Trans-PRK、FS-LASIK和SMILE矫正近视散光的对比观察

doi:10.6040/j.issn.1673-3770.0.2021.465

Abstract

Abstract: Objective This paper was aimed to investigate the clinical effect of Trans-PRK, conventional FS-LASIK, and SMILE for the correction of myopia and astigmatism. Methods In this retrospective study, we evaluated 54 eyes in the Trans-PRK group, 55 eyes in the FS-LASIK group, and 56 eyes in the SMILE group. ALL eyes follow-up period was 6 months. The visual acuity, diopters, and higher-order aberrations of the three groups were compared before and after surgery, and the safety and effectiveness of the three different methods were evaluated. Results (1)There was no significant difference in the preoperative baseline data among the three groups(P=0.148, 0.148, 0.31, 0.285, 0.283, 0.901). (2)There was also no significant difference in uncorrected visual acuity among the three groups at 1, 3, and 6 months after surgery(P=0.902). In the intra-group comparison, the UCVA at 6 months after surgery in the Trans-PRK group was higher than that at 1 month after surgery(χ2= 0.571, P=0.014). (3)The power of the cylinder among the three groups differed only at 1 month after the operation(χ2= 9.411, P=0.009). The degree of the cylinder in the FS-LASIK group was statistically significantly less than that in the SMILE group at 1-month post-operatively(χ2=24.400, P=0.004), while there was no significant difference among the three groups at 3 and 6 months after surgery(P=0.159, 0.106). (4)There was no significant difference in spherical equivalent among the three groups at 1, 3, and 6 months after the operation(P=0.132, 0.299, 0.643). (5)There was a significant difference in coma among the three groups at 1, 3, and 6 months post-operatively(χ2=20.939, 20.129, 19.208, all P<0.001), and the coma of the Trans-PRK group being statistically significantly less than that of the other two groups(P=0.008, 0.019, 0.034, <0.001, <0.001, <0.001). In the intra-group comparison, the coma of the Trans-PRK and FS-LASIK groups at 3 and 6 months after surgery were significantly higher than that before surgery(P=0.003, <0.001). The coma of the SMILE group at 1, 3, and 6 months postoperatively was significantly higher than that before surgery(all P<0.001). (6)There was a significant difference in spherical aberration difference among the three groups at 1, 3, and 6 months after surgery(χ2=47.363, 24.167, 22.913, all P<0.001). The spherical aberration at 1, 3, and 6 months after surgery was higher in the FS-LASIK group than in the Trans-PRK and SMILE groups(P<0.001, <0.001, 0.005, <0.001, 0.007, <0.001). In the intra-group comparison, the spherical aberration of the Trans-PRK group and FS-LASIK group at 1, 3, and 6 months after surgery was higher than that before surgery(all P<0.001). The spherical aberrations in smile group were higher than those before operation at 3 and 6 months after operation, and the difference was statistically significant(χ2=-1.726,-1.858, all P<0.001). The spherical aberration in the SMILE group was statistically significantly lower than that at 3 and 6 months after the operation, and the difference was statistically significant(χ2=-1.085,-1.217, all P<0.001). (7)There was a significant difference in higher-order aberrations among the three groups at 1, 3, and 6 months after surgery(χ2=14.267, 25.460, 13.210, and P=0.001, <0.001, 0.001, respectively). The total number of higher-order aberrations in the Trans-PRK group was lower than those in the FS-LASIK group at 1, 3, and 6 months after the operation(P=0.004, <0.001, 0.001). The total number of higher-order aberrations in the FS-LASIK group was greater than that in the SMILE group at 3 months post-operatively(P=0.009). The total number of higher-order aberrations in the SMILE group at 6 months was significantly higher than those before surgery(all P<0.001). (8)There was no significant difference in efficacy and safety among the three groups at 6 months after surgery(χ2=0.851, 0.893, and P=0.653, 0.640, respectively). Conclusion Trans-PRK, conventional FS-LASIK, and SMILE are safe and effective in correcting myopia astigmatism. Higher-order aberrations were introduced to varying degrees postoperatively. The coma in the Trans-PRK group was smaller than that in the conventional FS-LASIK and SMILE groups. The spherical aberration of the conventional FS-LASIK group was significantly higher than those of the Trans-PRK and SMILE groups. The total number of higher-order aberrations of the conventional FS-LASIK group was significantly higher than that in the Trans-PRK and SMILE groups.

Key words: Trans-PRK, FS-LASIK, SMILE, Diopter, Higher-order aberrations

CLC Number:

R771

ZHOU Qiliang, ZHOU Yuehua, ZHOU Chunyang, YU Jia, LI Chen. Comparative observation of Trans-PRK, FS-LASIK, and SMILE for myopia with astigmatism[J].Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(1): 85-93.

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Comparative observation of Trans-PRK, FS-LASIK, and SMILE for myopia with astigmatism

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