SMILE与FS-LASIK术后早期视觉质量评估与比较

发布时间：2018-06-12 07:30

本文选题：飞秒激光小切口基质透镜取出术 + 飞秒激光准分子激光原位角膜磨镶术　；参考：《北京协和医学院》2016年博士论文

【摘要】：目的对飞秒激光小切口基质透镜取出术(Small-incision lenticule extraction, SMILE)与飞秒激光准分子激光原位角膜磨镶术(femtosecond laser-assisted laser in situ keratomileusis, FS-LASIK)术后早期视觉质量进行评价和比较。方法1.入选2015年12月至2016年4月于北京协和医院眼科行SMILE和FS-LASIK术的54例(107只眼)患者进行分析。2.利用视觉质量分析系统(optical quality analysis system, OQAS)对患者术前、术后1周、术后1月进行OSI、MTF cut off、SR、width at 50%、width at 10%、VA100%、 VA20%、VA9%、OV100%、OV20%、OV9%、mean OV、mean OSI等参数的测量。3.利用视觉质量主观评价问卷评估患者术后1周及1月光晕、眩光、夜间视力下降、视近物疲劳和眼部干涩等症状的有无和严重程度,以及术后满意度程度。4.用SPSS19.0对数据进行两个独立样本的Mann-Whitney U检验、K个相关样本Friedman检验,Kruskal-Wallis秩和检验和Spearman等级相关系数分析。结果1.术后1周SMILE组MTF cut off显著高于FS-LASIK组,术后1月无显著差异,而OSI值两者无显著差异。2. SMILE组与FS-LASIK组术后1周视觉质量均较术前明显下降,术后1月有所恢复,但并未恢复到术前水平。3.OQAS参数中mean OSI值与视近物疲劳有显著相关。mean OV与夜视力下降有显著相关。4.SMILE组与FS-LASIK组均有较高的术后满意度,两组间无显著差异。5.SMILE组术后1周眼干症状比FS-LASIK组更轻微,术后1月两者无显著性差异。结论1. SMILE组与FS-LASIK术后1周及术后1月散射均有增加,术后1月散射较术前1周显著减小,但未恢复到术前水平。2.术后1周时SMILE组的视觉质量显著高于FS-LASIK,干眼症状较FS-LASIK更轻微。术后1月两组均无显著差异。
[Abstract]:Objective to evaluate and compare the early visual quality of Small-principle lenticule extraction (Small-principle lenticule extraction) and femtosecond laser-assisted laser in situ keratomileusis, FS-LASIKK (femtosecond laser-assisted laser in situ keratomileusis, FS-LASK) after femtosecond laser in situ keratomileusis (FS-LASIKK) with femtosecond laser in situ keratomileusis (FS-LASIKK). Method 1. A total of 54 patients with 107 eyes underwent Smile and FS-LASIK from December 2015 to April 2016 were analyzed. Visual quality analysis system (quality analysis system,) was used to measure the optical quality analysis system, OSI before operation, 1 week after operation, 1 month after operation, and 1 month after operation. The subjective evaluation questionnaire of visual quality was used to evaluate the severity and severity of the symptoms of halo glare nocturnal vision fatigue and ocular dryness in 1 week and 1 month after operation. Using SPSS 19.0, two independent samples were tested by Mann-Whitney U test. Friedman's test of Kruskal-Wallis rank sum and Spearman's rank correlation coefficient were carried out. Result 1. MTF cut off in Smile group was significantly higher than that in FS-LASIK group at 1 week after operation, but there was no significant difference at 1 month after operation. The visual quality in Smile group and FS-LASIK group decreased significantly 1 week after operation and recovered at 1 month after operation. However, there was no return to the preoperative level. 3. There was a significant correlation between mean OSI and visual proximal fatigue. There was a significant correlation between OV and visual acuity decline. 4. There was a higher degree of satisfaction between SMILE group and FS-LASIK group. There was no significant difference between the two groups. 5. The dry eye symptoms in the Smile group were more mild than those in the FS-LASIK group 1 week after operation, but there was no significant difference between the two groups at one month after operation. Conclusion 1. In Smile group and FS-LASIK group, the scattering increased 1 week after operation and 1 month after operation, and decreased significantly at 1 month after operation, but did not return to the preoperative level of 0.2. The visual quality of Smile group was significantly higher than that of FS-LASIK group 1 week after operation, and the dry eye symptom was more mild than FS-LASIK group. There was no significant difference between the two groups at 1 month after operation.
【学位授予单位】：北京协和医学院
【学位级别】：博士
【学位授予年份】：2016
【分类号】：R779.63

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