方法：回顾性分析2014-04/06在我院行角膜屈光手术患者110例220眼术后6mo的随访资料，其中飞秒激光小切口角膜基质透镜取出术(small incision lenticule extraction，SMILE)患者42例84眼，飞秒激光制瓣准分子激光原位角膜磨镶术(femtosecond laser in situ keratomileusis，FS-LASIK)37例74眼，准分子激光原位角膜磨镶术(laser in situ keratomileusis，LASIK)31例62眼。术前三组患者平均等效球镜度分别为-5.91±1.83、-5.89±1.96、-5.88±1.68D，术前三组患者最佳矫正视力(best corrected visual acuity，BCVA)、瞳孔直径差异及中央角膜厚度均无统计学差异(P>0.05)。对比分析三组患者术后1wk，1、3、6mo随访时裸眼视力(uncorrected visual acuity，UCVA)、最佳矫正视力(best corrected visual acuity，BCVA)、屈光度等。

结果：(1)术后1wk和1mo所有患者均按时随访，术后3mo时SMILE和FS-LASIK与LASIK组分别有5例10眼、5例10眼、4例8眼失访，术后6mo随访SMILE和FS-LASIK与LASIK组分别有9例18眼、6例12眼、7例14眼失访。(2)术后1wk，SMILE和FS-LASIK与LASIK组UCVA的差异具有统计学意义(t=4.098，P=0.000； t=2.493，P=0.004)。(3)LASIK组术后1wk与术后3、6mo的UCVA差异具有统计学意义(t=3.410，P=0.001； t=3.771，P=0.000)，术后1mo与术后6mo的UCVA差异具有统计学意义(t=2.283，P=0.026)。(4)术后1wk，1、3、6mo三组患者屈光度的差异均无统计学意义(χ²=0.119，P=0.942； χ²=1.504，P=0.471； χ²=0.949，P=0.622； χ²=0.277，P=0.871)。(5)术后1wk，SMILE组和FS-LASIK组与LASIK组裸眼视力≥5.0的眼数差异具有统计学意义(χ²=9.249，P=0.002<0.016； χ²=12.906，P=0.000<0.0016)，而FS-LASIK组与LASIK组裸眼视力≥5.0的眼数差异无统计学意义(χ²=0.500，P=0.604)。(6)三组患者术后1wk和1、3、6mo的等效球镜度数在±0.50D范围内的眼数差异无统计学意义(χ²=0.809，P=0.697； χ²=1.176，P=0.634； χ²=0.871，P=0.736； χ²=0.683，P=0.770)。

结论：在术后6mo内SMILE和FS-LASIK与LASIK矫正近视均具备有效性和稳定性，但SMILE在术后1wk的有效性优于FS-LASIK及LASIK，能够在术后更快速地改善裸眼视力。

METHODS: A retrospective study, 42 cases(84 eyes)received SMILE, 37 cases(74 eyes)received FS-LASIK and 31cases(62 eyes)undergone LASIK in our hospital during Apr.2014 to Jun.2014 were involved. The follow-up data of 6mo was analyzed. The preoperative spherical equivalent was -5.91±1.83D, -5.89±1.96D, -5.88±1.68D in SMILE, FS-LASIK and LASIK group, respectively. The differences of preoperative best corrected visual acuity(BCVA), pupil diameter(PD)and central corneal thickness(CCT)had no statistically significant between three groups. The postoperative uncorrected visual acuity(UCVA), BCVA and diopter were comparative analyzed at 1wk, 1, 3 and 6m after surgery.

RESULTS:1)No patients lost to follow-up of 1wk and 1mo. A total of 10 eyes(5 cases), 10 eyes(5 cases)and 8 eyes(4 cases)lost to follow-up of 3m in SMILE、FS-LASIK and LASIK group, respectively, and raised to 18 eyes(9 cases), 12 eyes(6 cases)and 14 eyes(7 cases)in follow-up of 6m. 2)At 1wk follow-up, the differences of UCVA between SMILE group, FS-LASIK group vs LASIK group was statistically significant respectively(t=4.098, P=0.000; t=2.493, P=0.004). 3)In LASIK group, the differences of UCVA between 1wk vs 3, 6m follow-up was statistically significant respectively(t=3.410, P=0.001; t=3.771, P=0.000), the differences of UCVA between 1m and 6m follow-up was statistically significant(t=2.283, P=0.026). 4)The differences of diopter were not statistically significant among three groups at 1wk, 1, 3 and 6mo follow-up respectively(χ²=0.119, P=0.942; χ²=1.504, P=0.471; χ²=0.949, P=0.622; χ²=0.277, P=0.871). 5)the differences of eyes with UCVA≥5.0 was statistically significant between SMILE group vs FS-LASIK group, LASIK group at 1wk follow-up(χ²=9.249, P=0.002<0.05/3; χ²=12.906, P=0.000<0.05/3), there was no significant statistical difference between FS-LASIK group and LASIK group(χ²=0.500, P=0.604). 6)there was no significant statistical difference of eyes with SE(±0.50D)at any time post operation among three groups(χ²=0.809, P=0.697; χ²=1.176, P=0.634; χ²=0.871, P=0.736; χ²=0.683, P=0.770).

CONCLUSION: All of SMILE, FS-LASIK and LASIK are effective and stable on treating myopia according to follow-up of 6mo. However, in this study, SMILE group shows more effective than FS-LASIK and LASIK at 1wk, which could enhance postoperative UCVA more rapidly.