不同程度近视患者行SMILE术后的有效光学区及角膜高阶像差比较

Comparison of effective optical zone and corneal high order aberration following small incision lenticule extraction for different degrees of myopia

摘要:

目的：比较低、中、高度近视患者行飞秒激光小切口基质透镜取出术(SMILE)后的有效光学区和角膜高阶像差。

方法：收集2019-02/2021-02在我院行SMILE手术的患者134例，均取右眼入组，按等效球镜度(SE)分为低度近视组SE>-3.00 D，中度近视组-6.00 D结果：SMILE术后1 mo，三组术后有效光学区均小于预设光学区，随着屈光度数增加，有效光学区越小(P<0.05)； 术后1 mo角膜总高阶像差、球差、彗差均高于术前，除低近视度组球差术前与术后1 mo无差异(P>0.05)，其余组别均有差异(P<0.05)； 角膜总高阶像差、球差和彗差随着屈光度数增加而增加，三组角膜总高阶像差和球差有差异(均P<0.05)，高度近视组与中度近视组、低度近视组彗差结果均有差异(P<0.05)，中度近视组与低度近视组彗差结果无差异(P>0.05)。

结论：随着手术矫正的屈光度数增加，术后有效光学区减少越多，角膜高阶像差增加越明显； SMILE术后1 mo角膜高阶像差较术前增加。

Abstract:

AIM: To compare the effective optical zone(EOZ)and corneal high order aberrations(HOAs)after small incision lenticule extraction(SMILE)among low, moderate, and high myopic patients.

METHODS:A total of 134 patients who had undergone SMILE at the Second People's Hospital of Foshan from February 2019 to February 2021 were recruited, with all right eyes enrolled. The patients were divided into low myopia group(SE >-3.00 D), moderate myopia group(-6.00 D< SE ≤-3.00 D), and high myopia group(SE ≤-6.00 D)according to the spherical equivalent(SE). The total HOA(tHOA), spherical aberration, coma, and EOZ were measured by Pentacam preoperatively and 1 mo postoperatively, and differences in tHOA, spherical aberration, coma, and EOZ among the three groups were analyzed.

RESULTS: EOZ was smaller than programmed EOZ in all groups at 1 mo after SMILE. With the increase in corrected refractive error, the EOZ decreased further(P<0.05); The tHOA, spherical aberration, and coma were significantly higher than their corresponding preoperative values in all groups at 1 mo after surgery, and there were statistical differences in the spherical aberration of all the groups at 1 mo after surgery(P<0.05), except for that of the mild myopia group(P>0.05). The tHOA, spherical aberration and coma increased with corrected refractive errors; the difference in tHOA and spherical aberration was statistically significant among the three groups(all P<0.05). Coma in the high myopia group was significantly greater than that in the moderate myopia group and the mild myopia group(P<0.05). In addition, the coma in the moderate myopia group and the mild myopia group was not statistically significant(P>0.05).

CONCLUSION: With the increase of the refractive power corrected by surgery, the postoperative EOZ reduced more after surgery, and the HOA of the cornea is increased; corneal HOA increases at 1 mo after SMILE.