山东大学耳鼻喉眼学报 ›› 2023, Vol. 37 ›› Issue (1): 85-93.doi: 10.6040/j.issn.1673-3770.0.2021.465
• 论著 • 上一篇
周其亮1,周跃华1,2,周春阳1,于嘉1,李辰1
ZHOU Qiliang1, ZHOU Yuehua1,2, ZHOU Chunyang1, YU Jia1, LI Chen1
摘要: 目的 探讨Trans-PRK、FS-LASIK和SMILE矫正近视散光的临床效果。 方法 选择Trans-PRK组54眼、FS-LASIK 组55眼和SMILE组 56眼进行回顾性病例研究,随访6个月,比较三组的术前术后各个时间点的视力、屈光度、高阶像差,评估三种不同术式的安全性、有效性。 结果 (1)三组术前基线数据差异无统计学意义(P=0.148, 0.148, 0.31, 0.285, 0.283, 0.901);(2)术后1、3、6个月三组之间的UCVA差异无统计学意义(P=0.902),组内比较时Trans-PRK组术后6个月视力高于术后1个月差异具有统计学意义(χ2=0.571,P=0.014);(3)三组间只有在术后1个月柱镜度数差异具有统计学意义(χ2=9.411,P=0.009),两两比较时FS-LASIK组柱镜度数小于SMILE组差异具有统计学意义(χ2=24.400,P=0.004),在术后3、6个月三组之间的柱镜度数差异无统计学意义(P=0.159, 0.106);(4)术后1、3、6个月三组之间的SE差异无统计学意义(P=0.132, 0.299, 0.643);(5)术后1、3、6个月三组间彗差差异具有统计学意义(χ2 =20.939,20.129,19.208,P均<0.001),Trans-PRK组小于FS-LASIK组及SMILE组差异具有统计学意义(P=0.008, 0.019, 0.034,<0.001,<0.001, <0.001),组内比较Trans-PRK组及FS-LASIK组术后3、6个月彗差高于术前差异具有统计学意义(P=0.003,<0.001),SMILE组术后1、3、6个月彗差高于术前差异具有统计学意义(P均<0.001);(6)术后1、3、6个月三组间球差差异具有统计学意义(χ2=47.363,24.167, 22.913, P均<0.001),FS-LAISK组在术后的1、3、6个月球差均高于Trans-PRK组与SMILE组差异具有统计学意义(P<0.001,<0.001,0.005,<0.001,0.007,<0.001),组内比较时Trans-PRK、组与FS-LASIK组术后1、3、6个月球差高于术前差异具有统计学意义(P均<0.001),SMILE组术后3、6个月球差高于术前差异具有统计学意义(χ2=-1.726,-1.858,P均<0.001),SMILE组术后1月球差低于术后3、6个月差异具有统计学意义(χ2=-1.085,-1.217,P均<0.001);(7)三组患者在术后1、3、6个月的高阶像差差异有统计学意义(χ2=14.267,25.460,13.210, P=0.001,<0.001,0.001),术后1、3、6个月Trans-PRK组总高阶像差低于FS-LASIK组差异具有统计学意义(P=0.004, <0.001,0.001),术后3个月FS-LASIK组总高阶像差大于SMILE组差异具有统计学意义(P=0.009),组内比较时,三组在术后1、3、6个月的总高阶像差高于术前有统计学意义(P均<0.001);(8)三组术后6个月有效性及安全性差异无统计学意义(χ2=0.851,0.893, P=0.653,0.640)。 结论 Trans-PRK、常规FS-LASIK、SMILE矫正近视散光都具有很好的安全性、有效性,术后均不同程度地引入了高阶像差,Trans-PRK组术后彗差小于常规FS-LASIK组及SMILE组,常规FS-LAIK组的球差明显高于Trans-PRK组与SMILE组,行常规FS-LAIK组的总高阶像差明显高于Trans-PRK组。
中图分类号:
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