目的：研究近视患者SMILE术后早期前房形态及相关参数的变化。
方法：抽取2018-12/2019-01在本院接受飞秒激光小切口角膜基质透镜取出术(SMILE)的近视患者39例74眼，分为中低度近视组(≤-6.00D)23例44眼、高度近视组(>-6.00D)16例30眼。观察两组患者术前，术后1d， 1wk， 1mo中央前房深度(ACD)、前房容积(ACV)、前房角(ACA)、角膜中央后表面高度(PCE)及调节幅度(AMP)的变化。
结果：中低度近视组术前和术后1d，1wk，1mo ACD分别为：3.18±0.21、3.10±0.21、3.11±0.21、3.12±0.2mm，ACV分别为：201.1±29.3、187.9±27.1、187±26.4、187.7±24.9mm3， AMP分别为：8.4±2.6、6.5±1.6、7±1.7、8.3±1.9D，PCE分别为：2.1±2.1、1±2.2、1.2±2.3、1.1±1.9μm； 高度近视组术前和术后1d，1wk，1mo ACD分别为：3.25±0.2、3.18±0.19、3.16±0.19、3.23±0.24mm， ACV分别为：204.1±31、194.5±27、194.5±28.6、196.5±31.7mm3， AMP分别为：8.9±2、6.8±1.9、7.9±1.4、8.9±1.5D，PCE分别为：2.4±2.7、1.4±2.7、1.1±2.8、1.4±2.9μm， ACA分别为：42.4°±3.1°、42.3°±3.6°、42.1°±4.6°、40.7°±4.5°。采用Pearson相关性进行分析，两组患者术后ACD与ACA、ACV均呈正相关性(均P<0.01)。其中中低度近视组ACD与AMP呈正相关性(r=0.301，P<0.01)，与PCE呈较弱的正相关性(r=0.161，P<0.05)； 高度近视组ACD与AMP、PCE则无相关性(r=0.069、0.103，均P>0.05)。
结论：屈光度不同患者SMILE术后早期前房形态变化不相同，SMILE术后早期ACD的变化与角膜后表面高度和术后调节力的改变有关。
AIM: To study the changes of anterior chamber morphology and related parameters in patients with myopia after small incision lenticule extraction(SMILE).
METHODS: A total of 39 patients with myopia(74 eyes)who underwent SMILE surgery in our hospital during December 2018 to January 2019 were selected. They were divided into two groups: 23 patients(44 eyes)in low and medium myopia group(≤-6.00D)and 16 patients(30 eyes)in the high myopia group(>-6.00D). Changes of central anterior chamber depth(ACD), anterior chamber volume(ACV), anterior chamber angle(ACA), posterior central elevation(PCE), and accommodation amplitude(AMP)were observed in the two groups before the surgery and 1d, 1wk, and 1mo after surgery. The related data were statistically analyzed, and the changes before and after the surgery were compared. The causes of the morphological changes of the anterior chamber in the early stage after the SMILE were discussed.
RESULTS: The ACD before and 1d, 1wk, 1mo after surgery were 3.18±0.21, 3.10±0.21, 3.11±0.21 and 3.12±0.2mm, respectively, the ACV were 201.1±29.3, 187.9±27.1, 187±26.4 and 187.7±24.9mm3, respectively, the AMP were 8.4±2.6, 6.5±1.6, 7±1.7 and 8.3±1.9D, respectively, the ACD in the high myopia group before and 1d, 1wk, 1mo after surgery were 3.25±0.2, 3.18±0.19, 3.16±0.19 and 3.23±0.24mm, respectively, the ACV were 204.1±31mm3, 194.5±27mm3, 194.5±28.6mm3 and 196.5±31.7mm3, respectively, the AMP were 8.9±2D, 6.8±1.9D, 7.9±1.4D and 8.9±1.5D, respectively, the PCE 2.4±2.7μm, 1.4±2.7μm, 1.1±2.8μm and 1.4±2.9μm, respectively, the ACA were 42.40°±3.1°, 42.30°±3.6°, 42.10°±4.6°and 40.70°±4.5°, respectively. Pearson correlation analysis showed that postoperative ACD was positively correlated with ACA and ACV in both groups(P<0.01). ACD in the low myopia group was positively correlated with AMP(r=0.301, P<0.01), but weakly with PCE(r=0.161,P<0.05). ACD was not correlated with AMP and PCE in the high myopia group(r=0.069, 0.103, P>0.05).
CONCLUSION: In the early stage after SMILE, the diopter is different and the morphology of the anterior chamber is different. We believe that the change of ACD in the early stage after SMILE is related to changes of the corneal posterior elevation and postoperative accommodation.
