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Abstract：
BACKGROUND: To evaluate the influence of preoperative optical zone on myopic correction in small incision lenticule extraction.
METHODS: In this retrospective clinical study, 581 eyes from 316 patients underwent SMILE were selected, including 117 eyes in the small optical zone group (range from 6.0 to 6.4 mm) and 464 eyes in the large optical zone group (range from 6.5 to 6.8 mm). The measurements included uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), spherical, and cylinder were measured preoperatively and 3 months postoperatively. Propensity score match (PSM) analysis was performed with age, gender, eye (right/left), keratometry and preoperative spherical equivalent between two different groups. The influence of optical zones on postoperative refractive outcomes were evaluated using univariate regression analysis.
RESULTS: In total, 78 pairs of eyes were selected by PSM (match ratio 1:1). There were no differences in the age, gender, eye (right/left), keratometry or preoperative spherical equivalent between the small and large optical zone groups. However, the difference of postoperative spherical equivalent was significantly between groups. Patients with larger optical zones had a trend towards less undercorrection (P = 0.018). Univariate linear regression model analysis found that each millimeter larger optical zone resulted in 8.13% or 0.39D less undercorrection (P < 0.001). The dependency between the optical zones and postoperative spherical equivalent was significant in the higher preoperative myopia group (r = 0.281, P < 0.001), but not significant in the lower myopia group (r = 0.028, P = 0.702).
CONCLUSIONS: The diameter of optical zones would affect postoperative refractive outcomes in small incision lenticule extraction. This study indicated that larger optical zones induced less undercorrection, especially in patients with high myopia.
METHODS: In this retrospective clinical study, 581 eyes from 316 patients underwent SMILE were selected, including 117 eyes in the small optical zone group (range from 6.0 to 6.4 mm) and 464 eyes in the large optical zone group (range from 6.5 to 6.8 mm). The measurements included uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), spherical, and cylinder were measured preoperatively and 3 months postoperatively. Propensity score match (PSM) analysis was performed with age, gender, eye (right/left), keratometry and preoperative spherical equivalent between two different groups. The influence of optical zones on postoperative refractive outcomes were evaluated using univariate regression analysis.
RESULTS: In total, 78 pairs of eyes were selected by PSM (match ratio 1:1). There were no differences in the age, gender, eye (right/left), keratometry or preoperative spherical equivalent between the small and large optical zone groups. However, the difference of postoperative spherical equivalent was significantly between groups. Patients with larger optical zones had a trend towards less undercorrection (P = 0.018). Univariate linear regression model analysis found that each millimeter larger optical zone resulted in 8.13% or 0.39D less undercorrection (P < 0.001). The dependency between the optical zones and postoperative spherical equivalent was significant in the higher preoperative myopia group (r = 0.281, P < 0.001), but not significant in the lower myopia group (r = 0.028, P = 0.702).
CONCLUSIONS: The diameter of optical zones would affect postoperative refractive outcomes in small incision lenticule extraction. This study indicated that larger optical zones induced less undercorrection, especially in patients with high myopia.
摘要：
背景：评估术前光学区对小切口微透镜摘出术中近视矫正的影响。
方法：在这项回顾性临床研究中，从316例接受SMILE的患者中选择581只眼，包括在小光学区组（范围从6.0到6.4毫米）中的117只眼和在大光学区组（范围从6.5到6.8毫米）中的464只眼。测量包括未校正的远距视力（UDVA），矫正视力（CDVA），球形,术前和术后3个月测量圆柱体。倾向评分匹配（PSM）分析与年龄，性别,眼睛（右/左），两个不同组之间的角膜曲率测量和术前球形等效。使用单变量回归分析评估光学区对术后屈光结果的影响。
结果：总计，通过PSM(匹配比1:1)选择78对眼睛。年龄没有差异，性别,眼睛（右/左），小光学区组和大光学区组之间的角膜曲率测量或术前球面等效。然而,术后球面当量组间差异显著。具有较大光学区的患者具有矫正不足的趋势（P=0.018）。单变量线性回归模型分析发现，每毫米大的光学区导致8.13％或0.39D的欠校正较少（P<0.001）。术前近视程度较高组的光学区与术后等效球度之间的依赖性显着（r=0.281，P<0.001），但在低近视组中不显著(r=0.028,P=0.702)。
结论：光学区的直径会影响小切口微透镜摘除术后的屈光效果。这项研究表明，较大的光学区引起较少的欠校正，尤其是高度近视患者。
方法：在这项回顾性临床研究中，从316例接受SMILE的患者中选择581只眼，包括在小光学区组（范围从6.0到6.4毫米）中的117只眼和在大光学区组（范围从6.5到6.8毫米）中的464只眼。测量包括未校正的远距视力（UDVA），矫正视力（CDVA），球形,术前和术后3个月测量圆柱体。倾向评分匹配（PSM）分析与年龄，性别,眼睛（右/左），两个不同组之间的角膜曲率测量和术前球形等效。使用单变量回归分析评估光学区对术后屈光结果的影响。
结果：总计，通过PSM(匹配比1:1)选择78对眼睛。年龄没有差异，性别,眼睛（右/左），小光学区组和大光学区组之间的角膜曲率测量或术前球面等效。然而,术后球面当量组间差异显著。具有较大光学区的患者具有矫正不足的趋势（P=0.018）。单变量线性回归模型分析发现，每毫米大的光学区导致8.13％或0.39D的欠校正较少（P<0.001）。术前近视程度较高组的光学区与术后等效球度之间的依赖性显着（r=0.281，P<0.001），但在低近视组中不显著(r=0.028,P=0.702)。
结论：光学区的直径会影响小切口微透镜摘除术后的屈光效果。这项研究表明，较大的光学区引起较少的欠校正，尤其是高度近视患者。
