目的：探讨飞秒激光小切口透镜切除术(small incision lenticule extraction，SMILE)和飞秒辅助准分子激光原位角膜磨镶术(femtosecond laser in situ keratomileusis，Fs-LASIK)对角膜后表面高度的影响。

方法：回顾性分析2016-01/12我院收治的行激光角膜屈光手术治疗的近视患者113例226眼，其中51例102眼行SMILE术治疗，62例124眼行Fs-LASIK术治疗。观察两组患者手术前后角膜后表面高度、裸眼视力、等效球镜度数变化，并分析手术安全性。

结果：术前两组患者角膜后表面高度差异无统计学意义(P>0.05)； 术后1、3、6mo两组患者角膜后表面高度均较术前提高，差异均有统计学意义(P<0.05)，但两组间差异均无统计学意义(P>0.05)。术前两组患者裸眼视力差异无统计学意义(P>0.05)； 术后1、3、6mo两组患者裸眼视力均较术前显著改善，差异均有统计学意义(P<0.05)，但两组间差异均无统计学意义(P>0.05)。术前两组患者等效球镜度数比较差异无统计学意义(P>0.05)； 术后1wk两组患者等效球镜度数均较术前改善，差异均有统计学意义(P<0.05)，但两组间差异无统计学意义(P>0.05)。术后随访6mo，两组患者角膜水肿、角膜感染、弥漫性板层角膜炎及眩光等不良反应发生率差异均无统计学意义(P>0.05)。

结论：SMILE术与Fs-LASIK术均可安全有效地矫正视力，但两种术式术后均出现角膜后表面部分前移情况。

METHODS: A retrospective analysis of 113 cases of patients(226 eyes)with myopia underwent laser corneal refractive surgery in our hospital from January to December 2016 was taken. There were 51 cases(102 eyes)with SMILE and 62(124 eyes)with Fs-LASIK. Postoperative posterior corneal surface height, uncorrected visual acuity, spherical equivalent change, operation safety were analyzed and compared between the two groups.

RESULTS: The preoperative posterior corneal surface height had no statistical difference between the two groups(P>0.05). Corneal surface height at 1, 3 and 6mo after operation were significantly higher than those before operation(P<0.05), but the differences between the two groups at different time points after operation were not significant(P>0.05). Preoperative uncorrected visual acuity had no statistical difference between the two groups(P>0.05); postoperative uncorrected visual acuity at 1, 3 and 6mo were significantly better than those before operation(P<0.05), but the differences between the two groups at different time points after operation were not significant(P>0.05). Preoperative spherical equivalent had no statistical difference between the two groups(P>0.05); postoperative spherical equivalent at 1wk were significantly better than those before operation(P<0.05), but the differences between the two groups after operation were not significant(P>0.05). Postoperative incidence of adverse reactions such as corneal edema, corneal infection, diffuse lamellar keratitis and postoperative glare had no statistical difference between the two groups at 6mo after operation(P>0.05).

CONCLUSION: SMILE and Fs-LASIK can be safely and effectively correcting visual acuity, but posterior corneal surface partial forward occurred after either operation.