摘要
目的 研究飞秒激光小切口角膜基质透镜取出术(SMILE)矫正近视对术后视野的影响.方法 前瞻性病例系列研究.纳入周口市眼科医院 2023 年1 月至2023 年3 月行SMILE的近视者41 例(41 眼)作为研究对象,术前、术后 1 d、7 d及 1 个月采用Humphrey视野计 30-2 SITA 标准程序进行视野检查.主要测量 0 到 30°视野指数平均偏差(MD)和模式标准差(PSD)变化情况,并对手术前、后MD和 PSD与术前屈光度、切削角膜厚度、术后裸眼视力、残余屈光度、负压吸引时间进行相关性分析.结果 术前、术后1 d、7 d、1个月平均MD分别为(-3.26±1.48)、(-3.68±1.18)、(-2.71±1.17)、(-2.73±0.93)dB,术后各时间点的MD与术前比较,总体差异有统计学意义(F=220.59,P<0.001).术前MD与术前等效球镜度(-5.14±1.51)D呈正相关(r=0.53,P<0.001),与切削角膜厚度呈负相关(r=-0.48,P=0.002).术后 1 d、7 d及 1 个月MD与术前等效球镜度均无相关性(r=0.28,P=0.072;r=0.12,P=0.474;r=0.04,P=0.823).与切削角膜厚度均无相关性(r=-0.27,P=0.086;r=-0.12,P=0.440;r=-0.03,P=0.855).术前、术后 1 d、7 d、1 个月PSD分别为(1.77±0.43)、(1.76±0.47)、(1.72±0.46)、(1.73±0.45)dB,与术前比较,差异无统计学意义(F=10.21,P=0.310).术前、术后 1 d、7 d及 1 个月PSD与术前屈光度(r=0.23,P=0.149;r=0.20,P=0.217;r=0.25,P=0.122;r=0.24,P=0.132)及切削角膜厚度(r=-0.21,P=0.195;r=-0.17,P=0.276;r=-0.22,P=0.159;r=-0.21,P=0.192)均无相关性.手术前、后MD和 PSD与术后裸眼视力、残余屈光度、负压吸引时间均无相关性(均P>0.05).结论 SMILE 术后视野阈值降低,随着时间推移逐渐恢复.
Abstract
Objective To study the influence of small incision lenticule extraction(SMILE)on visual field in myopia.Methods This was a prospective case series study.A total of 41 eyes of 41 cases with myopia undergone SMILE in the Zhoukou City Eye Hospital from Jan.2023 to Mar.2023 were selected.Visual field examinations were performed using the Humphrey period 30-2 SITA standard procedure before and 1 day,7 days and 1 month after surgery.The mean deviation(MD)and pattern standard deviation(PSD)of visual field index from 0 to 30° were measured,and the correlation between preoperative and postoperative MD and PSD with preoperative diopter,cutting corneal thickness,postoperative uncorrected vision,residual diopter,and negative pressure suction time were analyzed.Results MD at preoperation and 1 day,7 days and 1 month postoperatively were(-3.26±1.48),(-3.68±1.18),(-2.71±1.17)and(-2.73±0.93)dB,respectively.The difference in MD at each postoperative time point was statistically significant,compared to the preoperative data(F=220.59,P<0.001).There was a positive correlation between preoperative MD and preoperative spherical equivalent[(-5.14±1.51)D(r=0.53,P<0.001)].There was no correlation between postoperative MD and preoperative diopter at 1 day,7 days and 1 month after surgery(r=0.28,P=0.072;r=0.12,P=0.474;r=0.04,P=0.823).There was a negative correlation between preoperational MD and corneal thickness after cutting(r=-0.48,P=0.002).There was no correlation between MD and corneal thickness at 1 day,7 days and 1 month after surgery(r=-0.27,P=0.086;r=-0.12,P=0.440;r=-0.03,P=0.855).The average PSD at preoperation and 1 day,7 days and 1 month postoperatively were(1.77±0.43),(1.76±0.47),(1.72±0.46)and(1.73±0.45)dB,respectively.There was no statistically significant difference in the pattern standard deviation(PSD)at each postoperative time point compared to the preoperational data(F=10.21,P=0.310).There was no correlation between preoperational PSD and preoperational diopter at 1 day,7 days and 1 month after surgery(r=0.23,P=0.149;r=0.20,P=0.217;r=0.25,P=0.122;r=0.24,P=0.132).There was no correlation between PSD and corneal thickness after ablation at preoperation,1 day,7 days and 1 month after surgery(r=-0.21,P=0.195;r=-0.17,P=0.276;r=-0.22,P=0.159;r=-0.21,P=0.192).There was no correlation between preoperational and postoperational MD and PSD with postoperative uncorrected vision,residual diopter,and negative pressure suction time(P>0.05).Conclusion After SMILE,the visual threshold decreases and gradually recovers over time.
NETL
NSTL
万方数据