方法：采用前瞻性病例对照研究，选取我院行角膜屈光手术的近视及近视散光患者共84例168眼分为两组：Ⅰ组为接受SMILE手术的患者42例84眼； Ⅱ组为接受准分子激光LASIK手术的患者42例84眼。两组患者术前近视度数在-3.00～-8.00D，散光-0.25～-2.00D。术后跟踪随访6mo，分别对术前、术后1、3、6mo的裸眼视力(uncorrected visual acuity， UCVA)、等效球镜(spherical equivalent， SE)、高阶像差(higher order aberration， HOA)、对比敏感度(contrast sensitivity， CS)进行比较并作统计学分析。

结果：全部患者手术进行顺利，术中和术后均无危害视力的并发症发生。术后Ⅰ组UCVA好于Ⅱ组，且SE低于Ⅱ组(P<0.05)。两组患者术后高阶像差均较术前增加，Ⅱ组球差高于Ⅰ组(P<0.05)。术后两组患者低、中、高频率空间点对比敏感度较术前相比均下降(P<0.05)； 3、6mo对比敏感度均有所恢复。

结论：SMILE手术能够有效矫正中高度近视和散光，与LASIK手术相比术后视力较好、屈光度更稳定、球差增加较少、在对比敏感度的恢复及提高视觉质量方面优于LASIK手术，但需加大样本量及延长随访时间做远期观察。

METHODS: The prospective study was applied.Eighty four patients(168 eyes)were divided into two groups: 42 patients(84 eyes)with myopia underwent SMILE was group Ⅰ, 42 patients(84 eyes)with myopia underwent LASIK was groupⅡ. The myopia degree of the patients was -3.00～-8.00D and astigmatism was -0.25～-2.00D before treatments and they were followed for 6mo. Uncorrected visual acuity(UCVA), spherical equivalent(SE), high order aberration(HOA), contrast sensitivity(CS)were compared and statistically analyzed at preoperatively, 1,3 and 6mo postoperatively.

RESULTS: All operations were successful without serious complications that damaged vision. The UCVA in group Ⅰwas higher than that in group Ⅱ, and the SE was lower than that in group Ⅱ postoperatively(P<0.05).The HOA in both groups increased compared with those preoperative(P<0.05), but the increase of spherical aberration(SA)in groupⅡ were significantly higher than that in groupⅠ(P<0.05). The CS at each spatial frequency in both groups decreased compared with those preoperative(P<0.05). At 3 and 6mo postoperatively, the CS in both groups was improved.

CONCLUSION: Moderate or high myopia and astigmatism can be effectively corrected by SMILE. Better visual acuity, more stable refractive state, less increase on SA, the recovery of CS and the improvement on visual quality, are the advantage of SMILE, but investigation with larger sample size and long term observation are needed.