【摘要】 目的评价飞秒激光微小切口角膜基质透镜取出术(SMILE)治疗高度近视的效果。方法 90例(180眼)高度近视患者,按照随机法分为观察组及对照组,各45例(90眼)。观察组采取SMILE治疗,对照组采取飞秒激光制瓣的准分子激光原位角膜磨镶术(FS-LASIK)治疗。比较两组患者术后裸眼视力、最佳矫正视力、角膜后表面高度、角膜最薄点高度、泪膜破裂时间、基础泪液分泌试验。结果术后1、3个月,两组患者的裸眼视力、最佳矫正视力比较,差异无统计学意义(P>0.05)。术前及术后1个月,两组角膜后表面高度、角膜最薄点高度、泪膜破裂时间、基础泪液分泌试验比较,差异无统计学意义(P>0.05)。术后3个月,观察组角膜后表面高度(1.39±0.60)mm、角膜最薄点高度(4.11±0.80)mm低于对照组的(1.60±0.30)、(4.40±0.30)mm,差异有统计学意义(P<0.05);观察组术后3个月泪膜破裂时间短于术前,基础泪液分泌试验小于术前,但差异无统计学意义(P>0.05);对照组术后3个月泪膜破裂时间短于术前、基础泪液分泌试验小于术前,差异有统计学意义(P<0.05);两组术后3个月泪膜破裂时间、基础泪液分泌试验比较,差异无统计学意义(P>0.05)。结论高度近视患者采取SMILE、FS-LASIK两种术式均可获得理想的手术效果,而前者对泪膜稳定性影响较小。更多还原

【Abstract】 Objective To evaluate the effect of small incision lenticule extraction(SMILE) in correcting high myopia. Methods A total of 90 patients(180 involved eyes) with high myopia were randomly divided into observation group and control group, with 45 cases(90 involved eyes) in each group. The observation group was treated with SMILE, and the control group was treated with femtosecond laser in situ keratomileusis(FS-LASIK). The postoperative uncorrected visual acuity, best corrected visual acuity, height of posterior corneal surface, height of corneal thinnest point, tear film break-up time, basic tear secretion test were compared between the two groups. Results 1 and 3 months after operation, there was no statistically significant difference in uncorrected visual acuity and best corrected visual acuity between the two groups(P>0.05). Before operation and 1 month after operation, there was no statistically significant difference in height of posterior corneal surface, height of corneal thinnest point, tear film break-up time and basic tear secretion test between the two groups(P>0.05). 3 months after operation, the height of posterior corneal surface(1.39±0.60) mm, height of corneal thinnest point(4.11±0.80) mm of the observation group were lower than(1.60±0.30) and(4.40±0.30) mm of the control group, and the difference was statistically significant(P<0.05). 3 months after operation, the tear film break-up time of the observation group was shorter than that before operation, and basic tear secretion test was less than that before operation. But the difference was not statistically significant(P>0.05). 3 months after operation, the tear film break-up time of the control group was shorter than that before operation, and basic tear secretion test was less than that before operation. All the difference was statistically significant(P<0.05). All the difference was statistically significant(P<0.05). 3 months after operation, there was no statistically significant difference in tear film break-up time and basic tear secretion test between the two groups(P>0.05). Conclusion Both two surgical methods of SMILE and FS-LASIK provides ideal surgical effect in patients with high myopia, but the former has less impact on tear film stability.更多还原