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Abstract：
OBJECTIVE: To study the changes and effect factors of posterior corneal surface after small incision lenticule extraction (SMILE) with different myopic diopters.
METHODS: Ninety eyes of 90 patients who underwent SMILE were included in this retrospective study. Patients were allocated into three groups based on the preoperative spherical equivalent (SE): low myopia (SE≥-3.00 D), moderate myopia (-3.00 D>SE>-6.00 D) and high myopia (SE≤-6.00 D). Posterior corneal surfaces were measured by a Scheimpflug camera preoperatively and different postoperative times (1wk, 1, 3, 6mo, and 1y). Posterior mean elevation (PME) at 25 predetermined points of 3 concentric circles (2-, 4-, and 6-mm diameter) above the best fit sphere was analyzed.
RESULTS: All surgeries were completed uneventfully and no ectasia was found through the observation. The difference of myopia group was significant at the 2-mm ring at 1 and 3mo postoperatively (1mo: P=0.017; 3mo: P=0.018). The effect of time on ΔPME was statistically significant (2-mm ring: P=0.001; 4-mm ring: P<0.001; 6-mm ring: P<0.001). The effect of different corneal locations on ΔPME was significant except 1wk postoperatively (1mo: P=0.000; 3mo: P=0.000; 6mo: P=0.001; 1y: P=0.001). Posterior corneal stability was linearly correlated with SE, central corneal thickness, ablation depth, residual bed thickness, percent ablation depth and percent stromal bed thickness.
CONCLUSIONS: The posterior corneal surface changes dynamically after SMILE. No protrusion is observed on the posterior corneal surface in patients with different degrees of myopia within one year after surgery. SMILE has good stability, accuracy, safety and predictability.
METHODS: Ninety eyes of 90 patients who underwent SMILE were included in this retrospective study. Patients were allocated into three groups based on the preoperative spherical equivalent (SE): low myopia (SE≥-3.00 D), moderate myopia (-3.00 D>SE>-6.00 D) and high myopia (SE≤-6.00 D). Posterior corneal surfaces were measured by a Scheimpflug camera preoperatively and different postoperative times (1wk, 1, 3, 6mo, and 1y). Posterior mean elevation (PME) at 25 predetermined points of 3 concentric circles (2-, 4-, and 6-mm diameter) above the best fit sphere was analyzed.
RESULTS: All surgeries were completed uneventfully and no ectasia was found through the observation. The difference of myopia group was significant at the 2-mm ring at 1 and 3mo postoperatively (1mo: P=0.017; 3mo: P=0.018). The effect of time on ΔPME was statistically significant (2-mm ring: P=0.001; 4-mm ring: P<0.001; 6-mm ring: P<0.001). The effect of different corneal locations on ΔPME was significant except 1wk postoperatively (1mo: P=0.000; 3mo: P=0.000; 6mo: P=0.001; 1y: P=0.001). Posterior corneal stability was linearly correlated with SE, central corneal thickness, ablation depth, residual bed thickness, percent ablation depth and percent stromal bed thickness.
CONCLUSIONS: The posterior corneal surface changes dynamically after SMILE. No protrusion is observed on the posterior corneal surface in patients with different degrees of myopia within one year after surgery. SMILE has good stability, accuracy, safety and predictability.
摘要：
目的：研究不同近视屈光度的小切口微透镜摘除（SMILE）后角膜后表面的变化及其影响因素。
方法：这项回顾性研究包括90例接受SMILE治疗的患者的90只眼。根据术前等效球形（SE）将患者分为三组：低近视（SE≥-3.00D），中度近视（-3.00D>SE>-6.00D）和高度近视（SE≤-6.00D）。术前和术后不同时间通过Scheimpflug相机测量角膜后表面（1wk，1，3，6个月，和1y）。3个同心圆（2-，4-,和6毫米直径）在最佳拟合球体上方进行了分析。
结果：所有手术均顺利完成，观察未发现扩张。近视组术后1和3mo在2-mm环处差异有统计学意义（1mo：P=0.017；3mo：P=0.018）。时间对ΔPME的影响具有统计学意义(2mm环:P=0.001;4mm环:P<0.001;6mm环:P<0.001)。除术后1wk外，不同角膜位置对ΔPME的影响显着（1mo：P=0.000；3mo：P=0.000；6mo：P=0.001；1y：P=0.001）。后角膜稳定性与SE呈线性相关,中央角膜厚度,烧蚀深度,剩余床层厚度,消融深度百分比和基质床厚度百分比。
结论：SMILE后角膜后表面动态变化。不同程度近视患者术后1年内角膜后表面未见前凸。微笑具有良好的稳定性，准确度,安全性和可预测性。
方法：这项回顾性研究包括90例接受SMILE治疗的患者的90只眼。根据术前等效球形（SE）将患者分为三组：低近视（SE≥-3.00D），中度近视（-3.00D>SE>-6.00D）和高度近视（SE≤-6.00D）。术前和术后不同时间通过Scheimpflug相机测量角膜后表面（1wk，1，3，6个月，和1y）。3个同心圆（2-，4-,和6毫米直径）在最佳拟合球体上方进行了分析。
结果：所有手术均顺利完成，观察未发现扩张。近视组术后1和3mo在2-mm环处差异有统计学意义（1mo：P=0.017；3mo：P=0.018）。时间对ΔPME的影响具有统计学意义(2mm环:P=0.001;4mm环:P<0.001;6mm环:P<0.001)。除术后1wk外，不同角膜位置对ΔPME的影响显着（1mo：P=0.000；3mo：P=0.000；6mo：P=0.001；1y：P=0.001）。后角膜稳定性与SE呈线性相关,中央角膜厚度,烧蚀深度,剩余床层厚度,消融深度百分比和基质床厚度百分比。
结论：SMILE后角膜后表面动态变化。不同程度近视患者术后1年内角膜后表面未见前凸。微笑具有良好的稳定性，准确度,安全性和可预测性。
