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[摘要]
目的:基于倾向性评分匹配分析全飞秒小切口角膜基质透镜取出术(SMILE)治疗高度近视的疗效。方法:选取2019-05/2021-05在本院行SMILE术的高度近视患者48例48眼作为观察组,以倾向性评分匹配法进行1:1匹配纳入行FS-LASIK术的高度近视患者48例48眼作为对照组。术后随访6mo,比较两组患者柱镜度、角膜中央厚度、裸眼视力(UCVA)、角膜内皮细胞相关指标[六边形内皮细胞百分比(6A)、内皮细胞面积的变异系数(CV)、中央角膜内皮细胞密度(ECD)]及角膜生物力学指标[模拟Goldmann眼压(IOPg)、角膜滞后量(CH)、角膜阻力因子(CRF)、角膜补偿眼压(IOPcc)]的变化,记录两组患者并发症发生情况。结果:与术前比较,两组患者术后3、6mo柱镜度和UCVA均显著改善,角膜中央厚度、角膜内皮细胞和角膜生物力学相关指标均降低,且观察组变化更为显著(均P<0.05)。随访期间,观察组和对照组并发症发生率无显著差异(8% vs 17%,P>0.05)。结论:SMILE术治疗高度近视疗效确切,有助于改善视力。
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[Abstract]
AIM: To analyze the effect of full-femtosecond small incision lenticule extraction(SMILE)on the treatment of high myopia based on propensity score matching.METHODS: A total of 48 cases(48 eyes)of high myopia patients who underwent SMILE surgery in our hospital from May 2019 to May 2021 were selected as the observation group, and 48 cases(48 eyes)of high myopia patients who underwent FS-LASIK surgery were matched using propensity score matching as the control group. Follow up for 6mo after surgery, the changes in cylindrical, central corneal thickness, uncorrected visual acuity(UCVA), corneal endothelial cell related indicators [percentage of hexagonal endothelial cells(6A), coefficient of variation(CV)of endothelial cell area, central corneal endothelial cell density(ECD)] and corneal biomechanical indicators [simulated Goldman intraocular pressure(IOPg), corneal hysteresis(CH), corneal resistance factor(CRF), corneal compensated intraocular pressure(IOPcc)] between the two groups were compared, and the incidence of complications in both groups of patients was recorded.RESULTS: Both groups of patients showed significant improvements in cylindrical and UCVA at 3 and 6mo after surgery, as well as decreased central corneal thickness, corneal endothelial cells, and corneal biomechanics related indicators. The changes in the observation group were more significant(all P<0.05). During the follow-up period, there was no significant difference in the incidence of complications between the observation group and the control group(8% vs. 17%, P>0.05).CONCLUSION: SMILE has a definite effect on patients with high myopia and is helpful to improve visual acuity.
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