摘要
目的探究屈光不正患者小切口飞秒激光角膜基质透镜切除术(small incision lenticule extraction,SMILE)及飞秒激光角膜基质透镜切除术(femtosecond laser lenticule extraction,FLEx)治疗后组织去除厚度对角膜生物力学影响的对比研究。方法选取因屈光不正需行屈光性透镜切除术的患者240例。按照手术方法,分为观察组和对照组,观察组采用SMILE术式,对照组采用FLEx术式。术后观察2组患者视力变化、不同区域角膜高度变化以及角膜生物力学指标的变化情况。结果2组患者术后1 d、1周、1个月以及1年UDVA、BCVA变化差异显著(P<0.01),且不同手术与时间具有交互作用(P<0.01),但各时间点组间比较差异无统计学意义(P>0.05);术后3个月,对照组与观察组测得角膜各区域高度均有改变,顶点处与2 mm环处的改变量无明显差异,但4 mm环与6 mm环处,2组的改变量差异无统计学意义(P<0.05)。2组患者术后1周、1个月、3个月△CH、△CRF变化差异有统计学意义(P<0.01),且不同手术与时间具有交互作用(P<0.01),但2组各时间点比较差异无统计学意义(P>0.05)。结论SMILE与FLEx术后患者视力均能获得较好改善。但就角膜的生物力学变化情况而言,SMILE对角膜生物力学的影响更小,术后角膜的生物力学稳定性更好。
Objective To investigate the effects of tissue removal thickness on corneal biomechanics after small incision femtosecond laser corneal stromal lens extraction(SMILE)and femtosecond laser corneal stromal lens extraction(FLEx)in ametropic patients.Methods A total of 240 cases of refractive lensectomy due to refractive errors.According to the operation method,the patients were divided into observation group and control group.The observation group was treated with SMILE,while the control group was treated with FLEx.The changes of visual acuity,corneal height and corneal biomechanical parameters were observed after operation.Results There were significant differences in UDVA and BCVA between two groups at 1 day,1 week,1 month,and 1 year(P<0.01),and interactions between different operations and time(P<0.01).However,there was no difference between the groups at each time point(P>0.05);after 3 months,the control group and the observation group measured the cornea.The height of each region was changed,and there was no significant difference between the apex and the 2 mm ring.However,the difference between two groups was significant at 4 mm and 6 mm rings(P<0.05).There were significant differences in△CH and△CRF between two groups at 1 week,1 month,and 3 months after operation(P<0.01),and interactions between different operations and time(P<0.01),but two groups.There was no difference at the time point(P>0.05).Conclusion The visual acuity of patients after SMILE and FLEx can be improved.However,in terms of corneal biomechanical changes,SMILE has less impact on corneal biomechanics,and corneal biomechanical stability is better after surgery.
作者
吕鹏
白宁艳
徐浩
陈玉红
陈桌倩
LYU Peng;BAI Ning-yan;XU Hao;CHEN Yu-hong;CHEN Zhuo-qian(Department of Ophthalmology, People′s Hospital of Southwest Guizhou, Guizhou Province, Xingyi City, Guizhou 562400, China)
出处
《河北医科大学学报》
CAS
2020年第10期1172-1175,1199,共5页
Journal of Hebei Medical University
