Changes in higher-order aberrations in the anterior and posterior corneal surfaces and total cornea after 2 mm micro-incision SMILE and 3-5 mm SMILE
Li Xiaojing,Wang Yan,Dou Rui,Zhang Jiamei,Li Hua
Tianjin Eye Hospital， Tianjin Key Lab of Ophthalmology and Visual Science， Tianjin Eye Institute， Clinical College of Ophthalmology Tianjin Medical University， Tianjin 300020， China
Objective To evaluate the changes in higher order aberrations in the anterior and posterior corneal surfaces and the total cornea after 2 mm micro-incision small incision lenticule extraction （SMILE） and 3-5 mm SMILE. Methods Sixty-one subjects （61 eyes） were enrolled in this prospective study. Although the surgery was performed on both eyes， only the right eyes were chosen for analysis. Two mm micro-incision SMILE surgery was performed on 26 subjects and SMILE surgery with an incision ranging from 3-5 mm was performed on another 35 subjects. Aberrations on the anterior and posterior corneal surfaces and total corneal aberrations were measured by Pentacam topography preoperatively and 1 month and 6 months postoperatively. Twenty subjects （20 eyes） who underwent the 2 mm SMILE surgery remained after 6 months and all 35 subjects （35 eyes） who underwent the 3-5 mm SMILE surgery remained. Repeated ANOVA was used to compare the Zernike coefficients of the corneal aberrations before and after surgery. The difference in aberrations between the 2 mm and 3-5 mm SMILE groups was compared with an independent t test. Results In the 2 mm SMILE group， the total higher order aberrations （tHOA）， vertical coma （Z3-1）， horizontal coma （Z31） and spherical aberrations （Z40） for the anterior corneal surface and total corneal had increased significantly 1 month and 6 months postoperatively （all at P<0.05）. There were significant differences in Z3-1 and Z40 for the posterior corneal surface postoperatively compared with preoperative values （all at P<0.05）. While in the 3-5 mm SMILE group， significant differences were found in tHOA， Z3-1， Z31 and Z40 for the anterior and posterior corneal surfaces and the complete cornea at various follow-up visits （all at P<0.01）. Differences in the anterior corneal surface between the 2 mm SMILE and 3-5 mm SMILE groups were found in tHOA， Z3-1， Z31 at 1 month and 6 months postoperatively （t1 m=3.509， -4.103， 2.418， all at P<0.05， t6 m=2.248， -2.628， 2.617， all at P<0.05）. There was a significant difference in Z31 for the posterior corneal surface between the two groups at 1 month and 6 months postoperatively （t=-2.416， -2.852， all at P<0.05）. The difference in total corneal aberrations between the two groups was noted for tHOA， Z3-1 and Z31 1 month after surgery （t=2.376， -3.323， 2.623， all at P<0.05）. Conclusion Different changes in aberrations of the anterior and posterior corneal surfaces and total cornea were noted after 2 mm and 3-5 mm SMILE surgery. There was no significant difference in total corneal aberrations between the 2 mm and 3-5 mm SMILE groups for tHOA， Z3-1， Z31 and Z40 at 6 months postoperatively. The influence of 2 mm micro-incision SMILE on the posterior corneal surface was relatively slight compared with that for the 3-5 mm SMILE group.
李晓晶,王雁,窦瑞,张佳媚,李华. 2 mm微切口与3~5 mm切口SMILE术后角膜高阶像差的比较[J]. 中华眼视光学与视觉科学杂志, 2015, 17(10): 609-613.
Li Xiaojing,Wang Yan,Dou Rui,Zhang Jiamei,Li Hua. Changes in higher-order aberrations in the anterior and posterior corneal surfaces and total cornea after 2 mm micro-incision SMILE and 3-5 mm SMILE. Chinese Journal of Optometry Ophthalmology and Visual science, 2015, 17(10): 609-613. DOI: 10.3760/cma.j.issn.1674-845X.2015.10.008
Sekundo W， Kunert K， Russmann C， et al. First efficacy and safety study of femtosecond lenticule extraction for the correction of myopia： six-month results[J]. J Cataract Refract Surg，2008， 34（9）：1513-1520.
[3]
Wu D， Wang Y， Zhang L， et al. Corneal biomechanical effects： Small-incision lenticule extraction versus femtosecond laser-assisted laser in situ keratomileusis[J]. J Cataract Refract Surg， 2014，40（6）：954-962.
[4]
Wei S， Wang Y. Comparison of corneal sensitivity between FS-LASIK and femtosecond lenticule extraction （ReLEx flex） or small-incision lenticule extraction （ReLEx smile） for myopic eyes[J]. Graefes Arch Clin Exp Ophthalmol，2013，251（6）：1645-1654.
[5]
Ang M， Tan D， Mehta JS. Small incision lenticule extraction （SMILE） versus laser in-situ keratomileusis（LASIK）： study protocol for a randomized， non-inferiority trial[J]. Trials，2012， 13：75.
[6]
Shah R.， Shah S， Sengupta S. Results of small incision lenticule extraction： All-in-one femtosecond laser refractive surgery[J]. J Cataract Refract Surg，2011，37（1）：127-137.
[7]
Sekundo W， Gertnere J， Bertelmann T， et al. One-year refractive results， contrast sensitivity， high-order aberrations and complications after myopic small-incision lenticule extraction （ReLEx SMILE）[J]. Graefes Arch Clin Exp Ophthalmol，2014， 252（5）：837-843.
[8]
王雁，赵堪兴. 波前像差与临床视觉矫正[M]. 北京：人民卫生出版社，2011：159-160.
[9]
Parede TR， Torricelli AA， Mukai A， et al. Quality of vision in refractive and cataract surgery， indirect measures： review article[J]. Arq Bras Oflalmol，2013，76（6）：386-390.
[10]
Wang Y， Zhao K， Yang X， et al. Higher-order aberrations and low contrast vision function in myopic eyes （-3.00 to -6.00 D） under mesopic conditions[J]. J Refract Surg，2011，27（2）：127-134.
[11]
Dubbelman M， Sicam VA， van der Heijde RG. The contribution of the posterior surface to the coma aberration of the human cornea[J]. J Vis，2007，7（7）：10.1-8.
[12]
Sicam VA， Dubbelman M， van der Heijde RG. Spherical aberration of the anterior and posterior surfaces of the human cornea[J]. J Opt Soc Am A Opt Image Sci Vis，2006，23（3）：544-549.
[13]
Lee MJ， Lee SM， Lee HJ， et al. The changes of posterior corneal surface and higher-order aberrations after refractive surgery in moderate myopia[J]. Korean J Ophthalmol，2007，21（3）：131-136.
浙公网安备 33030202001892号