SMILE矫正低中度近视与高度近视的效果对比

Comparison of the Effects of SMILE in Correcting Low Myopia, Medium Myopia and High Myopia

摘要: 目的：比较低中高度近视SMILE术后不同时间点的视力与屈光度变化。方法：回顾性研究，选择了2021年12月至2022年12月在青岛大学附属医院进行SMILE手术的患者，将纳入患者按等效球镜分为低中高度近视组，在术后完成1 d、1 wk、1 mo、3 mo的随访检查，观察患者各项数据变化情况。结果：患者术后各时点裸眼视力、等效球镜、球镜度数、柱镜度数均优于术前。术后裸眼视力比较：术后1 w低度近视组与高度近视组的差异有统计学意义(p = 0.004)；低、中度近视组术后1 d与1 mo差异有统计学意义(p < 0.05)；术后等效球镜比较：术后3 mo低度近视组与高度近视组的差异有统计学意义(p = 0.004)；高度近视组术后1 d与3 mo差异有统计学意义(p < 0.05)；术后球镜比较：高度近视组术后1 d与3 mo差异有统计学意义(p < 0.05)；术后柱镜比较：术后1 d低度近视组与中度近视组的差异有统计学意义(p = 0.009)；术后1 mo低度近视组与中、高度近视组差异有统计学意义(对应p = 0.011，p < 0.001)，术后3 mo低度近视组与中、高度近视组差异有统计学意义(对应p = 0.001，p < 0.001)。术后3 mo，裸眼视力 ≥ 1.0，三组占比均 > 90%，柱镜 ≤ |0.25| D，三组占比均高于术前。结论：三组患者术后裸眼视力明显提高，散光仍存在矫正不足。

Abstract: Objective: To compare the visual acuity and refraction at different times after SMILE for low to moderate to high myopia. Method: Retrospective study. We selected patients who underwent SMILE surgery at the Affiliated Hospital of Qingdao University from December 2021 to December 2022. All patients were divided into low myopia group, medium myopia group and high myopia group ac-cording to their equivalent spherical diameter, follow-up examinations will be completed at 1st day, 1st week, 1st month and 3rd mont after surgery to observe the changes in various data of the pa-tients. Result: The postoperative uncorrected visual acuity, spherical equivalent, spherical diopter, and cylinder diopter were all better than preoperative. Comparison of uncorrected visual acuity: there was a statistically significant difference (p = 0.004) between the low myopia group and the high myopia group after 1st day of surgery; there was a statistically significant difference between the low and medium myopia groups at 1st day and 1st week after surgery (p < 0.05); comparison of spherical equivalent: there was a statistically significant difference (p = 0.004) between the low myopia group and the high myopia group 3rd month after surgery; there was a statistically signifi-cant difference (p < 0.05) between 1st day with 3rd month after surgery in the high myopia group; comparison of spherical diopter: there was a statistically significant difference between the high myopia group at 1st day with 3rd month after surgery (p < 0.05); comparison of cylinder diopter: there was a statistically significant difference (p = 0.009) between the low myopia group and the medium myopia group 1st day after surgery; there was a statistically significant difference between the low myopia group and the medium and high myopia groups 1st month after surgery (corre-sponding to p = 0.011, p < 0.001), and a statistically significant difference between the low myopia group and the medium and high myopia groups 3rd month after surgery (corresponding to p = 0.001, p < 0.001). After 3 months of surgery, uncorrected visual acuity was ≥ 1.0, and the proportion of all three groups was > 90%, cylinder diopter ≤ |0.25| D, and the proportion of the three groups was higher than before surgery. Conclusion: The postoperative uncorrected visual acuity of the three groups of patients has significantly improved, and there is still insufficient correction for astigmatism.