目的：比较飞秒激光辅助的准分子激光原位角膜磨镶术(FS-LASIK)与FS-LASIK联合快速角膜胶原交联术(FS-LASIK Xtra)矫正高度近视术后早期屈光度及角膜高阶像差变化特点，评估两种术式矫正高度近视的早期效果。

方法：回顾性病例对照研究。纳入2019-04/2020-04在我院进行FS-LASIK Xtra及FS-LASIK的高度近视患者42例84眼，每组各21例42眼，术后随访3mo，比较两组患者术后裸眼视力(UCVA)、等效球镜(SE)、散光度及角膜高阶像差。

结果：FS-LASIK Xtra组患者术后1d UCVA(LogMAR)低于FS-LASIK组(P<0.01)，其余时间点两组间比较均无差异(P>0.05)。两组患者术后SE均较术前明显降低，术后3mo，FS-LASIK Xtra组有38眼(90%)、FS-LASIK组有41眼(98%)术眼SE在±1.00D以内。两组患者术后均有35眼(83%)的术眼残余散光在0.50D以内。两组术后3mo角膜总高阶像差、球差、彗差及三叶草差均较术前增大，FS-LASIK Xtra组总高阶像差及三叶草差大于FS-LASIK组(均P<0.05)。

结论：FS-LASIK与FS-LASIK Xtra矫正高度近视在术后早期均具有较好的有效性和可预测性，术后早期角膜总高阶像差均增加，且行FS-LASIK Xtra增加更显著。

AIM: To compare the change of refractive power and corneal high-order aberrations after femtosecond laser-assisted excimer laser in situ keratomileusis(FS-LASIK)and FS-LASIK combined with accelerated corneal cross-linking(FS-LASIK Xtra)for high myopia correction, and to evaluate the early effects of two surgical methods to correct high myopia.

METHODS:Retrospective case-control study. Totally 42 patients(84 eyes)with high myopia underwent FS-LASIK Xtra and FS-LASIK in our hospital from April 2019 to April 2020 were followed up for 3mo, including 21 patients in each group(42 eyes). The uncorrected visual acuity(UCVA), spherical equivalent(SE), astigmatism and corneal high-order aberration of the two groups were analyzed and compared.

RESULTS: The UCVA of the FS-LASIK Xtra group was significantly lower than that of the FS-LASIK group at 1d after surgery(P<0.01), there was no statistical difference in UCVA at the other time points after surgery between the two groups(P>0.05). The postoperative SE of the two groups was significantly lower than that before surgery, at 3mo after surgery, 38 eyes(90%)in the FS-LASIK Xtra group and 41 eyes(98%)in the FS-LASIK group had SE within ±1.00D. In both groups, 35 eyes(83%)had residual astigmatism within 0.50D after surgery. The total corneal high-order aberrations, spherical aberrations, coma and clover aberrations in the two groups were increased at 3mo after surgery, the total high-order aberration and clover aberration in the FS-LASIK Xtra group were greater than those in the FS-LASIK group(all P<0.05).

CONCLUSION:FS-LASIK and FS-LASIK Xtra have good effectiveness and predictability in correcting high myopia in the early postoperative period, the total high-order aberrations of the cornea both increased in the early postoperative period, and the patients who underwent FS-LASIK Xtra were increased significantly.

陕西省重点研发计划项目(No.2018SF-216); 陕西省自然科学基础研究计划——一般(面上)项目(No.2021JM-593)