背景:本研究旨在评估小切口微透镜摘除(SMILE)手术后不同切口位置对散光和视觉质量的短期影响。
方法:这项前瞻性研究招募了决定使用SMILE矫正近视的患者。将患者随机分为三组不同切口位置(A组,B,C,切口位置90°,120°,和分别为150°)。术前术后视力,球形当量,测量并比较各组间的高阶像差(HOAs)。使用基于Alpins方法的ASSORT组分析计算器分析了散光。
结果:共148只眼进行分析(A组48只眼,B组50只眼,C组50只眼)。术后1个月,A组的平均未矫正视力(UDVA)logMAR,B,C分别为-0.03、-0.03和-0.04。A组平均矫正视力(CDVA)logMAR,B,C分别为-0.03、-0.04和-0.04(P>0.05)。A组术后平均球面当量(SE)值分别为-0.01±0.38,-0.07±0.39,-0.16±0.49(D),B,C,分别为(P>0.05)。不同组患者术前、术后散光程度差异无统计学意义(P>0.05)。术后1天(P=0.02)和1周(P=0.02)三组间散光轴分布差异有统计学意义。然而,术后1个月,差异无统计学意义(P>0.05).术后1个月不同组间HOAs差异无统计学意义(P>0.05)。
结论:不同切口位置对SMILE术后1个月散光和视觉质量无影响,尽管术后1周内散光轴的分布存在差异。
BACKGROUND: This study aimed to evaluate the short-term impact of different incision positions on astigmatism and visual quality after small incision lenticule extraction (SMILE) surgery.
METHODS: This prospective study enrolled patients who decided to have SMILE to correct myopia. Patients were randomly allocated into three groups of different incision positions (group A, B, and C with incision position at 90°, 120°, and 150° respectively). Preoperative and postoperative visual acuity, spherical equivalent, and high-order aberrations (HOAs) were measured and compared among groups. Astigmatism was analyzed with the ASSORT Group Analysis Calculator based on the Alpins method.
RESULTS: A total of 148 eyes were included for analysis (48 eyes in group A, 50 eyes in group B, and 50 eyes in group C). At 1 month postoperatively, the mean uncorrected distance visual acuity (UDVA) logMAR in group A, B, and C was - 0.03, - 0.03, and - 0.04, respectively. The mean corrected distance visual acuity (CDVA) logMAR in group A, B, and C was - 0.03, - 0.04, and - 0.04, respectively (P > 0.05). The mean postoperative spherical equivalent (SE) values were - 0.01 ± 0.38, - 0.07 ± 0.39, and - 0.16 ± 0.49 (D) in group A, B, and C, respectively (P > 0.05). There was no statistically significant difference in preoperative and postoperative magnitude of astigmatism among different groups (P > 0.05). Significant differences were found in the distribution of astigmatism axis among the three groups at 1 day (P = 0.02) and 1 week (P = 0.02) postoperatively. However, such differences were no longer significant at 1 month after surgery (P > 0.05). No significant differences were found in HOAs among different groups 1 month after surgery (P > 0.05).
CONCLUSIONS: Different incision positions have no effect on postoperative astigmatism and visual quality 1 month after SMILE surgery, though differences were found in the distribution of the astigmatism axis within 1 week after the surgery.