[1]宋学英,李岳美,李庆和,等.SMILE及LASEK治疗近视散光的临床对比研究[J].眼科新进展,2016,36(10):970-972.[doi:10.13389/j.cnki.rao.2016.0260]
　SONG Xue-Ying,LI Yue-Mei,LI Qing-He,et al.Clinical comparative study of small incision lenticule extraction and laser-assisted subepithelial keratomileusis in correction of myopia astigmatism[J].Recent Advances in Ophthalmology,2016,36(10):970-972.[doi:10.13389/j.cnki.rao.2016.0260]
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SMILE及LASEK治疗近视散光的临床对比研究
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
36卷
期数:
2016年10期
页码:
970-972
栏目:
应用研究
出版日期:
2016-10-05

文章信息/Info

Title:
Clinical comparative study of small incision lenticule extraction and laser-assisted subepithelial keratomileusis in correction of myopia astigmatism
作者:
宋学英; 李岳美; 李庆和; 胡长娥; 齐绍文
467000　河南省平顶山市，解放军第152医院眼科（宋学英，李庆和，胡长娥，齐绍文）；467000　河南省平顶山市，平顶山学院医学院（李岳美）
Author(s):
SONG Xue-Ying ;  LI Yue-Mei ;  LI Qing-He; HU Chang-E ;  QI Shao-Wen
Department of Ophthalmology , the 152nd Central Hospital of Chinese People ’ s Liberation Army ( SONG Xue-Ying, LI Qing-He, HU Chang-E , QI Shao-Wen ) . Pingdingshan 467000 . Henan Province , China ; Pingdingshan Medical College ( LI Yue-Mei ) , Pingdingshan 467000 . Henan Province . China
关键词:
小切口基质内透镜取出术; 准分子激光角膜上皮下磨镶术; 近视散光
Keywords:
small incision lenticule extraction; laser-assisted subepithelial keratomileusis ;  myopia astigmatism
分类号:
Ｒ７７９.６
DOI:
10.13389/j.cnki.rao.2016.0260
文献标志码:
A
摘要:
目的　对比研究ＳＭＩＬＥ及ＬＡＳＥＫ治疗近视散光患者的手术疗效。方法　回顾性分析在我院手术的高度近视患者８０例１５７眼，其中中度散光－１．００～－３．００Ｄ４８例９５眼、高度散光－３．００～－６．００Ｄ３２例６２眼。其中ＳＭＩＬＥ组（４０例７９眼）和ＬＡＳＥＫ组（４０例７８眼）。ＳＭＩＬＥ组采用小切口基质内透镜取出术，手术切口长度为２ｍｍ，位于１２０°，角膜帽厚度均为１２０μｍ，透镜直径６．４～６．６ｍｍ，帽直径为７．１～７．２ｍｍ；ＬＡＳＥＫ组行ＬＡＳＥＫ，体积分数２０％酒精浸泡２０ｓ，保留角膜上皮瓣。观察术后１ｄ、１周、１个月、３个月、６个月两组裸眼视力、等效球镜、最佳矫正视力、残余残光度数及角膜地形图形态。结果　ＳＭＩＬＥ组和ＬＡＳＥＫ组相比，术后１个月、３个月、６个月裸眼视力达到术前最佳矫正视力的比例分别为９３．７％（７４／７９）和８９．７％（７０／７８）、９２．４％（７３／７９）和８８．５％（６９／７８）、９１．１％（７２／７９）和８７．２％（７８／６８），差异均无统计学意义（均为Ｐ＞０．０５）；两组裸眼视力均无增加或减少两行及以上。两组的目标屈光度均为０，术后１个月等效球镜及残余散光差异均无统计学意义（均为Ｐ＞０．０５）；术后３个月、６个月等效球镜及残余散光差异均有统计学意义（均为Ｐ＜０．０５）。术后角膜地形图形态：术后两组地形图都以圆形及椭圆形最多，分别为７５．９％（６０／７９）、７１．８％（５６／７８），差异无统计学意义（Ｐ＞０．０５）。结论　ＳＭＩＬＥ及ＬＡＳＥＫ治疗近视散光均有安全性、有效性，术后角膜形态良好，但ＳＭＩＬＥ的稳定性及精确性优于ＬＡＳＥＫ，更值得临床应用。
Abstract:
Objective To observe the surgical results of myopia astignatism with small incision lenticule extraction ( SMILE) and laser-assisted subepithelial keratomileusis (LASEK). Methods A total of 157 eyes of 80 consecutive patients were enrolled in this retrospective study ,which included 95 eyes of 48 patients with moderate astigmatism and 66 eyes of 34 patients with high astigmatism,divided int0 2 groups depending on the operation method:SMILE group and LASEK group. 79 eyes of 40 cases underwent femtosecond laser SMILE. Intnded cap diameters was 7. I - 7. 2 mm,lenticule diameter was 6. 4 - 6. 6 mm.the thickness of cap was 120 run,the side cutting was 2 mm. 78 eyes of 40 cases underwent LASEK,20% alcohol solution soak for 20 seconds,preserved the flap of corneal epithelium. The results at I day,l week,l month,3 months and 6 months were observed. Postoperative best corrected visual acuity , spherical equivalent refraction ,postoperative uncorrected visual acuity ,corneal topogaphy were observed. Results The ratio of postoperative uncorrected visual acuity at I month .3 months and 6 months of operation reached the preoperative best corrected visual acuity in SMILE group and LASEK group were 93. 7% ( 74/79) and 89. 7% ( 70/78 ) , 92. 4% ( 73/79 ) and 88. 5% ( 69/78 ) , 91. 1% ( 72/79 ) and 87. 2% ( 78/68 ) , respectively , the difference was not statistically significant ( all P > 0. 05 ) . Compared with LASEK group, the difference of the equivalent refraction and residual astigmatism at month after operation in SMILE group was not statistically significant ( all P > 0. 05 ) . and the difference of the equivalent refraction and residual astigmatism at 3 months and 6 months after operation were statistically sigruficant ( all P < 0. 05 ) . The corneal topogaphy at 6 months after operation of two groups was mainly round and oval,respectively, the rate was 75. g% ( 60/79 ) .71. 8% ( 56/78 ) , the difference was not statistically significant (P > 0. 05) . Conclusion It is both safe .effective and accurate to correct myopia astigmatism with SMILE and LASEK, and the corneal morphology of SMILE is similar to LASEK.but SMILE is better stable to correct myopia astignatism than LASEK.

相似文献/References:

[1]李庆和,李岳美,侯红超,等.小切口基质内透镜取出术及飞秒激光LASIK治疗高度近视的临床对比研究[J].眼科新进展,2016,36(6):562.[doi:10.13389/j.cnki.rao.2016.0149]
　LI Qing-He,LI Yue-Mei,HOU Hong-Chao,et al.Clinical comparative study of small incision lenticule extraction and femtosecond laser-assisted LASIK for high myopia[J].Recent Advances in Ophthalmology,2016,36(10):562.[doi:10.13389/j.cnki.rao.2016.0149]
[2]胡雅斌,周跃华,张晶,等.全飞秒激光小切口角膜基质透镜取出术（SMILE）角膜帽与飞秒激光辅助的准分子激光角膜原位磨镶术（FS-LASIK）角膜瓣的对比[J].眼科新进展,2018,38(9):869.[doi:10.13389/j.cnki.rao.2018.0205]
　HU Ya-Bin,ZHOU Yue-Hua,ZHANG Jing,et al.Characteristics of caps created with SMILE versus flaps created with FS-LASIK[J].Recent Advances in Ophthalmology,2018,38(10):869.[doi:10.13389/j.cnki.rao.2018.0205]

更新日期/Last Update: 2016-10-25