Abstract：【Objective】To compare clinical efficacy (the visual quality, dry eye symptom and biomechanical stability) of patients with myopia and astigmatism treated by femtosecond laser small incision keratomileusis (Smile), femtosecond laser flap excimer laser in situ keratomileusis (Fs-lasik) and excimer laser in situ keratomileusis (Lasik). 【Methods】The clinical data of 698 cases of myopia and astigmatism treated in our hospital from January 2015 to October 2018 were analyzed retrospectively. According to the surgical methods, they were divided into the Smile group (with Smile operation, n=302 cases for 508 eyes), the Fs-lasik group (with Fs-lasik operation, n=189 cases for 321 eyes) and the Lasik group (with Lasik operation, n=207 cases for 356 eyes). The postoperative visual quality, dry eye condition and postoperative biomechanical stability of the patients were compared in three groups. 【Results】①There were no significant differences in diopter, UCVA, BCVA and high order shadow aberrations between the Fs-lasik group and the Lasik group before and after operation (P>0.05). In the Smile group, there was no significant difference in diopter, UCVA and BCVA before and after operation (P>0.05), however, there was significant difference in high-order shadow aberrations between pre- and post-operation (P<0.05). One month after operation, the differences among the Smile group, the Fs-lasik group and the Lasik group were statistically significant (P<0.05). The number of eyes in the range of ±0.50D was also significantly different among the three groups at 1 month after operation (P<0.05); and there was significant difference between Fs-lasik group and Lasik group (t=3.319, P=0.003). However, there was no significant difference in the other indicators among the three groups at the same time point(P>0.05).②After surgery, the values of NIBUTf and NIBUTa among the three groups were lower than those before surgery (P<0.05), however, there was no significant changes in LTMH (P＞0.05). There were no significant differences of NIBUTf and LTMH in the three groups of patients at the same time point before and after surgery (all P> 0.05). At 3 months after operation, the NIBUTa in the Smile group was significantly lower than that in the Fs-lasik group and the Lasik group (χ2=8.573,P=0.004;χ2=9.047,P=0.003). There were no significant differences at other time points (all P> 0.05).③The levels of postoperative corneal lag (CH) and corneal resistance factor (CRF) in the three groups were significantly lower than those before operation (P<0.05).However, among the three groups there were no significant differences in the CH and CRF values at the same time point before and after operation (all P＞0.05). 【Conclusion】Laser surgeries of Smile, Fs-lasik and Lasik have effectiveness and stability in the correction of myopia and astigmatism at 3 months after operation. Effects of Smile on UCVA and NIBUTa are relatively better than those of Fs-lasik and Lasik, which is worthy of clinical application.
邹广程, 叶静娟. 三种准分子激光角膜屈光手术治疗近视及散光的临床研究[J]. 医学临床研究, 2019, 36(11): 2172-2175.
ZOU Guang-cheng, YE Jing-juan. A Comparative Study of Three Excimer Laser Refractive Surgical Methods for Myopia and Astigmatism. JOURNAL OF CLINICAL RESEARCH, 2019, 36(11): 2172-2175.
2019, Vol. 36 
