摘要目的 比较准分子激光前弹力层下角膜磨镶术(SBK)与飞秒激光小切口角膜基质透镜取出术(SMILE)术后早期视力及残余屈光度.方法 前瞻性研究.近视及近视散光60例(120只眼),SBK和SMILE两种手术各30例(60只眼).比较两组术后1d、7d和1个月裸眼视力和残余屈光度.结果 术后1d和7 d SBK组裸眼视力≥1.0者分别占85.0％和95.0％,明显多于SMILE组的48.3％和81.7％,差异有统计学意义(P=0.000和0.023);术后1个月SBK组裸眼视力≥1.0者占96.7％,与SMILE组的95.0％比较差异无统计学意义(P=0.648);术后1个月,SBK组有效指数为1.001 ±0.005,SMILE组有效指数为1.005±0.012,两组之间的差异无统计学意义(P=0.128).术后1个月,两组安全指数差异无统计学意义(P =0.547).术后1d、7d和1个月SBK组的残余屈光度(等效球镜度)依次为(0.376 ±0.471)D、(0.070 ±0.413)D和(0.185±0.292)D,SMILE组分别为(-0.073 ±0.433)D、(0.006 ±0.338)D和(0.079±0.270)D,SBK组和SMILE组残余屈光度(等效球镜)比较术后1d和1个月差异有统计学意义,而术后7d,差异无统计学意义(t=5.439、0.932、2.061,P=0.000、0.353、0.041).结论 SMILE术后早期残余屈光度与目标屈光度更为接近,但其视力恢复比SBK术稍慢.

abstractsObjective To compare visual acuity and residual diopter after sub-Bowman's keratectomy (SBK) and femtosecond small incision lenticule extraction (SMILE).Methods In this prospective,non-randomized observational study,120 eyes of 60 patients were included,60 eyes of 30 patients received SBK surgery as the SBK group,and 60 eyes of 30 patients received SMILE surgery as the SMILE group.The differences of the visual acuity and residual diopter between the two groups on 1 d,7 d and 1 month postoperatively were compared.Results At 1 day and 1 week postoperatively,the proportion of uncorrected visual acuity ≥ 1.0 in SBK group were 85.0％ and 95.0％,more than that in group SMILE (48.3％ and 81.7％),the differences was statistically significant (P =0.000 and 0.023).There were no statistically significant difference in uncorrected visual acuity between SBK (96.7％) and SMILE group (95.0％) at 1 month postoperatively (P =0.648).No statistically significant difference in efficacy index was found between the two groups at 1 month postoperathely (P =0.128).There was no statistically significant difference in safety index between the two groups at 1 month after surgery (P =0.547).At 1 day,1 week and 1 month postoperatively,the residual diopter in SBK group were (0.376 ±0.471) D,(0.070 ± 0.413) D and (0.185 ±0.292) D respectively.In the SMILE group the residual diopter were (-0.073 ± 0.433) D,(0.006± 0.338) D and (0.079 ± 0.270) D correspondingly.The residual diopter was statistically significant between the two groups at 1 day、1 month after surgery.There was no statistically significant difference between the two groups at 1 week visit(t =5.439、0.932、2.061,P =0.000、0.353、0.041).Conclusion After SMILE,the consistency of residual diopter and objective diopter are better,but recovery of visual acuity is slightly slower than that of SBK.