飞秒激光小切口角膜基质透镜取出术后前房形态的变化

目的　探讨飞秒激光小切口角膜基质透镜取出术（SMILE）后前房形态的变化。方法　选取2015年3月至2018年5月于天津医科大学总医院收治的80例（160眼）行SMILE的患者为研究对象，观察患者手术前后不同时间点前房容积（ACV）、中央前房深度（ACD）、前房角度（ACA）、中央角膜厚度（CCT）、角膜后表面高度（PCE）变化。Pearson相关性分析中低度近视组（≤-6.00 D，39例78眼）及高度近视组（＞-6.00 D，41例82眼）患者ACD与各参数相关性。结果　患者手术前后不同时间点CCT总体比较，差异有统计学意义（P<0.001）。患者术后1个月、4个月、8个月CCT均明显低于术前,患者术后4个月和8个月CCT均明显高于术后1个月，差异均有统计学意义（均为P<0.05）。患者手术前后不同时间点PCE、ACD、ACV总体比较，差异均有统计学意义（均为P<0.05）。患者术后各时间点PCE与术前比较，差异均有统计学意义（均为P<0.05）。患者术前的ACD均高于术后1个月、4个月及8个月，差异均有统计学意义（均为P<0.05）。患者术后4个月及8个月ACV较术前减少，差异均有统计学意义（均为P<0.05）。患者手术前后不同时间点ACD与ACV均呈显著正相关（均为P<0.001）。中低度近视组及高度近视组患者术后ACD与ACA及ACV均呈正相关（均为P<0.05），中低度近视组患者术后ACD与PCE呈正相关（P<0.05），高度近视组患者术后ACD与PCE无相关性（P=0.089）。结论　SMILE术后ACD变浅，术后ACD、ACV不随时间的延长而变化，术后早期ACD的变化与角膜后表面的高度及术后调节力的改变有关。

Morphological changes of anterior chamber after femtosecond laser small incision corneal stromal lens extraction

Objective　To investigate the change characteristics of anterior chamber shape after femtosecond laser incision corneal stromal lens extraction (SMILE).Methods　Eighty patients (160 eyes) undergoing SMILE who were admitted to the General Hospital of Tianjin Medical University from March 2015 to May 2018 were selected as the subjects. Observations on variables, including the anterior chamber volume (ACV), central anterior chamber depth (ACD), anterior chamber angle (ACA), central corneal thickness (CCT), and posterior corneal surface height (PCE) were performed at different time points before and after surgery. Pearson correlation analysis was used to analyze the correlation between ACD and various parameters in the low and medium myopia myopia group (≤-6.00 D, 39 patients of 78 eyes) and the high myopia group (>-6.00 D, 41 patients of 82 eyes).Results　The difference in CCT at different time points before and after surgery was statistically significant (P<0.001). The preoperative CCT of the patients was significantly thicker than that of the patients 1 month,4 months and 8 months after the operation, and the CCT of the patients 4 months and 8 months after the operation was significantly thicker than that of the patients 1 month after the operation, and the differences were statistically significant (all P<0.05). The overall comparison of PCE, ACD and ACV at different time points before and after the operation showed statistically significant differences (all P<0.05). Postoperative PCE at each time point was slightly backward compared with that before operation, and the difference was statistically significant (all P<0.05). The ACD of the patients before surgery was higher than that of the patients 1 month, 4 months and 8 months after surgery, with statistically significant differences (all P<0.05). The ACV at 4 months and 8 months after surgery was significantly reduced compared with that before surgery, and the difference was statistically significant (all P<0.05). The correlation analysis showed that ACD was significantly positively correlated with ACV before and 1 month, 4 months and 8 months after surgery (all P<0.001). According to Pearson correlation analysis, ACD was positively correlated with ACA and ACV after surgery in the low and medium myopia myopia group and high myopia group (P< 0.05); but ACD was positively correlated with PCE after surgery in the low and medium myopia group (P<0.05), while ACD was not correlated with PCE after surgery in the high myopia group (P=0.089).Conclusion　After SMILE, the central ACD became shallow, and ACD and ACV do not change with the extension of time. The changes in ACD in the early postoperative period are related to the height of the back surface of the cornea and the changes in postoperative regulation.