飞秒激光小切口基质透镜取出术后早期视力恢复的相关因素分析

doi:10.6040/j.issn.1673-3770.0.2017.298

摘要/Abstract

摘要： 目的探讨飞秒激光小切口角膜基质透镜取出术(SMILE)术后早期视力恢复的相关因素,以期为SMILE手术方案提供临床依据。方法回顾性分析2016年1月至2016年8月行SMILE手术的64例近视及近视散光患者共128只眼的临床资料,记录术后1 d、术后1周的裸眼视力(UCVA)。术后视力与年龄、性别、术前预矫等效球镜度(SE)、K值、中央角膜厚度(CCT)、术后残余基质床厚度(RST)、切削比(AD/CT)之间进行相关分析。结果术后1 d 30.4%眼裸眼视力达到0.8以上,10.2%眼裸眼视力达到1.0以上,约5.5%的眼裸眼视力达到术前最佳矫正视力(BCVA);术后1周90.6%裸眼视力达到0.8以上,64.1%达到1.0以上,约33.6%的眼裸眼视力达到术前BCVA。术后第1天、第7天视力与年龄、性别、K值、CCT、屈光度、RST、AD/CT之间均无明显相关性。结论 SMILE术后早期视力恢复可能与术后早期角膜的炎性及创伤愈合反应及术后角膜微结构的变化有关。

关键词: 小切口基质透镜取出术, 近视, 飞秒激光

Abstract: Objective To investigate the visual acuity improvement and related factors in myopic patients after small incision lenticule extraction(SMILE), in order to provide clinical data for standardization of SMILE surgery. Methods This retrospective clinical study included a total of 64 myopic patients(128 eyes)between January 2016 and August 2016. All patients underwent standard SMILE surgery performed by a single experienced surgeon. Visual acuity was assessed 1 day and 1 week after surgery. Correlations among postoperative uncorrected visual acuity(UCVA)and preoperative factors such as age, gender, preoperative equivalent sphere(SE), keratometry, central corneal thickness(CCT), as well as postoperative factors such as residual stromal bed thickness(RST)and ablation depth/corneal thickness ratio(AD/CT)were statistically analyzed. Results On postoperative day 1, 30.4% of eyes achieved a UCVA of 0.8 or better and 10.2% eyes achieved a UCVA of 1.0 or better. Additionally, 5.5% of the eyes achieved preoperative best corrected visual acuity(BCVA). At 1 week postoperatively, 90.6% of the eyes achieved a UCVA of 0.8 or better and 64.1% of the eyes achieved a UCVA of 1.0 or better. Additionally, 33.6% of the eyes achieved preoperative BCVA. No significant correlations were observed among the preoperative and postoperative visual acuity and age, gender, keratometry, CCT, SE, RST, and AD/CT. Conclusion Recovery of early visual acuity may be correlated with corneal wound healing and inflammatory responses, and changes in the corneal microstructure may be another factor responsible for slower visual recovery following SMILE.

Key words: Small incision lenticule extraction, Femtosecond laser, Myopia

中图分类号:

R772.2

宋森,李莹,丁欣,金玉梅. 飞秒激光小切口基质透镜取出术后早期视力恢复的相关因素分析[J]. 山东大学耳鼻喉眼学报, 2018, 32(4): 77-79.

SONG Sen, LI Ying, DING Xin, JIN Yumei. Early visual acuity recovery and related factors in myopic patients after small incision lenticule extraction[J]. J Otolaryngol Ophthalmol Shandong Univ, 2018, 32(4): 77-79.

参考文献

[1] 瞿佳,王雁,张丰菊,等. 我国飞秒激光小切口角膜基质透镜取出手术规范专家共识(2016年)[J]. 中华眼科杂志,2016,52(1):15-21.
[2] Shah R, Shah S, Senqupta S. Results of small incision lenticule extraction: All-in-one femtosecond laser refractive surgery[J]. J Cataract Refrat Surg, 2011, 37(1):127-137.
[3] Liu M, Chen Y, Wang D, et al. Clinical outcomes after SMILE and femtosecond laser-assisted lasik for myopia and myopic astigmatism: a prospective randomized comparative study[J]. Cornea, 2016, 35(2):210-216.
[4] Ganesh S, Gupta R. Comparison of visual and refractive outcomes following femtosecond laser-assisted lasik with smile in patients with myopia or myopic astigmatism[J]. J Refract Surg, 2014, 30(9):590-596.
[5] Agca A, Ozgurhan EB, Yildirim Y, et al. Corneal backscatter analysis by in vivo confocal microscopy: fellow eye comparison of small incision lenticule extraction and femtosecond laser-assisted LASIK[J]. J Ophthalmol, 2014:265012. DOI: 10.1155/2014/265012.
[6] Brenner LF, Alió JL, Vega-Estrada A, et al. Clinical grading of post-LASIK ectasia related to visual limitation and predictive factors for vision loss[J]. J Cataract Refract Surg, 2012, 38(10):1817-1826.
[7] 唐平, 王康宏, 陈梨萍. 近视患者飞秒制瓣准分子激光术后视力改善情况及相关影响因素分析[J]. 实用医学杂志, 2014, 30(16):2626-2628. TANG Ping, WANG Kanghong, CHEN Liping. Analysis of visual acuity improvement and related factors for myopia patients after Femtosecond flap excimer laser surgery[J]. J Practical Med, 2014, 30(16):2626-2628.
[8] Liu YC, Teo EP, Lwin NC, et al. Early corneal wound healing and inflammatory responses after SMILE: comparison of the effects of different refractive corrections and surgical experiences[J]. J Refract Surg, 2016, 32(5):346-353.
[9] Zhang L, Wang Y, Yang X. Ablation depth and its effects on corneal biomechanical changes in laser in situ keratomileusis and epipolis laser in situ keratomileusis[J]. Int Ophthalmol, 2014, 34(2):157-164.
[10] Shetty R, Shroff R, Kaweri L, et al. Intra-operative cap repositioning in small incision lenticule extraction(SMILE)for enhanced visual recovery[J]. Curr Eye Res, 2016, 41(12):1532-1538.
[11] Luo J, Yao P, Li M, et al. Quantitative analysis of microdistortions in bowmans layer using optical coherence tomography after SMILE among different myopic corrections[J]. J Refract Surg, 2015, 31(2):104-109.

相关文章 15

[1]	朱希倩,王佳,孙祖贤,冯建秀,张梦佳,赵颖,王宏,姜敏敏. 上海市杨浦区2022—2024年6~9岁学龄儿童屈光状态分析[J]. 山东大学耳鼻喉眼学报, 2026, 40(3): 102-109.
[2]	孙凡敏,张娟美,高杰,赵军. 近视中Shh、PI3K/AKT、MMP-2通路及关联性研究进展[J]. 山东大学耳鼻喉眼学报, 2026, 40(1): 142-148.
[3]	陈涛,姜洋,李莹. SMILE矫正PRK术后屈光回退1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2025, 39(6): 148-153.
[4]	杜一帆,齐林嵩,李莹. 飞秒激光小切口角膜基质透镜取出术对眼高阶像差影响的研究进展[J]. 山东大学耳鼻喉眼学报, 2025, 39(1): 152-161.
[5]	张莉苑,郭颖卓,陈蛟,王华,钟定娟. 650 nm低能量红光联合角膜塑形镜控制近视的临床效果[J]. 山东大学耳鼻喉眼学报, 2024, 38(5): 52-57.
[6]	王东芳,张清雨,宋继科,毕宏生. 基于CONSORT声明和STRICTA清单评价针刺防控儿童青少年近视随机对照试验的报告质量[J]. 山东大学耳鼻喉眼学报, 2024, 38(5): 66-79.
[7]	张金木,郭滨,蒋文君,刘冬梅. M受体信号通路在近视发生发展中作用的研究进展[J]. 山东大学耳鼻喉眼学报, 2024, 38(5): 160-164.
[8]	张莉苑,钟定娟,王华. 非手术的近视管理方法与脉络膜的研究进展[J]. 山东大学耳鼻喉眼学报, 2024, 38(4): 149-153.
[9]	李飏,刘鸫,曹文捷. 红光治疗对近视儿童等效球镜度、眼轴长度及脉络膜厚度影响的Meta分析[J]. 山东大学耳鼻喉眼学报, 2024, 38(3): 74-81.
[10]	卢松,夏逸帆,李子晔,魏菁. 无视网膜脱离的儿童Stickler综合征1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2024, 38(3): 97-101.
[11]	胡亚柔,赵欣予,吴桢泉,范梓欣,余震,刘亚玲,陈婷毅,曾键,张国明. 早产儿屈光状态与眼部生物特征的研究进展[J]. 山东大学耳鼻喉眼学报, 2024, 38(3): 144-150.
[12]	吴丽丽,曲毅. OCTA在病理性近视脉络膜新生血管应用及其在人工智能的研究进展[J]. 山东大学耳鼻喉眼学报, 2024, 38(2): 144-149.
[13]	买尔哈巴·玉素甫,克里木江·阿不拉,丁琳,秦艳莉,陈雪艺. 伴发于后巩膜葡萄肿的高度近视性白内障眼底病变相关研究[J]. 山东大学耳鼻喉眼学报, 2023, 37(5): 107-114.
[14]	尤冉,郭笑霄,王薇,陈曦,王艳玲. 高度近视患者黄斑区视网膜劈裂分型与脉络膜特征分析[J]. 山东大学耳鼻喉眼学报, 2023, 37(3): 83-87.
[15]	孟博,王康,罗丽华,王艳玲,李爽. 基于WOS数据库的高度近视黄斑裂孔性视网膜脱离研究特征及趋势分析[J]. 山东大学耳鼻喉眼学报, 2023, 37(2): 84-90.

多维度评价

Viewed

Full text

Abstract

Cited

Shared

Discussed