AIM:To compare the effect of myopia and astigmatism correction and postoperative change in higher-order aberration as results of receiving small-incision lenticule extraction(SMILE)and femtosecond laser-assisted in si...AIM:To compare the effect of myopia and astigmatism correction and postoperative change in higher-order aberration as results of receiving small-incision lenticule extraction(SMILE)and femtosecond laser-assisted in situ keratomileusis(FS-LASIK).METHODS:A prospective and non-randomized controlled study was conducted.The subjects are divided into two groups according to different operations received:229 eyes of 116 patients in the SMILE group and 168 eyes of 86 patients in the FS-LASIK group.All subjects were followed up for 3 mo by monitoring their uncorrected visual acuity(UCVA),best-corrected visual acuity(BCVA),spherical equivalent,higher-order aberrations,and the preoperative and postoperative complications.RESULTS:At 1 wk,1,and 3 mo post-surgery,224 eyes(97.8%),227 eyes(99.1%)and 229 eyes(100%)had UCVA≥20/20 in the SMILE group,while 165 eyes(98.2%),167 eyes(99.4%)and 167 eyes(99.4%)had UCVA≥20/20 in the FS-LASIK group,respectively(χ^(2)=0.146,2.135,and 1.124;all P>0.05).BCVA reduction was not observed in both groups at 1 and 3 mo of post-surgery(χ^(2)=0.734 and 1.898,P>0.05).There was no statistically significant difference in the spherical equivalent between the two groups at 1 and 3 mo post-surgery,though the percentage of the spherical equivalent within±0.50 D at 3 mo postsurgery was 98%in the SMILE group,which was higherthan that of the FS-LASIK group(92%,χ^(2)=1.872,P>0.05).The root mean square(RMS)values of total high-order aberration,coma,and spherical aberration of the two groups increased significantly in the early postoperative period and decreased after 3 mo,but the values were still higher than the preoperative levels(P<0.05);there was no significant difference between the two groups in the RMS values of total higher-order aberrations and specific higherorder aberrations(P>0.05).The incidence of complications in the SMILE group was lower than that in the FS-LASIK group(χ^(2)=14.52,P<0.05).CONCLUSION:SMILE and FS-LASIK can effectively treat myopia,significantly improve visual acuity,and increase the total high-order aberration,spherical aberration,and coma.The incidence of complications after SMILE is relatively low.展开更多
AIM: To investigate the incidence of preoperative dry eye and related factors in patients undergoing corneal refractive surgery to correct myopia.METHODS: A total of 141 patients with myopia who underwent corneal refr...AIM: To investigate the incidence of preoperative dry eye and related factors in patients undergoing corneal refractive surgery to correct myopia.METHODS: A total of 141 patients with myopia who underwent corneal refractive surgery were surveyed by questionnaires, tear film break-up time(BUT) test, Schimer I test(SIt), corneal fluorescein staining(FL) test and diagnosed according to the currently recognized domestic diagnostic criteria for dry eye. Correlation analysis of factors such as age, gender, regular wearing of contact lens(CL), diopter(spherical equivalent), corneal thickness, and corneal curvature that may affect the onset of dry eye was carried out to clarify the main influencing factors. RESULTS: There were 64 patients(45.39%) diagnosed with dry eye. The male patients(20.31%) was significantly less than that of non-dry eye subjects(41.56%;χ~2=7.260, P=0.007);the proportion of patients with dry eye wearing CL(81.25%) was significantly higher than that of non-dry eye subjects(51.95%;χ~2=13.234, P<0.001);the median diopter level of dry eye patients was-6.59(IQR:-8.87,-4.58) D, and the median diopter level of non-dry eye subjects was-5.69(IQR:-7.15,-4.03) D. The diopter level of dry eye patients was significantly higher(Z=-2.086, P=0.019). However, the age, best corrected visual acuity, and intraocular pressure of dry eye patients were not statistically different from those of non-dry eye subjects(t=-0.257,-0.383 and 0.778, P=0.798, 0.702, and 0.438);the corneal thickness and corneal curvature(K1 and K2) were also not statistically different either(Z=-1.487,-1.036 and-1.707, P=0.137, 0.300, and 0.088). The research further analyzes the three significant factors in the single factor analysis(gender, CL wear, and diopter) in a multi-factor way: CL wear and diopter were the influencing factors of dry eye disease. Among them, CL wear increased the risk of dry eye by 2.934 times compared with no CL wear;for every 1 D increase in diopter, the risk of dry eye increased by 0.761 times.CONCLUSION: Preoperative dry eye is relatively common in patients who undergo corneal refractive surgery to correct myopia, especially in patients who have a history of CL wear and a high diopter level before surgery. Therefore, it is necessary to carry out preoperative screening and timely treatment of dry eye to obtain the best treatment outcome and postoperative satisfaction.展开更多
文摘AIM:To compare the effect of myopia and astigmatism correction and postoperative change in higher-order aberration as results of receiving small-incision lenticule extraction(SMILE)and femtosecond laser-assisted in situ keratomileusis(FS-LASIK).METHODS:A prospective and non-randomized controlled study was conducted.The subjects are divided into two groups according to different operations received:229 eyes of 116 patients in the SMILE group and 168 eyes of 86 patients in the FS-LASIK group.All subjects were followed up for 3 mo by monitoring their uncorrected visual acuity(UCVA),best-corrected visual acuity(BCVA),spherical equivalent,higher-order aberrations,and the preoperative and postoperative complications.RESULTS:At 1 wk,1,and 3 mo post-surgery,224 eyes(97.8%),227 eyes(99.1%)and 229 eyes(100%)had UCVA≥20/20 in the SMILE group,while 165 eyes(98.2%),167 eyes(99.4%)and 167 eyes(99.4%)had UCVA≥20/20 in the FS-LASIK group,respectively(χ^(2)=0.146,2.135,and 1.124;all P>0.05).BCVA reduction was not observed in both groups at 1 and 3 mo of post-surgery(χ^(2)=0.734 and 1.898,P>0.05).There was no statistically significant difference in the spherical equivalent between the two groups at 1 and 3 mo post-surgery,though the percentage of the spherical equivalent within±0.50 D at 3 mo postsurgery was 98%in the SMILE group,which was higherthan that of the FS-LASIK group(92%,χ^(2)=1.872,P>0.05).The root mean square(RMS)values of total high-order aberration,coma,and spherical aberration of the two groups increased significantly in the early postoperative period and decreased after 3 mo,but the values were still higher than the preoperative levels(P<0.05);there was no significant difference between the two groups in the RMS values of total higher-order aberrations and specific higherorder aberrations(P>0.05).The incidence of complications in the SMILE group was lower than that in the FS-LASIK group(χ^(2)=14.52,P<0.05).CONCLUSION:SMILE and FS-LASIK can effectively treat myopia,significantly improve visual acuity,and increase the total high-order aberration,spherical aberration,and coma.The incidence of complications after SMILE is relatively low.
文摘AIM: To investigate the incidence of preoperative dry eye and related factors in patients undergoing corneal refractive surgery to correct myopia.METHODS: A total of 141 patients with myopia who underwent corneal refractive surgery were surveyed by questionnaires, tear film break-up time(BUT) test, Schimer I test(SIt), corneal fluorescein staining(FL) test and diagnosed according to the currently recognized domestic diagnostic criteria for dry eye. Correlation analysis of factors such as age, gender, regular wearing of contact lens(CL), diopter(spherical equivalent), corneal thickness, and corneal curvature that may affect the onset of dry eye was carried out to clarify the main influencing factors. RESULTS: There were 64 patients(45.39%) diagnosed with dry eye. The male patients(20.31%) was significantly less than that of non-dry eye subjects(41.56%;χ~2=7.260, P=0.007);the proportion of patients with dry eye wearing CL(81.25%) was significantly higher than that of non-dry eye subjects(51.95%;χ~2=13.234, P<0.001);the median diopter level of dry eye patients was-6.59(IQR:-8.87,-4.58) D, and the median diopter level of non-dry eye subjects was-5.69(IQR:-7.15,-4.03) D. The diopter level of dry eye patients was significantly higher(Z=-2.086, P=0.019). However, the age, best corrected visual acuity, and intraocular pressure of dry eye patients were not statistically different from those of non-dry eye subjects(t=-0.257,-0.383 and 0.778, P=0.798, 0.702, and 0.438);the corneal thickness and corneal curvature(K1 and K2) were also not statistically different either(Z=-1.487,-1.036 and-1.707, P=0.137, 0.300, and 0.088). The research further analyzes the three significant factors in the single factor analysis(gender, CL wear, and diopter) in a multi-factor way: CL wear and diopter were the influencing factors of dry eye disease. Among them, CL wear increased the risk of dry eye by 2.934 times compared with no CL wear;for every 1 D increase in diopter, the risk of dry eye increased by 0.761 times.CONCLUSION: Preoperative dry eye is relatively common in patients who undergo corneal refractive surgery to correct myopia, especially in patients who have a history of CL wear and a high diopter level before surgery. Therefore, it is necessary to carry out preoperative screening and timely treatment of dry eye to obtain the best treatment outcome and postoperative satisfaction.
