SMILE和FS-LASIK术后24h内视力变化
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摘要
目的:观察飞秒激光小切口角膜基质透镜取出术(SMILE)和飞秒激光制瓣的准分子激光原位角膜磨镶术(FSLASIK)治疗近视术后24h内视力变化情况。方法:回顾性分析2017-08/2018-03于我院行角膜屈光手术的近视患者80例160眼,根据手术方式不同分为两组,其中SMILE组40例80眼接受SMILE手术,FS-LASIK组40例80眼接受FS-LASIK手术。观察两组患者术后24h内裸眼视力情况,手术前后眼压和角膜内皮细胞情况,术中及术后并发症情况。结果:两组患者手术过程均顺利完成。SMILE组与FSLASIK组患者术后2、4、6、8、12、24h裸眼视力呈逐渐改善趋势。术后2、4、6、8、12、24h,FS-LASIK组患者裸眼视力均优于SMILE组,差异均有统计学意义(P <0. 05)。SMILE组患者裸眼视力在术后12、24h最优,FS-LASIK组患者裸眼视力在术后6、24h最优。术后24h,两组患者眼压均低于术前,角膜内皮细胞密度、变异系数均较术前显著下降,角膜内皮细胞面积、六角形细胞比例均较术前显著升高,差异均具有统计学意义(P<0. 01),但两组患者之间眼压和角膜内皮细胞相关指标比较,差异均无统计学意义(P>0. 05)。两组术中及术后均未发生严重并发症。结论:SMILE和FS-LASIK术后24h内视力均发生较大变化,术后均能获得良好的视力。
AIM: To observe the visual acuity changes within 24 h after femtosecond laser small incision lenticule extraction( SMILE) and femtosecond laser in situ keratomileusis( FS-LASIK) for myopia.METHODS: A retrospective analysis was made of 80 myopic patients( 160 eyes) who underwent corneal refractive surgery in our hospital from August 2017 to March 2018. They were divided into two groups according to different surgical methods,40 cases( 80 eyes) in SMILE group and 40 cases( 80 eyes) in FS-LASIK group.The visual acuity,intraocular pressure,corneal endothelial cells,intraoperative and postoperative complications were observed within 24 h.RESULTS: The operation was successfully completed in both groups. The uncorrected visual acuity( UCVA) of SMILE group and FS-LASIK group improved gradually at 2,4,6,8,12 and 24 h after operation. At 2,4,6,8,12,24 h after operation,the UCVA of FS-LASIK group was better than that of SMILE group,and the difference was statistically significant( P < 0. 05). The UCVA of SMILE group was the best 12 and 24 h after operation,and that of FS-LASIK group was the best 6 and 24 h after operation. The results of intragroup comparison before and after operation showed that the intraocular pressure( IOP) of the two groups was lower than that before operation, the density of corneal endothelial cells, the coefficient of variation were significantly decreased, the area of corneal endothelial cells and the proportion of hexagonal cells were significantly increased; the difference was statistically significant( P< 0. 01). The results of comparison between groups after operation showed that there was no significant difference in intraocular pressure and corneal endothelial cell related indexes between the two groups( P > 0. 05). No serious complications occurred during and after operation in both groups.CONCLUSION: Within 24 h after SMILE and FS-LASIK,the visual acuity changed greatly,and good visual acuity was obtained.
AIM: To observe the visual acuity changes within 24 h after femtosecond laser small incision lenticule extraction( SMILE) and femtosecond laser in situ keratomileusis( FS-LASIK) for myopia.METHODS: A retrospective analysis was made of 80 myopic patients( 160 eyes) who underwent corneal refractive surgery in our hospital from August 2017 to March 2018. They were divided into two groups according to different surgical methods,40 cases( 80 eyes) in SMILE group and 40 cases( 80 eyes) in FS-LASIK group.The visual acuity,intraocular pressure,corneal endothelial cells,intraoperative and postoperative complications were observed within 24 h.RESULTS: The operation was successfully completed in both groups. The uncorrected visual acuity( UCVA) of SMILE group and FS-LASIK group improved gradually at 2,4,6,8,12 and 24 h after operation. At 2,4,6,8,12,24 h after operation,the UCVA of FS-LASIK group was better than that of SMILE group,and the difference was statistically significant( P < 0. 05). The UCVA of SMILE group was the best 12 and 24 h after operation,and that of FS-LASIK group was the best 6 and 24 h after operation. The results of intragroup comparison before and after operation showed that the intraocular pressure( IOP) of the two groups was lower than that before operation, the density of corneal endothelial cells, the coefficient of variation were significantly decreased, the area of corneal endothelial cells and the proportion of hexagonal cells were significantly increased; the difference was statistically significant( P< 0. 01). The results of comparison between groups after operation showed that there was no significant difference in intraocular pressure and corneal endothelial cell related indexes between the two groups( P > 0. 05). No serious complications occurred during and after operation in both groups.CONCLUSION: Within 24 h after SMILE and FS-LASIK,the visual acuity changed greatly,and good visual acuity was obtained.
引文
1陈跃国.应重视准分子激光角膜屈光手术对角膜生物力学结构完整性的影响.中华眼科杂志2011;47(7):577-579
2霍银平,周利晓,齐若.准分子激光角膜屈光手术术前检查临床分析.中国老年学杂志2013;33(18):4552-4553
3 Sekundo W,Kunert KS,Blum M.Small incision corneal refractive surgery using the small incision lenticule extraction(SMILE)procedure for the correction of myopia and myopic astigmatism:results of a 6 month prospective study.Br J Ophthalmol 2011;95(3):335-339
4刘淑娟,侯杰,张乐乐,等.SMILE手术矫治中高度近视术后角膜上皮重塑及其与屈光度的关系.眼科新进展2017;37(11):1060-1063
5董子献,何丽,孙周延,等.飞秒激光小切口角膜基质透镜取出术后兔角膜组织学观察.中华眼科杂志2016;52(7):507-513
6许多,阚秋霞,张国伟,等.SMILE矫正中度和高度近视散光6个月疗效分析.眼科2014;23(5):295-300
7 Shah R,Shah S,Sengupta S.Results of small incision lenticule extraction:All-in-one femtosecond laser refractive surgery.J Cataract Refract Surg 2011;37(1):127-137
8王雁,鲍锡柳,汤欣,等.飞秒激光角膜微小切口基质透镜取出术矫正近视及近视散光的早期临床研究.中华眼科杂志2013;49(4):292-298
9王雁,武志清,汤欣,等.飞秒激光2.0mm微切口角膜基质透镜取出术屈光矫正效果的临床初步研究.中华眼科杂志2014;50(9):671-680
10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.眼科新进展2016;36(6):562-565
11邢星,李世洋,赵爱红,等.飞秒激光小切口角膜基质透镜取出术与准分子激光原位角膜磨镶术治疗近视对角膜内皮细胞密度影响的比较.眼科新进展2016;36(3):247-249
12武志清,王雁,张琳,等.飞秒激光小切口角膜基质内透镜取出术与飞秒激光LASIK术后高阶像差改变的对比研究.中华眼科杂志2015;51(3):193-201
13梅波,张卉卉,段丽,等.2.0mm小切口飞秒激光角膜基质透镜取出术与飞秒激光辅助的LASIK矫正近视的疗效比较.眼科新进展2016;36(12):1133-1137
14 Riau AK,Angunawela RI,Chaurasia SS,et al.Early corneal wound healing and inflammatory responses after refractive lenticule extraction(ReLEx).Invest Ophthalmol Vis Sci 2011;52(9):6213-6221
15李美燕.准分子激光角膜原位磨镶术和飞秒激光小切口透镜取出术术后的泪液功能障碍.中华实验眼科杂志2016;34(9):847-850
16危平辉,王雁,李华,等.飞秒激光小切口角膜基质透镜取出术光学区大小对角膜生物力学特性影响的研究.中华眼科杂志2017;53(3):182-187
2霍银平,周利晓,齐若.准分子激光角膜屈光手术术前检查临床分析.中国老年学杂志2013;33(18):4552-4553
3 Sekundo W,Kunert KS,Blum M.Small incision corneal refractive surgery using the small incision lenticule extraction(SMILE)procedure for the correction of myopia and myopic astigmatism:results of a 6 month prospective study.Br J Ophthalmol 2011;95(3):335-339
4刘淑娟,侯杰,张乐乐,等.SMILE手术矫治中高度近视术后角膜上皮重塑及其与屈光度的关系.眼科新进展2017;37(11):1060-1063
5董子献,何丽,孙周延,等.飞秒激光小切口角膜基质透镜取出术后兔角膜组织学观察.中华眼科杂志2016;52(7):507-513
6许多,阚秋霞,张国伟,等.SMILE矫正中度和高度近视散光6个月疗效分析.眼科2014;23(5):295-300
7 Shah R,Shah S,Sengupta S.Results of small incision lenticule extraction:All-in-one femtosecond laser refractive surgery.J Cataract Refract Surg 2011;37(1):127-137
8王雁,鲍锡柳,汤欣,等.飞秒激光角膜微小切口基质透镜取出术矫正近视及近视散光的早期临床研究.中华眼科杂志2013;49(4):292-298
9王雁,武志清,汤欣,等.飞秒激光2.0mm微切口角膜基质透镜取出术屈光矫正效果的临床初步研究.中华眼科杂志2014;50(9):671-680
10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.眼科新进展2016;36(6):562-565
11邢星,李世洋,赵爱红,等.飞秒激光小切口角膜基质透镜取出术与准分子激光原位角膜磨镶术治疗近视对角膜内皮细胞密度影响的比较.眼科新进展2016;36(3):247-249
12武志清,王雁,张琳,等.飞秒激光小切口角膜基质内透镜取出术与飞秒激光LASIK术后高阶像差改变的对比研究.中华眼科杂志2015;51(3):193-201
13梅波,张卉卉,段丽,等.2.0mm小切口飞秒激光角膜基质透镜取出术与飞秒激光辅助的LASIK矫正近视的疗效比较.眼科新进展2016;36(12):1133-1137
14 Riau AK,Angunawela RI,Chaurasia SS,et al.Early corneal wound healing and inflammatory responses after refractive lenticule extraction(ReLEx).Invest Ophthalmol Vis Sci 2011;52(9):6213-6221
15李美燕.准分子激光角膜原位磨镶术和飞秒激光小切口透镜取出术术后的泪液功能障碍.中华实验眼科杂志2016;34(9):847-850
16危平辉,王雁,李华,等.飞秒激光小切口角膜基质透镜取出术光学区大小对角膜生物力学特性影响的研究.中华眼科杂志2017;53(3):182-187