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Abstract：
BACKGROUND: To evaluate the possible topographic and surgical risk factors for high postoperative residual astigmatism in patients who undergo small-incision lenticule extraction (SMILE) surgery and have different myopia degrees.
METHODS: A retrospective cohort study was conducted, and patients who underwent SMILE surgery were enrolled. A total of 80 and 150 eyes from 40 to 75 individuals, respectively, were selected as the low myopia and high myopia groups. The demographic data, visual acuity, refraction, topographic parameters and surgical settings were recorded. Multiple linear regression with interaction tests were performed to survey the risk factors for high postoperative residual astigmatism in each group.
RESULTS: Five (6.25%) and 9 (6.00%) eyes presented with high postoperative residual astigmatism in the low myopia and high myopia groups, respectively, but these differences were not significant (P = 0.569). A steep corneal curvature was correlated with a greater risk of high postoperative residual astigmatism in the low myopia group (P = 0.015), while a higher degree of cycloplegic cylinder power, steeper corneal curvature, greater topographic cylinder power, smaller optic zone and longer incision length were associated with a high rate of postoperative residual astigmatism in the high myopia group (all P < 0.05). In addition, the interaction effects of cycloplegic and topographic cylinder power and longer incision length on the incidence of high postoperative residual astigmatism development were more evident in the high myopia group than in the low myopia group (all P < 0.05).
CONCLUSIONS: A steep corneal curvature correlates with a high risk of high postoperative residual astigmatism after SMILE surgery, and a higher degree of cycloplegic and topographic cylinder and longer incision are associated with high postoperative residual astigmatism in individuals with high myopia.
METHODS: A retrospective cohort study was conducted, and patients who underwent SMILE surgery were enrolled. A total of 80 and 150 eyes from 40 to 75 individuals, respectively, were selected as the low myopia and high myopia groups. The demographic data, visual acuity, refraction, topographic parameters and surgical settings were recorded. Multiple linear regression with interaction tests were performed to survey the risk factors for high postoperative residual astigmatism in each group.
RESULTS: Five (6.25%) and 9 (6.00%) eyes presented with high postoperative residual astigmatism in the low myopia and high myopia groups, respectively, but these differences were not significant (P = 0.569). A steep corneal curvature was correlated with a greater risk of high postoperative residual astigmatism in the low myopia group (P = 0.015), while a higher degree of cycloplegic cylinder power, steeper corneal curvature, greater topographic cylinder power, smaller optic zone and longer incision length were associated with a high rate of postoperative residual astigmatism in the high myopia group (all P < 0.05). In addition, the interaction effects of cycloplegic and topographic cylinder power and longer incision length on the incidence of high postoperative residual astigmatism development were more evident in the high myopia group than in the low myopia group (all P < 0.05).
CONCLUSIONS: A steep corneal curvature correlates with a high risk of high postoperative residual astigmatism after SMILE surgery, and a higher degree of cycloplegic and topographic cylinder and longer incision are associated with high postoperative residual astigmatism in individuals with high myopia.
摘要：
背景：评估接受小切口微透镜摘除（SMILE）手术并有不同程度近视的患者术后高残余散光的可能地形和手术危险因素。
方法：进行了一项回顾性队列研究，纳入接受SMILE手术的患者。共有80眼和150眼40～75人，分别,分别选择低近视和高近视组。人口统计数据，视敏度,折射,记录地形参数和手术设置.采用多重线性回归和交互作用检验对各组术后高残余散光的危险因素进行调查。
结果：在低近视和高度近视组中，5只（6.25%）和9只（6.00%）眼表现出术后高残余散光，分别,但差异无统计学意义(P=0.569)。在低近视组中，陡峭的角膜曲率与较高的术后残余散光风险相关(P=0.015)。而睫状肌麻痹的圆柱体功率更高，更陡的角膜曲率，更大的地形气缸功率，较小的视区和较长的切口长度与高度近视组术后残余散光的发生率相关(均P<0.05)。此外,与低近视组相比，高度近视组的睫状肌麻痹和地形圆柱体屈光度以及较长的切口长度对术后高残余散光发生率的交互作用更为明显（均P<0.05）。
结论：陡峭的角膜曲率与SMILE术后高残余散光的高风险相关，高度近视患者的睫状肌麻痹和地形图柱体程度较高，切口较长与术后残余散光高相关。
方法：进行了一项回顾性队列研究，纳入接受SMILE手术的患者。共有80眼和150眼40～75人，分别,分别选择低近视和高近视组。人口统计数据，视敏度,折射,记录地形参数和手术设置.采用多重线性回归和交互作用检验对各组术后高残余散光的危险因素进行调查。
结果：在低近视和高度近视组中，5只（6.25%）和9只（6.00%）眼表现出术后高残余散光，分别,但差异无统计学意义(P=0.569)。在低近视组中，陡峭的角膜曲率与较高的术后残余散光风险相关(P=0.015)。而睫状肌麻痹的圆柱体功率更高，更陡的角膜曲率，更大的地形气缸功率，较小的视区和较长的切口长度与高度近视组术后残余散光的发生率相关(均P<0.05)。此外,与低近视组相比，高度近视组的睫状肌麻痹和地形圆柱体屈光度以及较长的切口长度对术后高残余散光发生率的交互作用更为明显（均P<0.05）。
结论：陡峭的角膜曲率与SMILE术后高残余散光的高风险相关，高度近视患者的睫状肌麻痹和地形图柱体程度较高，切口较长与术后残余散光高相关。
