摘要
目的:探讨SMILE(small incision lenticule extraction)手术对青壮年近视患者玻璃体后脱离(posterior vitreous detachment,PVD)的影响,并与飞秒激光制瓣的准分子激光原位角膜磨镶术(femtosecond assisted laser-in-situ keratomileusis,FS-LASIK)和前弹力层下激光角膜磨镶术(sub-bowman's keratomileusis,SBK)的术后PVD发生率比较。方法:共纳入青壮年近视患者113例(219眼),分别接受SMILE、FS-LASIK和SBK治疗,术前、术后1 d、10 d、1个月、3个月、6个月分别使用光学相干断层扫描(optical coherence tomography,OCT)检测。结果:(1)SMILE组术前PVD发生率为2.1%(2/95眼),术后新增7眼,术后PVD发生率为9.5%,术前与术后PVD发生率差异有统计学意义(P<0.001)。(2)FS-LASIK组术前PVD发生率为9.8%(8/82眼),术后新增10眼,术后PVD发生率为22.0%,术前与术后PVD发生率差异有统计学意义(P<0.001)。(3)SBK组42眼术前无PVD发生,术后新增3眼,术后PVD发生率为7.1%,术前与术后PVD发生率差异无统计学意义(P>0.05)。(4)SMILE组术后新增PVD发生率与FS-LASIK组、SBK组相比差异无统计学意义(P>0.05)。(5)术后不同时间点,SMILE组和FS-LASIK组术后3个月内均有新增PVD,术后6个月无新增PVD;SBK组术后1月内有新增PVD,术后3个月后无新增PVD。(6)3组术后PVD在不同程度近视度数组中分布差异无统计学意义(P>0.05)。(7)SMILE组术前2眼有PVD,术后未变化,FS-LASIK组术前有8眼发生PVD,术后5眼PVD脱离范围扩大。结论:青壮年近视患者在SMILE、FS-LASIK和SBK术后短期内均可诱发PVD,FS-LASIK组使原有PVD脱离范围扩大。
Objective:To investigate the impact of SMILE on posterior vitreous detachment(PVD)in young adult myopic patients,and to compare the incidence of postoperative PVD with femtosecond assisted laser-in-situ keratomileusis(FS-LASIK)and sub-Bowman's keratomileusis(SBK).Methods:This study involved 113 young adult myopic patients(219 eyes).Optical coherence tomography(OCT)was used to assess PVD preoperatively and at 1 day,10 days,1 month,3 months,and 6 months postoperatively.Results:(1)In the SMILE group,2 out of 95 eyes had preoperative PVD(2.1%).Postoperatively,7 new cases occurred,leading to a rate of 9.5%(P<0.001).(2)In the FS-LASIK group,8 out of 82 eyes had preoperative PVD(9.8%),with 10 new cases postoperatively,raising the rate to 22%(P<0.001).(3)In the SBK group,no preoperative PVD was noted among 42 eyes,but 3 new cases emerged postoperatively,resulting in a 7.1%rate(P>0.05).(4)The postoperative PVD rate in the SMILE group was not significantly different from the FS-LASIK and SBK groups(P>0.05).(5)Both SMILE and FS-LASIK groups saw PVD development within 3 months postoperatively,while SBK had new cases only within 1 month.(6)The distribution of postoperative PVD across different myopia degrees showed no significant differences(P>0.05).(7)The SMILE group showed no change in the 2 preoperative PVD cases,while in the FS-LASIK group,5 out of 8 preoperative PVD cases expanded postoperatively.Conclusion:All three procedures can induce PVD in young adult myopic patients following SMILE,FS-LASIK,and SBK procedures in the short term.Additionally,FS-LASIK can also promote progression of pre-existing PVD.
作者
周翠平
陈辉
徐绘
张书强
俞莹
ZHOU Cuiping;CHEN Hui;XU Hui;ZHANG Shuqiang;YU Ying(Department of Ophthalmology,Affiliated Hos-pital of Nantong University,Jiangsu 226001;Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education,Co-innovation Center of Neuroregeneration,Nantong University)
出处
《南通大学学报(医学版)》
2025年第4期384-388,共5页
Journal of Nantong University(Medical sciences)
基金
南通市社会民生科技计项目(MSZ2022024)。
关键词
玻璃体后脱离
SMILE手术
光学相关断层扫描
近视
posterior vitreous detachment
small incision lenticule extraction
optical coherence tomography
myopia
