SMILE与ICL V4c植入术矫正高度近视的临床效果及视觉质量对比分析

目的 探讨飞秒激光小切口角膜基质透镜取出术(small incision lenticule extraction,SMILE)和中央孔型有晶体眼后房型人工晶状体(implantable collamer lens,ICL)V4c植入术矫正高度近视的临床效果及高阶像差的变化特点.方法 收集于行近视矫正手术的高度近视患者...

Comparative analysis of clinical effect and visual quality of SMILE and ICL V4c implantation in the correction of high myopia

ObjectiveTo explore the clinical effects and the variation features of higher-order aberrations(HOAs) of femtosecond laser small incision lenticule extraction（SMILE）and implantable collamer lens （ICL） V4cafter the correction surgery of high myopia.MethodsThe patients with -6.00 D plus high myopia who underwent myopic surgery were enrolled. In accordance with the surgical methods, they were divided into two groups, SMILE group(30 cases, 58 eyes) and ICL group(30 cases, 59 eyes), and a series of data before and after surgery, including uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), refraction, spherical equivalent(SE), intra-ocular tension and HOAs of corneas, were observed. All patients were followed up for 1 year and analyzed statistically.ResultsAs for security, the BCVA of both groups reached 20/20 plus. None eyes experienced the loss of more than one line at BCVA. As for effectiveness, at one year after the surgery, 53 eyes （91.38%） and 32 eyes （94.91%） reached 20/20 plus at UCVA in two groups respectively, and 58 eyes （100%） and 59 eyes （100%） reached 20/25 plus respectively. In terms of predictability, at one year after the surgery, the proportion of SE at ±1.0 D was 100% in both groups. The residual refractive error in SMILE group was higher than that in ICL group, and the difference between two groups was statistically significant. As for HOAs, total higher-order aberration, spherical aberration and vertical comatic aberration were increased in SMILE group after surgery. As for ICL group, the oblique trefoil was increased whilst horizonal comatic aberration was decreased. Spearman correlation analysis revealed no correlation between the aberration variation value and the preoperative spherical equivalent, cylindrical equivalent, SE, as well as the postoperative residual SE in two groups.ConclusionBoth SMILE and ICL have advantages of security and effectiveness for correction surgery of high myopia. ICL possessed stronger predictability for high myopia, and HOAs were not much generated.