目的：探讨低、中、高度近视患者飞秒激光小切口角膜基质透镜取出术(SMILE)后正常眼压(IOP)波动范围的变化，探索术后眼压(IOP_post)校正的新方法。

方法：前瞻性病例研究。纳入2018-03/2019-09在青岛大学附属医院接受SMILE治疗的近视患者79例158眼，分为低度近视(A)、中度近视(B)和高度近视(C)组。24h眼压采用非接触式眼压计(NCT)和Goldmann眼压计(GAT)测量。记录术前3d和术后6mo等效球差(SE)、中央角膜厚度(CCT)、角膜横径(WTW)、角膜曲率、角膜体积(CV)、中央3mm直径范围内角膜体积(CCV_3mm)与CV之比、切削CV(△CV)与CV的比值。统计分析术后NCT测量值(NCT_post)与各因素的相关性，并通过分阶段多元线性回归分析建立IOP_post表达模型。

结果：NCT和GAT测得的眼压无差异(P>0.05)，但3组眼压有差异(P<0.05)。NCT的IOP_post范围：A组为8～17mmHg，B组为7～16.3mmHg，C组为7.7～14.3mmHg。GAT的IOP_post范围为8～17mmHg。IOP_post的昼夜波动范围 <6mmHg。IOP_post双眼差值为0～4mmHg。建立分阶段多元回归模型：NCT_{post校正(A)}=0.349 × NCT_post + 4.137 × CCV_pre3mm -1.533； NCT_{post校正(B)}= 0.477 × NCT_post + 3.643 × CCV_post3mm -1.125； NCT_{post 校正(C)}= 0.638 × NCT_post + 3.426 × CCV_post3mm-0.716。

结论：SMILE术后NCT和GAT测得的眼压均低于术前。患者手术前后角膜体积变化率越大，术后眼压值越低。中央3mm直径范围内角膜体积是评价SMILE术后眼压的重要指标，从而指导术后用药。

AIM:To investigate changes in the normal intraocular pressure(IOP)fluctuation range after the small incision lenticule extraction(SMILE)in patients with low, moderate and high myopia and to explore new methods for postoperative IOP(IOP_post)correction.

METHODS: In this prospective case series study, 79 patients(158 eyes)who underwent SMILE at the Affiliated Hospital of Qingdao University from March 2018 to September 2019 were involved, and they were divided into low myopia(A), moderate myopia(B), and high myopia(C)groups. The 24-hour IOP was measured by the non-contact tonometer(NCT)and Goldmann applanation tonometer(GAT). Spherical equivalent(SE), central corneal thickness(CCT), the horizontal corneal diameter(WTW), corneal curvature, corneal volume(CV), ratio of the central 3-mm diameter CV(CCV_3mm)to the total CV, and the ratio of the cutting CV(ΔCV)to the CV were measured 3d preoperatively and 6mo postoperatively. The correlation between the postoperative NCT measurements(NCT_post)and various factors was statistically analysed, and the IOP_post expression model was established by phased multiple linear regression analysis.

RESULTS:The differences in IOP measured by NCT and GAT were not statistically significant(P>0.05), but the differences in IOP of the three groups were statistically significant(P<0.05). The IOP_post range by NCT were 8-17 mmHg in group A, 7-16.3 mmHg in group B, and 7.7-14.3 mmHg in group C. The IOP_post range by GAT were 8-17 mmHg. The IOP_post fluctuation was <6 mmHg. The IOP_post difference between the right eye and left eye was 0-4 mmHg. A staged multivariate regression model was established: NCT_{post corrected(A)}= 0.349 × NCT_post + 4.137 × CCV_pre3mm - 1.533; NCT_{post corrected(B)}= 0.477 × NCT_post + 3.643 × CCV_post3mm -1.125; NCT_{post corrected(C)}= 0.638 × NCT_post + 3.426 × CCV_post3mm -0.716.

CONCLUSION:The IOP measured by NCT and GAT after SMILE was lower than that measured before surgery. For different patients, the greater the rate of change in CV before and after surgery, the lower the IOP_post. CCV_post3mm is an important index for evaluating IOP after SMILE and thus guide postoperative medication administration.