SMILE与FS-LASIK术后光学区特性比较

doi:10.3760/cma.j.cn115909-20190818-00229

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Abstract Objective: To compare the actual diameter, asphericity and higher order aberrations (HOAs) of the optical zone after small incision lenticule extraction (SMILE) and femtosecond-assisted laser in situ keratomileusis (FS-LASIK) using the SCHWIND Amaris1050 and WaveLight EX500 excimer laser platforms for myopia. Methods: This was a retrospective study that included 91 patients (113 eyes) from January 2018 to January 2019 in the Refractive Surgery Center, Guangzhou Aier Eye Hospital. The patients were divided into a SMILE group (42 eyes), an Amaris1050 (25 eyes) and and an EX500 group (46 eyes). The postoperative optical zone was measured using two different maps. A tangential curvature map was generated with a placido corneal topographer (Topolyzer) and a tangential curvature difference map was generated with a Scheimplfag tomographer (Pentacam) for each eye 1 month and 3 months after surgery. The Q value and HOAs were also obtained with the Topolyzer. The postoperative optical zone, Q-value and HOAs among the three groups were analyzed with a one-way analysis of variance with Bonferroni-adjusted post hoc comparisons. The optical zones measured with the two maps were analyzed with a paired-samples t test. Results: The mean optical zones measured on the two maps were 6.90±0.12 mm and 5.17±0.15 mm with SMILE, 6.58±0.19 mm and 5.00±0.10 mm with Amaris1050, 6.56±0.16 mm and 4.86±0.15 mm with EX500 at 3 months postoperatively. The postoperative optical zones of SMILE were larger than Amaris1050 and EX500 in both maps (P<0.001), the optical zone of Amaris1050 was larger than EX500 in the tangential curvature difference map (P=0.003); the optical zone measured in the tangential curvature map was significantly larger than in the tangential curvature difference map (t=64.836, 34.146, 63.927, P<0.001). The postoperative Q-values of the cornea in the 5 mm and 6 mm areas of SMILE were both smaller than Amaris1050 and EX500 (5 mm: P=0.017, 0.013; 6 mm: P=0.004, 0.005). No significant difference was found between Amaris1050 and EX500 (P=1.000). As for the postoperative HOAs of the cornea in a 6 mm pupil diameter, the spherical aberrations of SMILE were larger than for both Amaris1050 and EX500 (P=0.004, 0.017). There was no significant difference between Amaris1050 and EX500 (P=0.793). Conclusions: When there is a same programmed optical zone, SMILE achieves a larger and a better aspheric shape of the optical zone than FS-LASIK, and induces fewer spherical aberrations after surgery. Whereas there was also a deeper ablation depth with SMILE and Amaris1050 than with EX500, thus consuming more corneal tissue.

Key words： small incision lenticule extraction femtosecond-assisted laser in situ keratomileusis Amaris1050 EX500 optical zone asphericity aberration

Received: 18 August 2019

Fund:Science and Technology Planning Project of Hunan Province (C2017057); Science Research Foundation of Aier Eye Hospital Group (AM169D04)

Corresponding Authors: Zheng Wang, Aier School of Ophthalmology, Central South University, Changsha 410015, China; Guangzhou Aier Eye Hospital, Guangzhou 510000, China (Email: gzstwang@gmail.com)

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