■为了检查使用小切口微透镜提取(SMILE)治疗近视期间导致高阶像差(HOA)的原因和因素,以及通过系统评价和荟萃分析SMILE与其他角膜屈光手术之间的差异。
■从2015年1月至2023年2月在Pubmed进行了系统搜索,Embase,WebofScience,和谷歌学者数据库,以收集有关SMILE和HOA的相关研究。选择了符合特定标准的研究,并检索临床数据进行分析.
■这项荟萃分析纳入了19项研究,涉及1,503只眼。汇总结果显示显著诱导总HOA(THOA,d=-0.21,p<0.001),球面像差(SA,d=-0.11,p<0.001)和慧差(CA,d=-0.18,p<0.001)在微笑后与微笑前相比,而三叶像差(TA)没有观察到显着变化(d=-0.00,p=0.91)。与飞秒激光辅助原位角膜磨镶术(FS-LASIK,d=0.04,p<0.001),与波前像差引导(WFG)屈光手术相比,没有观察到显着差异(d=0.00,p=0.75)。不同程度的近视和散光之间也有显著的关联,随访时间,透镜厚度,术前中央角膜厚度(CCT)对SMILE后诱导tHOA的影响(p<0.05),而术前近视较高组(球体>-5D),术前散光较低组(圆柱体≤-1D),较大的微透镜厚度组(微透镜厚度>100μm),较短的随访组(术后1个月随访)和较厚的CCT组(CCT>550μm)与对照组相比有显著的tHOA诱导(p<0.001)。
■虽然微笑可以显著诱导HOA,它比FS-LASIK诱导更少的HOA。术后微笑后的HOA可受到近视等因素的影响,散光,透镜厚度,CCT,和随访时间。未来的研究应继续探索使用该方法减少HOA诱导的技术。
■https://www.crd.约克。AC.英国/普华永道/。
UNASSIGNED: To examine the causes and factors that lead to high order aberration (HOA) during the treatment of myopia using small incision lenticule extraction (SMILE), as well as the differences between SMILE and other corneal refractive surgeries through a systematic review and meta-analysis.
UNASSIGNED: A systematic search was conducted from January 2015 to February 2023 in Pubmed, Embase, Web of Science, and Google Scholar databases to gather relevant studies on SMILE and HOA. Studies meeting specific criteria were chosen, and clinical data was retrieved for analysis.
UNASSIGNED: This meta-analysis resulted in the inclusion of 19 studies involving 1,503 eyes. Pooled results showed significant induction of total HOA (tHOA, d = -0.21, p < 0.001), spherical aberration (SA, d = -0.11, p < 0.001) and coma aberration (CA, d = -0.18, p < 0.001) after SMILE compared to pre-SMILE, while no significant change in trefoil aberration (TA) was observed (d = -0.00, p = 0.91). There was a significantly lower induction of tHOA after SMILE compared to femtosecond laser-assisted in situ keratomileusis (FS-LASIK, d = 0.04, p < 0.001), and no significant difference was observed compared to wavefront aberration-guided (WFG) refractive surgery (d = 0.00, p = 0.75). There was also a significant association between different levels of myopia and astigmatism, duration of follow-up, lenticule thickness, and preoperative central corneal thickness (CCT) on the induction of tHOA after SMILE (p < 0.05), while the higher preoperative myopia group (sphere > -5D), lower preoperative astigmatism group (cylinder ≤ -1D), larger lenticule thickness group (lenticule thickness > 100 μm), shorter follow-up group (follow-up 1 month postoperatively) and the thicker CCT group (CCT > 550 μm) brought a significant induction of tHOA compared to the opposite comparison group (p < 0.001).
UNASSIGNED: While SMILE can induce HOA significantly, it induces less HOA than FS-LASIK. Postoperative HOA following SMILE can be affected by factors such as myopia, astigmatism, lenticule thickness, CCT, and duration of follow-up. Future research should continue to explore techniques to decrease the induction of HOA by using this methodology.
UNASSIGNED: https://www.crd.york.ac.uk/prospero/.