Short-term outcomes of small-incision lenticule extraction (SMILE) for low, medium, and high myopia
Short-term outcomes of small-incision lenticule extraction (SMILE) for low, medium, and high myopia
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DOI：
10.5301/ejo.5000849
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发表时间：
2017-03-01
影响因子：
1.7
通讯作者：
Rodriuez-Vallejo, Manuel
中科院分区：
文献类型：
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作者：
Fernandez, Joaquin;Valero, Almudena;Rodriuez-Vallejo, Manuel
目的：根据近视屈光不正的程度，确定 6 个月随访时小切口晶状体摘除术的安全性、有效性和可预测性。手术由刚接触该技术的外科医生进行。方法：这项回顾性观察研究纳入了 71 名平均年龄为 31.86 +/- 5.57 岁的受试者。根据术前等效球镜 (SE) 将受试者分为 3 组：低组从 1.00 D 到 3.00 D，中组从 3.25 D 到 5.00 D，高组从 5.25 D 到 7.00 D。在术前和术后 6 个月测量明显屈光度、矫正远视力 (CDVA) 和裸眼远视力 (UDVA)。结果：总共有 1.4% 的眼睛在手术后 CDVA 减少 1 行，而 95.8% 的眼睛保持不变，2.8% 的眼睛增加 1 行。高度近视组（中位-0.50 D）存在显着的矫正不足（p = 0.031），而低度和中度近视组仍接近正视眼。就疗效而言，术后 UDVA 没有发现统计学上显着的组间差异 (p = 0.282)。矢量分析还显示术前柱面校正不足，尽管标准偏差从 x 轴的 0.9 D 和 y 轴的 0.7 D 分别降至 0.24 D 和 0.27 D。结论：即使对于经验不足的外科医生来说，小切口微透镜提取也可能是一种安全、有效且可预测的手术。尽管在高度近视中发现 SE 和柱镜矫正不足，但在近视级别之间没有发现疗效差异。
Purpose: To determine the safety, efficacy, and predictability of small-incision lenticule extraction at 6-month follow-up, depending on the level of the myopic refractive error. The surgeries were performed by a surgeon new to this technique.Methods: Seventy-one subjects with a mean age of 31.86 +/- 5.57 years were included in this retrospective observational study. Subjects were divided into 3 groups depending on the preoperative spherical equivalent (SE): low group from-1.00 D to-3.00 D, medium from-3.25 D to-5.00 D, and high from-5.25 D to-7.00 D. Manifest refraction, corrected distance visual acuity (CDVA), and uncorrected distance visual acuity (UDVA) were measured before surgery and at 6 months after the treatment.Results: In total, 1.4% of the eyes lost 1 line of CDVA after the procedure, whereas 95.8% remained unchanged and 2.8% gained 1 line. A significant undercorrection (p = 0.031) was found in the high myopia group (median -0.50 D), whereas the low and medium groups remained near to emmetropia. In terms of efficacy, no statistically significant intergroup differences for postoperative UDVA (p = 0.282) were found. The vector analysis also showed undercorrection of the preoperative cylinder, even though the standard deviations decreased from 0.9 D in the x axis and 0.7 D in the y axis to 0.24 D and 0.27 D, respectively.Conclusions: Small-incision lenticule extraction might be a safe, effective, and predictable procedure even for inexperienced surgeons. No differences in efficacy were found among myopia levels even though undercorrections were found for SE and cylinder in high myopia.