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SMILE术后视觉质量的相关影响因素研究进展
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Abstract:
角膜屈光手术是矫正屈光不正的方式之一。自从1979年前苏联眼科学家Fyodorov报道了放射状角膜切开术(RK)手术以来，角膜屈光手术经历了突飞猛进的发展，尤其是飞秒激光小切口角膜基质透镜取出术(femtosecond laser small incision lenticule extraction, SMILE)作为全新的角膜屈光手术方式更以极佳的手术安全性以及术后良好的视力而备受近视患者的青睐。SMILE术于2011年首次被报道，原理是通过小弧形切口取出角膜基质内透镜以矫正屈光不正。其优点包括干眼症状较少、术后炎性反应更轻、术后角膜生物力学较为稳定，并且因其无瓣，避免了与角膜瓣相关的并发症。长期以来，临床上主要以术后视力的恢复情况、是否出现并发症作为评判患者术后视功能的主要指标，而常常忽略患者的主观感受及客观测量指标(例如角膜像差等)，近年来近视术后视觉质量受到越来越多的关注，既往研究表明，术前屈光度、角膜高阶像差、角膜瓣(帽)的厚度等是角膜屈光手术后视觉质量的可能影响因素。本文主要对SMILE术后视觉质量的相关影响因素进行综述。
Corneal refractive surgery is one of the ways to correct ametropia. Since Fyodorov, a Soviet eye sci-entist, reported radial keratotomy (RK) in 1979, corneal refractive surgery has developed by leaps and bounds, especially Small Incision Lenticule Extraction (SMILE) as a new method of corneal re-fractive surgery, is favored by myopic patients because of its excellent surgical safety and good postoperative vision. SMILE was first reported in 2011. The principle is to remove the lenticule in the corneal stroma through a small arc incision to correct refractive errors. Its advantages include less dry eye symptoms, lighter postoperative inflammatory reaction, stable corneal biomechanics, and avoid complications related to corneal flap because of its absence of flap. For a long time, the recovery of postoperative visual acuity and complications are the main indexes to evaluate the vis-ual function of patients after operation, but the subjective feelings and objective measurement in-dexes (such as corneal aberration, etc.) are often ignored. In recent years, more and more attention has been paid to the visual quality of myopia after operation. Previous studies have shown that preoperative diopter, high-order corneal aberration and thickness of corneal flap (cap) are the pos-sible factors affecting visual quality after corneal refractive surgery. This article mainly reviews the related factors affecting visual quality after SMILE.
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