Objective To evaluate the predictability and efficacy of femtosecond small incision lenticule extraction (SMILE) with different refractive targets in order to provide data for the clinic. Methods This was retrospective clinical study that included 207 eyes from 104 patients who were treated for myopia or myopic astigmatism with SMILE surgery. The spherical equivalent (SE) of subjective manifest refraction less than -8.25 diopters (D) and astigmatism less than -3.25 D. SMILE surgery was performed on all eyes and patients were followed for 3 months. Patients were divided into three groups based on target refractions: group Ⅰ(target refraction was 0.00 D), group Ⅱ(target +0.25 D) and group Ⅲ(target +0.50 D). Preoperative mean SE refraction for group Ⅰ was -6.26±1.47 D, group Ⅱ was -5.62±1.43 D and group Ⅲ was -4.31±2.75 D. All surgeries were performed by the same doctor and uncorrected visual acuity (UCVA), refraction and residual astigmatism were measured 1 day, 7 days, 1 month and 3 months postoperatively. An analysis of variance was used to analyze the changes in visual acuity and refraction at the different time points. Results ①Differences in postoperative uncorrected visual acuity (UCVA) at the different time points were insignificant for the 3 groups (F=2.67, 0.82, 0.62, 0.25, P>0.05). ②The differences in target refraction at 1 day, 7 days, 1 month and 3 months postoperatively were also insignificant for the three groups (F=1.88, 1.03, 2.18, P>0.05). Conclusion Clinical outcomes of SE and UCVA were stable for different target refractions with the SMILE procedure for myopia and myopic astigmatism. This study suggests that the nomogram needs to be adjusted for different ages to account for potential refractive changes. Nomogram adjustment is safe and feasible for controlling overcorrections within 0.50 D.
梁刚,查旭,张丰菊. 不同的目标屈光度设计SMILE术后早期临床效果[J]. 中华眼视光学与视觉科学杂志, 2014, 16(7): 399-402.
Liang Gang*,Zha Xu,Zhang Fengju. An early clinical study on femtosecond small incision lenticule extraction for myopia and myopic astigmatism with different target refraction designs. Chinese Journal of Optometry Ophthalmology and Visual science, 2014, 16(7): 399-402. DOI: 10.3760/cma.j.issn.1674-845X.2014.07.004
Reinstein DZ, Archer TJ, Randleman JB. Mathematical model to compare the relative tensile strength of the cornea after PRK, LASIK, and small incision lenticule extraction[J]. J Refract Surg,2013,29:454-460.
[5]
Vestergaard AH, Grønbech KT, Grauslund J, et al. Subbasal nerve morphology, corneal sensation, and tear film evaluation after refractive femtosecond laser lenticule extraction[J]. Graefes Arch Clin Exp Ophthalmol,2013,251:2591-2600.
[6]
Demirok A, Agca A, Ozgurhan EB, et al. Femtosecond lenticule extraction for correction of myopia: a 6 month follow- up study[J]. Clin Ophthalmol,2013,7:1041-1047.
Vestergaard A, Ivarsen AR, Asp S, et al. Small-incision lenticule extraction for moderate to high myopia: predictability, safety, and patient satisfaction[J]. J Cataract Refract Surg,2012, 38:2003-2010.
[10]
Hjortdal JØ, Vestergaard AH, Ivarsen A, et al. Predictors for the outcome of small-incision lenticule extraction for myopia [J]. J Refract Surg,2012,28:865-871.
[11]
Ang M, Chaurasia SS, Angunawela RI, et al. Femtosecond lenticule extraction (FLEx): clinical results, interface evaluation, and intraocular pressure variation[J]. Invest Ophthalmol Vis Sci,2012,53:1414-1421.
[12]
Blum M1, Kunert KS, Voßmerbäumer U, et al. Femtosecond lenticule extraction (ReLEx) for correction of hyperopia-first results[J]. Graefes Arch Clin Exp Ophthalmol,2013,251:349-355.
[13]
Kamiya K, Shimizu K, Igarashi A, et al. Visual and refractive outcomes of femtosecond lenticule extraction and small-incision lenticule extraction for myopia[J]. Am J Ophthalmol,2014,157:128-134.e2.
[14]
Shah R1, Shah S, Sengupta S. Results of small incision lenticule extraction: all-in-one femtosecond laser refractive surgery[J]. J Cataract Refract Surg,2011,37:127-137.