目的：比较智能脉冲技术(SPT)辅助的1 050Hz切削频率经上皮准分子激光角膜切削术(TransPRK)与飞秒激光小切口角膜基质透镜取出术(SMILE)矫正近视和散光的视觉质量。方法：纳入2020-07/2021-01在成都中医药大学附属眼科医院接受角膜屈光手术的138例248眼患者，按术式分为TransPRK组(64例123眼)和SMILE组(74例125眼)。术后随访6mo，记录LogMAR视力，使用Sirius眼前节综合分析仪测量术前和术后不同时间点6mm瞳孔直径下斯特列尔比值(SR)和高阶像差。结果：与SMILE组相比，术后1wk，1mo，TransPRK组UCVA更差(均P<0.05)； 术后6mo，TransPRK组UCVA更优(P<0.05)。术后1wk，1mo，TransPRK组SR值比SMILE组低(均P<0.05)； 术后3、6mo，两组间SR值无显著差异(P=0.968、0.433)。术后1wk，两组间彗差无显著差异(P=0.554)； 术后1、3、6mo，TransPRK组彗差比SMILE组更低(均P<0.05)。术后1wk，1、3mo，TransPRK组三叶草像差比SMILE组更高(均P<0.05)； 术后6mo，两组间三叶草像差无显著差异(P=0.167)。术后6mo，TransPRK组和SMILE组UCVA分别为-0.13±0.05、-0.11±0.08，均优于各组术前的BCVA(-0.07±0.05、-0.07±0.05)(均P<0.05)； 且各组SR值较术前更高(均P<0.05)。结论：SPT辅助的1 050Hz切削频率TransPRK与SMILE矫正近视和散光术后均可获得较好的视力，SMILE术后1wk，1mo的视觉质量更好，但SPT辅助的1 050Hz切削频率TransPRK术后6mo的视力优于SMILE，且角膜彗差更小。

AIM: To compare the visual quality between smart pulse technology-assisted(SPT)transepithelial photorefractive keratectomy(TransPRK)of 1 050Hz ablation frequency and small incision lenticule extraction(SMILE)for myopia and astigmatism.METHODS: A total of 138 cases(248 eyes)who received corneal refractive surgery in the Eye Hospital of Chengdu University of TCM were enrolled from July 2020 to January 2021. The patients were divided into TransPRK group(64 cases, 123 eyes)and SMILE group(74 cases, 125 eyes)according to the surgical method. The follow-up duration was 6mo. Strehl ratio(SR)and high-order aberration at 6mm pupil diameter measured by Sirius anterior segment integrated analyzer and LogMAR visual acuity were recorded at different preoperative and postoperative time points.RESULTS: The uncorrected visual acuity(UCVA)of TransPRK group was worse than SMILE group at 1wk and 1mo after surgery(all P<0.05), but UCVA was better in TransPRK group at 6mo after surgery(P<0.05). SR in TransPRK group was lower than that in SMILE group at 1wk and 1mo after surgery(all P<0.05). There was no significant difference in SR between the two groups at 3 and 6mo after surgery(P=0.968, 0.433). At 1wk after surgery, there was no significant difference in coma between the two groups(P=0.554). At 1, 3, and 6mo after surgery, coma in the TransPRK group was lower than that in SMILE group(all P<0.05). At 1wk, 1 and 3mo after surgery, the trefoil aberration in TransPRK group was higher than that in SMILE group(all P<0.05). At 6mo after surgery, there was no significant difference in trefoil aberration between the two groups(P=0.167). At 6mo after surgery, UCVA of TransPRK group and SMILE group were -0.13±0.05 and -0.11±0.08, respectively, which were better than the best corrected visual acuity(BCVA)before surgery(-0.07±0.05 and -0.07±0.05; all P<0.05). Furthermore, the SR of both groups was higher than that before surgery(all P<0.05).CONCLUSION: Both SPT-assisted TransPRK of 1 050Hz ablation frequency and SMILE can achieve better visual acuity after refractive surgery, while SMILE has better visual quality at 1wk and 1mo after surgery. However, SPT-assisted TransPRK of 1 050Hz ablation frequency has better visual acuity at 6mo after surgery than SMILE, and the coma is smaller.

四川省中医药管理局科研项目(No.2021MS296)