切口晶状体摘除术(SMILE)治疗中高度近视术后的角膜曲率、角膜屈光度和高阶像差(HOA)。方法：对368例736只眼和74例148只眼进行回顾性研究。术前平均等球镜度数，SILE组为-7.3+/-1.5，FS-LASIK组为-7.6+/-1.3。结果：两组患者术前、术后3个月角膜曲率均有明显变化，但角膜后表面无明显变化；微笑后，中心直径4 mm处的矢状曲率基本不变，而FS-LASIK术后角膜曲率随直径增大而逐渐变陡。根据术后两组角膜测量直径的不同，角膜屈光力的计算也不同。在全角膜的5毫米范围内测量，FS-LASIK导致的昏迷(P<；.001)和球差(P<；.001)比SMILE高0.11微米(P<；.001)；在其他角膜表面的HOA中也发现了类似的结果。结论：SMILE和FS-LASIK术后角膜曲率和屈光度不同，角膜前部形态发生明显变化。与FS-LASIK相比，微笑后的HOA明显降低。
PURPOSE: To compare corneal curvatures, corneal power calculations, and higher-order aberrations (HOAs) of femtosecond laser-assisted LASIK (FS-LASIK) with small incision lenticule extraction (SMILE) following surgery for moderate to high myopia.METHODS: A retrospective study of 736 eyes of 368 patients treated with SMILE and 148 eyes of 74 patients treated with FS-LASIK. Preoperative mean spherical equivalent was -7.3 +/- 1.5 diopters in the SMILE group and -7.6 +/- 1.3 diopters in the FS-LASIK group. Corneal curvatures, corneal power calculations performed by ray tracing, and HOAs measured with Scheimpflug technology before and 3 months after surgery were analyzed.RESULTS: Corneal curvatures changed significantly in the anterior corneal surface, but not in the posterior corneal surface, in both groups; after SMILE, the sagittal curvature was constant for the central 4-mm diameter, in contrast to FS-LASIK where the curvature showed a gradual steepening with increasing diameter. Corneal power calculations were different across the cornea depending on the measurement diameter between the two groups postoperatively. Measured over a 5-mm zone on the total cornea, FS-LASIK induced 0.11 mu m more coma (P < .001) and 0.13 mu m higher spherical aberration (P < .001) as compared to SMILE; similar results in other HOAs were seen for the anterior corneal surface. Negligible differences in HOAs were induced on the posterior corneal surface.CONCLUSIONS: SMILE and FS-LASIK produced distinct changes in anterior corneal shape evident in different postoperative corneal curvatures and power measurements between the two groups. Postoperative HOAs were much lower after SMILE as compared to FS-LASIK.