FS-LASIK与SMILE矫正近视术后角膜高阶像差的变化

目的比较飞秒激光制瓣准分子激光原位角膜磨镶术(femtosecond-assisted laser in situ keratomileusis,FS-LASIK)与小切口飞秒激光基质透镜切除术(small incision lenticule extraction,SMILE)术后角膜高阶像差的变化。方法选取行FS-LASIK患者22例(22眼)及行SMILE患者30例(30眼)作为研究对象,测量并对比2种术式患者术前及术后1周、1个月的角膜波前像差。结果 FS-LASIK术后1周球差、倾斜三叶草分别为(0.517±0.193)μm、(0.096±0.146)μm,与术前相比均增大,差异均有统计学意义(均为P<0.05)。FS-LASIK术后1个月球差、水平彗差、倾斜三叶草分别为(0.534±0.178)μm、(0.151±0.263)μm、(0.088±0.152)μm,与术前相比均增大,差异均有统计学意义(均为P<0.05)。SMILE术后1周球差、倾斜三叶草分别为(0.361±0.189)μm、(0.017±0.147)μm,与术前相比均增大,差异均有统计学意义(均为P<0.05)。SMILE术后1个月球差为(0.382±0.178)μm,与术前相比增大,差异有统计学意义(P<0.05)。术后1个月2组间球差、倾斜三叶草、总高阶像差均方根值差异均有统计学意义(t=3.043、2.647、2.391,均为P<0.05)。结论 FS-LASIK术后早期角膜高阶像差改变以球差、彗差、倾斜三叶草为主;SMILE术后早期角膜高阶像差改变以球差为主。FS-LASIK和SMILE术后早期球差、倾斜三叶草、总高阶像差有显著差异。

Changes in higher order aberrations after FS-LASIK versus SMILE for myopia

Objective　To explore the changes in higher order aberrations in cornea after femtosecond-assisted laser in situ keratomileusis (FS-LASIK) versus small incision lenticule extraction (SMILE).Methods　There were 22 eyes of 22 patients who underwent FS-LASIK and 30 eyes of 30 patients who underwent SMILE selected as the subjects.The wavefront aberrations were measured and compared between the two groups preoperatively,one month and six months postoperatively.Results　At one week in the FS-LASIK group，spherical aberration and vertical trefoil were （0.517±0.193)μm and （0.096±0.146）μm,respectively，which had significantly increased compared with the pre-operative data (both P<0.05).At one month in the FS-LASIK group，spherical aberration，horizontal coma and vertical trefoil were (0.534±0.178)μm，(0.151±0.263)μm and (0.088±0.152)μm,respectively，which had significantly increased compared with the pre-operative data(all P<0.05).At one week in the SMILE group，spherical aberration and vertical trefoil were (0.361±0.189)μm and (0.017±0.147)μm,respectively，which had significantly increased compared with the pre-operative data(both P<0.05).One month in the SMILE group，spherical aberration was (0.382±0.178)μm，which had significantly increased compared with the pre-operative data (P<0.05).There were significant differences in the spherical aberration，vertical trefoil and total higher order aberrations between the two groups（t=3.043，2.647，2.391，all P<0.05）.Conclusion　The mainly changes in corneal high order aberration are spherical aberration，coma，vertical trefoil in the early stage after LASIK surgery.The mainly changes in corneal high order aberration are spherical aberration in the early stage after SMILE surgery.There are significant differences in spherical aberration，vertical trefoil and total higher order aberrations between FS-LASIK and SMILE surgery.