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Q值引导FS-LASIK与SMILE对眼高阶像差的影响
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Abstract:
目的：比较Q值引导飞秒激光辅助的准分子激光原位角膜磨镶术(Femtosecond laser-assisted excimer laser in situ keratomileusis, FS-LASIK)与小切口角膜基质透镜取出术(Small incision lenticule extraction, SMILE)对眼高阶像差的影响，为屈光手术方式的选择提供参考。方法：回顾性非随机对照研究。选取2022年7月至2022年10月接受飞秒激光屈光手术的近视患者72例(138眼)。按手术方式分为Q值引导FS-LASIK组42例(78眼)，SMILE组30例(60眼)。Q值引导的FS-LASIK采用Custom Q切削模式。术后随访3个月，比较2组患者术后3个月水平彗差、垂直彗差、三叶草、总球差、总彗差以及总高阶像差。采用独立样本t检验进行分析。结果：术后3个月SMILE组患者水平彗差高于Q值引导FS-LASIK组(t = ？3.598, P = 0)，而全眼总高阶像差(t = 3.373, P = 0.001)、总彗差(t = 4.101, P = 0)、总球差(t = 2.229, P = 0.028)均低于Q值引导FS-LASIK组，差异有统计学意义；两组患者垂直彗差与总三叶草无统计学差异。结论：两种手术相比，SMILE会引起更多水平彗差，Q值引导FS-LASIK引起更多总彗差，总球差以及总高阶像差。
Objective: To study the effects of Q value guided FS-LASIK and SMILE on the higher-order aberrations of the eye, and to provide a reference for the choice of refractive surgery. Methods: A retrospective non-randomized controlled study was conducted. 72 patients (138 eyes) with myopia and astigmatism who underwent femtosecond laser refractive surgery from July 2022 to October 2022 at Refractive Centre were selected. They were divided into 42 cases (78 eyes) in the Q value guided FS-LASIK group and 30 cases (60 eyes) in the SMILE group according to the surgical modality chosen by the patients. The patients in the 2 groups were followed up for 3 months after surgery, and the horizontal coma, the vertical coma, the trefoil, the overall spherical aberrations, the overall coma aberrations, and the overall higher-order aberrations of the whole eye were compared between the 2 groups at 3 months after surgery. Independent samples t-test was used for analysis. Results: The horizontal Coma of patients in the SMILE group was higher than that of the Q value guided FS-LASIK group at 3 months postoperatively (t = ？3.598, P = 0) whereas the overall higher-order aberration of the whole eye (t = 3.373, P = 0.001), the overall Coma (t = 4.101, P = 0), and the overall SA (t = 2.229, P = 0.028) were lower than those of the Q value guided group, and the difference was statistically significant; there was no statistically significant difference in vertical Coma and total Trefoil between the two groups. Conclusions: Compared with the two surgeries, SMILE caused more horizontal coma, and Q value guided FS-LASIK caused more overall coma, overall spherical aberrations, and overall higher-order aberrations.
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