[关键词]
[摘要]
目的：对比分析小切口飞秒激光基质透镜取出术(small incision lenticule extraction，SMILE)和飞秒激光准分子激光原位角膜磨镶术(femtosecond laser
in situ keratomileusis，FS-LASIK)术后干眼及泪膜稳定性的变化。
方法：回顾性分析2015-01/06在我院行角膜屈光手术患者60例120眼。其中SMILE组30例60眼， FS-LASIK组30例60眼。观察两组患者术前、术后1wk，1、3、6mo的干眼症状、角膜荧光素染色(corneal fluorescein staining，FL)、基础泪液分泌试验(Schirmer Ⅰtest，SⅠt)、泪膜破裂时间(tear break-up time，BUT)的变化，并进行对比分析。
结果：SMILE组和FS-LASIK组术后1wk、1mo干眼症状问卷评分分别为0.36±0.48、0.95±0.59分； 0.15±0.36、0.36±0.60分，差异具有统计学意义(t=-5.885，P<0.01； t=-2.370，P=0.019)。SMILE组和FS-LASIK组术后1wk、1mo的FL评分分别为1.13±0.72、1.85±0.79分； 0.68±0.50、1.38±0.55分，差异具有统计学意义(t=-5.149，P<0.01； t=-7.232，P<0.01)。SMILE组和FS-LASIK组术后1wk，1、3mo的SⅠt分别为13.11±1.93、8.76±1.36mm/5min，13.81±1.61、10.60±2.08mm/5min，14.45±1.51、11.85±2.42mm/5min，差异具有统计学意义(t=14.228，P<0.01； t=9.459，P<0.01； t=7.042，P<0.01)。SMILE组和FS-LASIK组术后1wk，1、3mo的BUT分别为11.15±1.71、8.55±1.19s； 12.15±1.69、9.68±1.40s； 12.51±1.83、10.93±1.90s，差异具有统计学意义(t=9.622，P<0.01； t=8.669，P<0.01； t=4.637，P<0.01)。
结论：与FS-LASIK手术比较，SMILE手术切口小、术后干眼症状轻、恢复快，舒适度更高。
[Key word]
[Abstract]
AIM: To evaluate the changes of dry eye and tear film stability after small incision lenticule extraction(SMILE)or femtosecond laser
in situ keratomileusis(FS-LASIK).
METHODS: Sixty cases(120 eyes)accepted refractive surgery from January to June 2015 was retrospectively analyzed, in which 30 cases(60 eyes)were performed SMILE(SMILE group), 30 cases(60 eyes)were performed FS-LASIK(FS-LASIK group).The symptoms of dry eye, corneal fluorescein staining(FL), Schirmer Ⅰtest(SⅠt), tear break-up time(BUT)were observed and compared preoperatively, 1wk, 1,3 and 6mo postoperatively.
RESULTS: The score of symptoms of dry eye in SMILE group were 0.36±0.48, 0.15±0.36, and 0.95±0.59, 0.36±0.60 in FS-LASIK group at postoperative 1wk and 1mo, the difference was statistically significant, respectively(t=-5.885, P<0.01; t=-2.370,P=0.019). The score of FL in SMILE group were 1.13±0.72, 0.68±0.50, and 1.85±0.79, 1.38±0.55 in FS-LASIK group at postoperative 1wk and 1mo, the difference was statistically significant, respectively(t=-5.149, P<0.01; t=-7.232, P<0.01). The SⅠt in SMILE group were 13.11±1.93, 13.81±1.61, 14.45±1.51, and 8.76±1.36, 10.60±2.08, 11.85±2.42mm/5min in FS-LASIK group at postoperative 1wk,1mo and 3mo, the difference was statistically significant, respectively(t=14.228, P<0.01; t=9.459, P<0.01; t=7.042, P<0.01). The BUT in SMILE group were 11.15±1.71s, 12.15±1.69s, 12.51±1.83s, and 8.55±1.19s, 9.68±1.40s, 10.93±1.90s in FS-LASIK group at postoperative 1wk,1mo and 3mo, the difference was statistically significant, respectively(t=9.622,P<0.01; t=8.669,P<0.01; t=4.637,P<0.01).
CONCLUSION: SMILE is more comfortable compared to FS-LASIK with smaller incision, faster corneal recovery and slighter postoperative dry eye sensation.
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