飞秒激光小切口基质透镜取出术后早期视力恢复的相关因素分析

目的 探讨飞秒激光小切口角膜基质透镜取出术(SMILE)术后早期视力恢复的相关因素,以期为SMILE手术方案提供临床依据。 方法 回顾性分析2016年1月至2016年8月行SMILE手术的64例近视及近视散光患者共128只眼的临床资料,记录术后1 d、术后1周的裸眼视力(UCVA)。术后视力与年龄、性别、术前预矫等效球镜度(SE)、K值、中央角膜厚度(CCT)、术后残余基质床厚度(RST)、切削比(AD/CT)之间进行相关分析。 结果 术后1 d 30.4%眼裸眼视力达到0.8以上,10.2%眼裸眼视力达到1.0以上,约5.5%的眼裸眼视力达到术前最佳矫正视力(BCVA);术后1周90.6%裸眼视力达到0.8以上,64.1%达到1.0以上,约33.6%的眼裸眼视力达到术前BCVA。术后第1天、第7天视力与年龄、性别、K值、CCT、屈光度、RST、AD/CT之间均无明显相关性。 结论 SMILE术后早期视力恢复可能与术后早期角膜的炎性及创伤愈合反应及术后角膜微结构的变化有关。

Early visual acuity recovery and related factors in myopic patients after small incision lenticule extraction

Objective To investigate the visual acuity improvement and related factors in myopic patients after small incision lenticule extraction(SMILE), in order to provide clinical data for standardization of SMILE surgery. Methods This retrospective clinical study included a total of 64 myopic patients(128 eyes)between January 2016 and August 2016. All patients underwent standard SMILE surgery performed by a single experienced surgeon. Visual acuity was assessed 1 day and 1 week after surgery. Correlations among postoperative uncorrected visual acuity(UCVA)and preoperative factors such as age, gender, preoperative equivalent sphere(SE), keratometry, central corneal thickness(CCT), as well as postoperative factors such as residual stromal bed thickness(RST)and ablation depth/corneal thickness ratio(AD/CT)were statistically analyzed. Results On postoperative day 1, 30.4% of eyes achieved a UCVA of 0.8 or better and 10.2% eyes achieved a UCVA of 1.0 or better. Additionally, 5.5% of the eyes achieved preoperative best corrected visual acuity(BCVA). At 1 week postoperatively, 90.6% of the eyes achieved a UCVA of 0.8 or better and 64.1% of the eyes achieved a UCVA of 1.0 or better. Additionally, 33.6% of the eyes achieved preoperative BCVA. No significant correlations were observed among the preoperative and postoperative visual acuity and age, gender, keratometry, CCT, SE, RST, and AD/CT. Conclusion Recovery of early visual acuity may be correlated with corneal wound healing and inflammatory responses, and changes in the corneal microstructure may be another factor responsible for slower visual recovery following SMILE.