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1、478.中華眼視光學與視覺科學雜志2014年8月第16卷第8期ChinJOptomOphthalmolVisSci'Augu!0l,Vo1.16INo·論著·SMILE與飛秒激光制瓣LASIK矯正近視的療效對比李凱王育良張傳偉吳靜黃海燕【摘要】目的對比和評價SMILE和飛秒激光制瓣的LASIK(FS—LASIK)矯正近視的效果。方法前瞻性對照研究。71例患者(142眼)分為2組:SMILE組36例和FS.LASIK組35例。術(shù)前及術(shù)后1d、7d、1個月、3個月、6個月分別檢查記錄2組患者的UCVA和屈光度,并用Zywave波前像差儀檢查總高階像差、球差、三階垂直彗差、三階水
2、平彗差。對數(shù)據(jù)進行卡方檢驗和獨立樣本t檢驗。結(jié)果術(shù)后ldFS.LASIK組UCVA較SMILE組好.術(shù)后7d、1個月時2組UCVA相近,術(shù)后3個月后,SMILE組顯示出較FS.LASIK組更好的UCVA.術(shù)后不同時間點2組UCVA≥術(shù)前BCVA的比例差異均無統(tǒng)計學意義:術(shù)后7d和6個月時2組等效球鏡度差異均無統(tǒng)計學意義(t=O.56、0.41,P>0.05);2組術(shù)后早期總高階像差均較術(shù)前明顯增加,術(shù)后3個月有所下降,術(shù)后6個月SMILE組低于FS—LASIK組;2組術(shù)后1d、7d、1個月、3個月球差均較術(shù)前明顯增加,術(shù)后6個月有所下降,但仍高于術(shù)前水平;術(shù)后2組垂直彗差均
3、較術(shù)前增加,術(shù)后3個月開始有所下降,術(shù)后6個月時接近于術(shù)前;術(shù)后各時間點2組水平彗差較術(shù)前均明顯增加。術(shù)后不同時間點2組總高階像差、球差、垂直彗差、水平彗差相比較差異均無統(tǒng)計學意義。結(jié)論SMILE和FS.LASIK矯正近視安全、有效,術(shù)后均有較好的視力矯正效果;2種手術(shù)都會造成總高階像差、球差、彗差的增加?!娟P(guān)鍵詞】飛秒激光;飛秒激光小切口基質(zhì)透鏡取出術(shù);角膜磨鑲術(shù),激光原位;近視;波前像差ComparisonofSMILEsurgeryandfemtosecondlaserLASIKformyopiaLiKai,Wangyuliang,ZhangChuauwei,Wuri
4、ng,Huanghaiyan.DepartmentofOphthalmology,theAffiliatedHospitalofNanjingUniversityofTraditionalChineseMedicine,Nanjing210029,ChinaCorrespondingauthor:Wangyuliang,Email:wyl0601@126.com【Abstract】ObjectiveTocompareandevaluatethepostoperativeoutcomesofsmallincisionlenticuleextraction(SMILE)andl
5、aserinsitukeratomileusiswithfemtosecondlaser(FS-LASIK)formyopia.MethodsThirty—sixpatients(72eyes)withmyopiawereselectedforsmallincisionlenticuleextraction(SMILEgroup)andanother35patients(70eyes)wereselectedforlaserinsitukeratomileusiswithfemtosecondlaser(FS—LASIKgroup).Uncorrectedvisualacu
6、ity(UCVA),bestcorrectedvisualacuity(BCVA),sphericalequivalent(SE)andwavefrontaberationweremeasuredpreoperativelyandat1dayand7daysand1month,3monthsand6monthspostoperatively.Totalhigherorderaberrations(HOAs),horizontalandverticalcomas,andsphericalaberationswererecordedwiththeZywavesystem.Dat
7、awereanalyzedusingachisquaretestandindependentsamplesttest.ResultsTheUCVAintheFS—LASIKgroupwasbetterthantheUCVAfortheSMILEgroupatpostoperative1day.The2groupshadsimilarUCVAsat7daysand1monthpostoperatively.TheUCVAintheSMILEgroupwasbetterthanUCVAfortheFS—LASIKgro