目的:探讨小切口微透镜摘除(SMILE)后高阶像差(HOA)与近视和散光严重程度的相关性,以及相关因素。这些发现将为减少微笑后HOA的发生和提高视觉质量提供有价值的见解。
方法:根据近视和散光的严重程度,将75例(150只眼)近视和散光患者分为四组:近视组1(M1组,球面屈光度范围为-1.00D至-4.00D),近视组2(M2组,球面屈光度范围为-4.10D至-10.00D),第1组散光(A1组,圆柱屈光度范围为0D至-1.00D),和散光组2(A2组,圆柱屈光度范围为-1.10D至-3.00D)。进行了全面评估,以检查HOA与各种相关因素之间的关联,包括对子组的详细分析。
结果:M1组的全眼昏迷像差(CA)水平明显降低,角膜总HOA(THOA),内部THOA,且垂直CA(Z3-1)后SMILE组优于M2组(P<0.05)。同样,A1组的总眼tHOA水平明显降低,CA,三叶像差(TA),角膜THOA,TA,且垂直TA(Z3-3)后SMILE优于A2组(P<0.05)。Pearson相关分析显示近视/散光严重程度与大部分HOA呈正相关(P<0.05)。亚组评估显示,与对照组相比,M2和A2组术后与近视和散光相关的HOA明显增加。透镜厚度,术后中央角膜厚度(CCT),术后未矫正视力(UDVA),术后角膜Km和Cyl与大多数HOA密切相关。年龄,眼睛,术后眼压(IOP)仅与特异性HOA相关。
结论:HOA与SMILE术后近视和散光的严重程度呈正相关。然而,这种关系不是线性的。微笑后的HOA受到各种因素的影响,需要额外的专门研究来确定其临床重要性。
OBJECTIVE: To investigate the correlation between higher-order aberrations (HOA) after small incision lenticule extraction (SMILE) and the severity of myopia and
astigmatism, along with the relevant factors. These findings will provide valuable insights for decreasing the occurrence of HOA after SMILE and enhancing visual quality.
METHODS: A total of 75 patients (150 eyes) with myopia and
astigmatism who underwent SMILE were categorized into four groups based on the severity of myopia and
astigmatism: Myopia Group 1 (Group M1, spherical diopter ranged from -1.00 D to -4.00 D), Myopia Group 2 (Group M2, spherical diopter ranged from -4.10 D to -10.00 D), Astigmatism Group 1 (Group A1, cylindrical diopter ranged from 0 D to -1.00 D), and
Astigmatism Group 2 (Group A2, cylindrical diopter ranged from -1.10 D to -3.00 D). A comprehensive assessment was performed to examine the association between HOA and various relevant factors, including a detailed analysis of the subgroups.
RESULTS: Group M1 had significantly lower levels of total eye coma aberration (CA), corneal total HOA (tHOA), internal tHOA, and vertical CA ( Z 3 - 1 ) after SMILE than Group M2 (P < 0.05). Similarly, Group A1 had significantly lower levels of total eye tHOA, CA, trefoil aberration (TA), corneal tHOA, TA, and vertical TA ( Z 3 - 3 ) after SMILE than Group A2 (P < 0.05). Pearson correlation analysis indicated a statistically significant positive relationship between the severity of myopia/astigmatism and most HOA (P < 0.05). Subgroup evaluations demonstrated a notable increase in postoperative HOA associated with myopia and astigmatism in Groups M2 and A2 compared with the control group. Lenticule thickness, postoperative central corneal thickness (CCT), postoperative uncorrected distance visual acuity (UDVA), and postoperative corneal Km and Cyl were strongly correlated with most HOA. Age, eyes, and postoperative intraocular pressure (IOP) were only associated with specific HOA.
CONCLUSIONS: HOA positively correlated with the severity of myopia and
astigmatism after SMILE. However, this relationship was not linear. HOA after SMILE was influenced by various factors, and additional specialized investigations are required to establish its clinical importance.