目的：分析飞秒激光小切口角膜基质透镜取出术(SMILE)后影响非接触式眼压(IOP_NCT)测量值的部分因素，探讨SMILE术后IOP_NCT与角膜中央厚度(CCT)及角膜曲率之间的相关性，并构建相应的回归模型，为临床评估SMILE术后患者眼压真实状况提供科学依据。

方法：回顾性分析2023-06/2024-05在成都市第三人民医院眼科行SMILE的近视患者107例206眼和行飞秒激光原位角膜磨镶术(FS-LASIK)的近视患者107例201眼，收集患者术前，术后1、3 mo的IOP_NCT测量值、CCT、角膜曲率等资料，通过重复测量数据的方差分析、Pearson相关性分析对手术前后的IOP_NCT、CCT、角膜曲率进行分析，并构建多元线性回归模型评估术后IOP_NCT与CCT、角膜曲率变化值之间的关联性。

结果：SMILE与FS-LASIK术后患者的IOP_NCT、CCT、角膜曲率在时间上均存在显著差异(均P<0.001)，组间和交互比较无差异(均P>0.05)，两组术后1、3 mo IOP_NCT、CCT、角膜曲率均显著低于术前(均P<0.05)。SMILE患者术后1、3 mo IOP_NCT与CCT之间呈正相关(r=0.261、0.267，均P<0.001)，而与角膜曲率无显著相关(均P>0.05)。SMILE术后1 mo IOP_NCT与CCT、角膜曲率之间的回归方程为：Y=3.426+0.019X₁-0.058X₂(Y代表IOP_NCT，X₁代表CCT，X₂代表角膜曲率)，方程差异有统计学意义(F=7.654，P=0.001)； 术后3 mo的回归方程为：Y=2.056+0.020X₁-0.038X₂(Y代表IOP_NCT，X₁代表CCT，X₂代表角膜曲率)，方程差异有统计学意义(F=7.903，P<0.001)。SMILE术前术后IOP_NCT变化值(△IOP_NCT)与术中切削角膜厚度(△CCT)、角膜曲率变化值在术后1 mo的回归方程为：Y=-2.252+0.008X₁+0.587X₂(其中Y代表△IOP_NCT，X₁代表△CCT，X₂代表角膜曲率变化值)，方程差异有统计学意义(F=17.550，P<0.001)； 术后3 mo的回归方程为：Y=-2.168+0.024X₁+0.281X₂(Y表示△IOP_NCT，X₁表示△CCT，X₂表示角膜曲率变化值)，方程差异有统计学意义(F=16.030，P<0.001)。

结论：SMILE与FS-LASIK手术后，患者IOP_NCT值主要受CCT影响较术前降低，术后短期内使用激素类滴眼液氟米龙不会使眼压升高，且SMILE术后1 mo眼压校正公式Y=3.426+0.019X₁-0.058X₂(Y代表IOP_NCT，X₁代表CCT，X₂代表角膜曲率)和术后3 mo眼压校正公式Y=2.056+0.020X₁-0.038X₂(Y代表IOP_NCT，X₁代表CCT，X₂代表角膜曲率)均可用于临床以评估SMILE术后患者的实际眼压并进行修正。

METHODS: Data from a retrospective analysis of 107 myopic patients(206 eyes)who underwent SMILE and 107 myopic patients(201 eyes)received femtosecond laser-assisted in situ keratomileusis(FS-LASIK)surgery from June 2023 to May 2024 were examined. IOP_NCT, CCT, and corneal curvature before surgery and at 1 and 3 mo were collected. The preoperative and postoperative IOP_NCT, CCT and corneal curvature were analyzed by ANOVA and Pearson correlation analysis, and multiple linear regression models were constructed to evaluate the association of postoperative changes of IOP_NCT, CCT and corneal curvature.

RESULTS: There were significant differences in IOP_NCT, CCT, and corneal curvature of both SMILE and FS-LASIK patients(all P<0.001), there was no significant difference between two groups and interaction effects(all P>0.05), and the IOP_NCT, CCT and corneal curvature at 1 and 3 mo post-surgery were significantly lower than preoperative(all P<0.05). Pearson correlation analysis showed a positive correlation between IOP_NCT and CCT at 1 and 3 mo after SMILE(r=0.261, 0.267, all P<0.001), but no significant correlation with corneal curvature(all P>0.05). Multiple linear regression analysis of IOP_NCT with CCT and corneal curvature at 1 mo after SMILE indicated that the regression equation was: Y=3.426+0.019X₁-0.058X₂(Y represents IOP_NCT, X₁ represents the CCT, and X₂ represents the corneal curvature), with statistical significant difference in the equation(F=7.654, P=0.001); the regression equation for 3 mo after surgery was: Y=2.056+0.020X₁-0.038 X₂(Y represents IOP_NCT, X₁ represents the CCT, and X₂ represents the corneal curvature), with statistically significance in the equation(F=7.903, P<0.001). The regression equation of postoperative IOP_NCT change(△IOP_NCT)and intraoperative cutting corneal thickness(△CCT)and corneal curvature at 1 mo was Y=-2.252+0.008X₁+0.587X₂(Y represents △IOP_NCT, X₁ stands for the △CCT, X₂ represents the corneal curvature change value), with statistical significant difference in the equation(F=17.550, P<0.001); the regression equation for 3 mo after surgery was: Y=-2.168+0.024X₁+0.281X₂(Y represents △IOP_NCT, X₁ represents △CCT, X₂ indicates the corneal curvature change values), with statistical significant difference in the equation(F=16.030, P<0.001).

CONCLUSION: After SMILE and FS-LASIK surgery, the IOP_NCT value of patients was mainly affected by CCT compared with preoperative surgery, and the short-term use of hormone eye drops, fluorometholone, did not cause a significant increase in IOP; both the IOP correction formula at 1 and 3 mo postoperatively can be used clinically to evaluate and correct actual IOP in patients after SMILE.