目的：探讨飞秒激光小切口角膜基质透镜取出术(SMILE)术后角膜上皮厚度的变化及其与切削深度、等效球镜度、有效光区的关系。

方法：选择2017-08/11我院行SMILE手术的近视或近视合并散光患者61例61眼，分别于术前、术后1wk，1、6mo做频域眼前节相干光断层扫描(RTvue-OCT)，对患者的角膜上皮厚度测量，研究手术前后角膜不同部位上皮厚度的变化及其与切削深度、等效球镜度、有效光区的相关性。

结果：术前三个区域(角膜中央区、旁中央区、周边区)的角膜上皮厚度均无差异(P>0.05)； 与术前基础值比较，术后1wk，1、6mo该三个区域的角膜上皮厚度均增厚(P<0.05)。三个区域角膜上皮厚度变化值从角膜中央区到周边区呈现递减的趋势，即角膜上皮增厚的形态呈凸透镜的形态。中央区和旁中央区角膜上皮的增厚和等效球镜度、切削深度呈正相关，但与有效光区无明显相关性。

结论：SMILE术后角膜不同区域上皮厚度均增加，增厚值与治疗的等效球镜度、切削深度呈正相关。

METHODS: Sixty-one myopic patients with or without astigmatism who underwent SMILE in our hospital from August 2017 to November 2017 were selected. RTvue-OCT was performed before surgery, 1wk, 1mo and 6mo after surgery, respectively, and the corneal epithelial thickness of patients were measured. The changes of corneal epithelial thickness following small incision lenticule extraction(SMILE), and its relationship with the ablation depth, spherical equivalent and optical zone were studied.

RESULTS: There was no statistically significant difference in the thickness of corneal epithelium among the three regions(central corneal region, para-central corneal region and peripheral region)before surgery(P>0.05). Compared with the baseline values before surgery, the thickness of corneal epithelium in the three areas was significantly thickened 1wk, 1mo and 6mo after surgery(P<0.05). The changes of corneal epithelium thickness in the three areas showed a significant decreasing trend from the central corneal area to the peripheral area, that is, the corneal epithelium thickened in the shape of a convex lens. The values of corneal epithelium thickness in the central and para-central areas were positively correlated with the equivalent sphericity and ablation depth, but there was no significant correlation with the optical zone.

CONCLUSION: The corneal epithelial thickness increases after SMILE in different regions, and the thickening value was positively correlated with the spherical equivalent, ablation depth.