目的：比较全飞秒激光小切口角膜基质内透镜取出术(SMILE)与飞秒激光辅助准分子激光原位角膜磨镶术(FS-LASIK)治疗近视伴散光患者的疗效。

方法：回顾性分析。收集2021-12/2022-12我院治疗的近视伴散光患者100例200眼。根据治疗方案分为SMILE组50例100眼，FS-LASIK组50例100眼。比较两组患者手术前后视力和散光值、角膜形态参数、主观视觉质量评分、眼表指标、术后并发症及生活质量。

结果：两组间患者术前，术后1 d，1、6 mo裸眼视力(UCVA)、最佳矫正视力(BCVA)、散光值、角膜非球面Q值、角膜表面规则性指数(SRI)、角膜厚度、角膜曲率比较均无差异(均P>0.05)。术后1、6 mo SMILE组主观视觉质量评分、生活质量评分、基础泪液分泌试验(SⅠt)、泪膜破裂时间(BUT)优于FS-LASIK组(均P<0.05)。SMILE组术后6 mo并发症发生率低于FS-LASIK组(P=0.005)。

结论：SMILE与FS-LASIK治疗近视伴散光均有较好的临床效果，但SMILE能减轻对眼表损伤，降低并发症风险，提高患者生活质量。

METHODS: Retrospective analysis. A total of 100 cases(200 eyes)of patients with myopia and astigmatism treated in our hospital from December 2021 to December 2022 were collected. Among them, 50 cases(100 eyes)were divided into SMILE group and 50 cases(100 eyes)were divided into FS-LASIK group according to the treatment plans. The visual acuity and astigmatism, corneal morphology parameters, subjective visual quality scores, ocular surface indicators, postoperative complications, and quality of life were compared between the two groups before and after surgery.

RESULTS: There was no significant difference in uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), astigmatism, corneal asphericity Q value, corneal surface regularity index(SRI), corneal thickness, and corneal curvature between the two groups before surgery and at 1 d, 1, and 6 mo after surgery(all P>0.05). At 1 and 6 mo after surgery, the subjective visual quality score, the quality of life score, Schirmer I test(SⅠt)and tear film break-up time(BUT)in the SMILE group were better than that in the FS-LASIK group(all P<0.05). The incidence of complications in the SMILE group was lower than that in the FS-LASIK group at 6 mo after surgery(P=0.005).

CONCLUSION: Both SMILE and FS-LASIK have good clinical effects in the treatment of myopia with astigmatism, but the SMILE could alleviate ocular surface injury, reduce the risk of complications and improve the quality of lifes for patients.