目的探讨飞秒激光小切口角膜基质透镜取出术(SMILE)与飞秒激光辅助准分子激光角膜原位磨镶术(FS-LASIK)术后眼调制传递函数(MTF)的变化。
方法采用队列研究设计。收集2015年12月至2016年6月于天津市眼科医院屈光手术中心行SMILE和FS-LASIK的近视患者102例102眼，根据手术方式不同将其分为SMILE组53例53眼和FS-LASIK组49例49眼。采用Pentacam角膜地形图仪和WaveScan像差仪分别在术前和术后1、3、6个月检测角膜形态特征和像差，应用MTF进行计算和分析。比较2个组不同空间频率下不同时间点MTF值变化和术后6个月2个组去除低阶像差后MTF值变化，以及术后6个月SMILE组去除垂直彗差、水平彗差、球差后MTF值的变化。
结果SMILE组和FS-LASIK组术后1、3、6个月各空间频率的MTF值较术前均明显升高，差异均有统计学意义(均 P<0.05)。SMILE组术后1、3、6个月各空间频率MTF值均高于FS-LASIK组。除55 c/d、60 c/d外，其余空间频率下2个组术后6个月MTF值比较差异均有统计学意义(均 P<0.05)。术后6个月去除低阶像差后，各空间频率下SMILE组的MTF值均明显高于FS-LASIK组，差异均有统计学意义(均 P<0.05)。术后6个月1 c/d空间频率下SMILE组去除球差、水平彗差后MTF值明显高于去除前MTF值，差异均有统计学意义(均 P<0.01)；1 c/d、3 c/d空间频率下去除垂直彗差后MTF值明显高于去除前MTF值，差异均有统计学意义(均 P<0.05)，其余空间频率去除单项高阶像差后与术后6个月MTF值比较差异均无统计学意义(均 P>0.05)。
结论SMILE和FS-LASIK术后眼MTF均较术前升高，且SMILE术后MTF值较FS-LASIK术后MTF值略高。
ObjectiveTo investigate and compare the changes of modulation transfer function (MTF) after small-incision lenticule extraction (SMILE) and femtosecond laser-assisted laser in situ keratomileusis(FS-LASIK).
MethodsA cohort study was conducted.One hundred and two myopic patients (102 eyes) who underwent SMILE and FS-LASIK in Tianjin Eye Hospital from December 2015 to June 2016 were enrolled and divided into SMILE group with 53 eyes and FS-LASIK group with 49 eyes according to different surgical methods.The ocular aberrations and corneal morphology of all patients were measured by the Hartman-Shack wave-front analyzer and Pentacam topography before surgery and 1, 3 and 6 months postoperatively.MTF of optic system was calculated and analyzed.The changes of MTF values were compared between the two groups at different time points under different spatial frequencies, after removal of low-order aberrations at postoperative 6 months, and after removal of vertical coma aberration, horizontal coma aberration and spherical aberration in the SMILE group at postoperative 6 months.The study protocol complied with the Declaration of Helsinki and was approved by an Ethics Committee of Tianjin Eye Hospital (No.TJYYLL-2014-17). Written informed consent was obtained from each patient before surgery.
ResultsCompared with the preoperative MTF, there were significant increases in postoperative 1-, 3- and 6-month MTF at all spatial frequencies in the SMILE group and FS-LASIK group (all at P<0.05). MTF values at all spatial frequencies in the SMILE group were significantly higher than those in the FS-LASIK group at 1, 3, and 6 months after surgery (all at P<0.05), except at 55 c/d and 60 c/d at 6 months postoperatively.The postoperative 6-month MTF values at all spatial frequencies without low-order aberration were higher in the SMILE group than those in the FS-LASIK group, showing significant differences between the two groups (all at P<0.05). In the SMILE group, the postoperative 6-month MTF values at 1 c/d spatial frequency without the horizontal coma aberration and spherical aberration were significantly higher than the preoperative MTF values (both at P<0.01); the postoperative 6-month MTF values at 1 c/d and 3 c/d spatial frequency without vertical coma aberration were significantly higher than the preoperative MTF values (both at P<0.05), and there were no statistically significant differences between the postoperative 6-month MTF values at the other spatial frequencies with and without single high-order aberrations (all at P>0.05).
ConclusionsOptic quality has been obviously improved after SMILE and FS-LASIK, and the SMILE is superior to FS-LASIK in the MTF value.
崔彤,王雁,张琳,等. SMILE与FS-LASIK术后调制传递函数在不同空间频率的变化[J]. 中华实验眼科杂志,2021,39(06)：515-521.
DOI:10.3760/cma.j.cn115989-20210310-00159版权归中华医学会所有。
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