目的：比较SMILE手术与V4c ICL植入术治疗高度近视患者术后的客观视觉质量。

方法：前瞻性对照研究。选取于我院行SMILE手术38例76眼及V4c ICL植入术32例64眼的高度近视患者，并按手术方式分为SMILE手术组及V4c ICL植入术组。术前，术后1wk，1、3、6mo时分别测量所有术眼的屈光度、裸眼视力(UCVA)和最佳矫正视力(BCVA)，同时使用双通道客观视觉质量分析系统(OQAS Ⅱ)获得术眼的客观散射指数(OSI)值、斯特列尔比(SR)和调制传递函数(MTF)截止频率。

结果：在术后所有随访点，SMILE手术组和V4c ICL植入术组的等效球镜(SE)、UCVA和BCVA均无差异。术后1wk，1mo时，两组患者术后OSI值与术前相比均升高(P<0.01)，术后3、6mo时两组OSI值恢复至术前水平且组间无差异。术后1wk两组患者MTF截止频率与术前相比下降(P<0.01)，至术后1mo时恢复至术前水平且所有时间点组间均无差异(P>0.05)。

结论：SMILE手术及V4c ICL植入术均能获得很好的术后视力及理想的客观视觉质量。

METHODS: This was a prospective control study. Thirty-eight patients underwent SMILE and thirty-two patients underwent V4c ICL implantation with high myopia were chosen for this study. Uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA)and refractive situation were evaluated preoperatively, at 1wk, 1mo, 3mo and 6mo postoperatively. The objective scattering index(OSI), strehl rate(SR)and modulation transfer function(MTF)cut off frequency were measured by the double-pass optical quality system at the same time.

RESULTS: No significant difference of spherical equivalent(SE), UCVA and BCVA was found between SMILE group and V4c ICL implantation group at all time points. At 1wk and 1mo after operation, the OSI values of two groups were significantly higher than pre-operation(P<0.01). OSI values of two groups returned to baseline at 3mo after operation. The MTF cut off frequency of both groups decreased significantly at 1wk after operation(P<0.05)and recovered to baseline at 1mo after operation, no significant difference was found between two group at all time points(P>0.05).

CONCLUSION: Both SMILE and V4c ICL implantation can obtain good visual acuity and objective optical quality.