| 邓娅,楼永倞,余璐,等.有晶状体眼后房型人工晶状体术与SMART 术矫治中低度近视术后效果及视觉质量的比较[J].安徽医药,2022,26(8):1602-1607. |
| 有晶状体眼后房型人工晶状体术与SMART 术矫治中低度近视术后效果及视觉质量的比较 |
| Comparison and analysis of the postoperative effect and visual quality of ICL surgery and SMART surgery for moderate and low myopia |
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| DOI：10.3969/j.issn.1009-6469.2022.08.027 |
| 中文关键词: 近视 ICL手术 SMART手术 视觉质量 全眼像差 眼血流动力学 |
| 英文关键词: Myopia ICL surgery SMART surgery Visual quality Aberrations of the whole eye Ocular hemodynamics |
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| 中文摘要: |
| 目的探究中低度近视有晶状体眼后房型人工晶状体(ICL)手术矫治与SMART手术矫治术后效果及视觉质量的变化。方法选取2019年1月至2020年1月武汉汉阳艾格眼科医院中低度近视病人148例(148眼)，随机数字表法分为ICL组(74例，74眼)和SMART组(74例，74眼)。ICL组施行ICL，SMART组施行SMART。统计两组并发症及术前、术后1周、1个月、6个月最佳矫正视力(BVCA)、裸眼视力(UCVA)、安全指数、有效指数、视觉质量［客观散射指数(OSI)、MTF截止频率(MTF cut?off)、斯特列尔比(SR)］、对比敏感度［低频段(3 cpd)、中频段(6 cpd)、中频段(12 cpd)］、全眼像差(垂直彗差、球差、总高阶像差)、眼血流动力学参数［眼动脉(OA)、睫状后动脉(PCA)舒张末期流速(Vd)、收缩期血流速度峰值(Vs)］。结果术前、术后1周、1个月、6个月两组BVCA、UCVA、安全指数、有效指数比较，差异无统计学意义(P>0.05)，术后1个月、6个月两组BVCA［ICL组(?0.77±0.06)、(?0.84±0.07)比(0.49±0.05)，SMART 组(?0.76±0.09)、(?0.82±0.08)比(0.50±0.03)］、UCVA［ICL 组(0.72±0.08)、(0.65±0.10)比(0.95±0.22)，SMART组(0.70±0.10)、(0.67±0.12)比(0.93±0.25)］优于其术前(P<0.017)；术后1周、1个月、6个月ICL组OSI低于SMART组，MTF cutoff、SR高于SMART组(P<0.05)；术后1周、1个月、6个月ICL组明光无眩光状态下3cpd、6 cpd、12 cpd对比敏感度高于SMART组(P<0.05)；术后1周、1个月、6个月ICL组总高阶像差低于SMART组(P<0.05)；术前、术后1周、术后1个月、6个月两组眼血流动力学指标比较，差异无统计学意义(P>0.05)；术后6个月内，两组haze、光晕、眼压升高等并发症发生率比较，差异无统计学意义(P>0.05)。结论ICL术、SMART均对中低度近视具有良好矫正作用，特别是ICL，有助于增加对比敏感度，提高视觉质量。 |
| 英文摘要: |
| Objective To explore the effects and visual quality of implantable contact lens (ICL) surgery and SMART surgery for phakic eyes with moderate to low myopia.Methods A total of 148 patients (148 eyes) with moderate to low myopia in Wuhan PRI Ophthalmic Hospital from January 2019 to January 2020 were selected. They were divided into ICL group (n=74, 74 eyes) and SMART group (n=74, 74 eyes) according to the random number table. The ICL group was given ICL, and the SMART group was given SMART.The complications and best corrected visual acuity (BVCA), uncorrected visual acuity (UCVA), safety index, effective index, and visual quality [Objective Scattering Index (OSI), MTF cutoff (MTF cutoff), Strehl ratio (SR)] and contrast sensitivity [low frequency range (3cpd), mid frequency range (6 cpd), mid frequency range (12 cpd)], aberrations of the whole eye (vertical coma, spherical aberration, to?tal high-order aberration), ocular hemodynamic parameters [end diastolic flow velocity (Vd) of ophthalmic artery (OA), posterior ciliary artery (PCA), peak systolic blood flow velocity (Vs)] before operation, 1 week, 1 month, and 6 months after operation of the two groups were counted.Results There was no significant difference between the two groups in BVCA, UCVA, safety index and effective index before operation, 1 week, 1 month, and 6 months after operation (P>0.05). The BVCA [ICL(?0.77±0.06),(?0.84±0.07) vs. (0.49±0.05),SMART(?0.76±0.09),(?0.82±0.08) vs. (0.50±0.03)] and UCVA [ICL(0.72±0.08),(0.65±0.10) vs. (0.95±0.22),SMART(0.70±0.10),(0.67±0.12) vs.(0.93±0.25)] at 1 month and 6 months after operation in the two groups were better than those before the operation (P<0.017);the OSI of the ICL group was lower than that of the SMART group at 1 week, 1 month, and 6 months after operation, and the MTF cutoff and SR were higher than the SMART group (P<0.05); the contrast sensitivity of 3 cpd, 6 cpd, and 12 cpd under bright light and no glare in the ICL group at 1 week, 1 month, and 6 months after operation was higher than that of the SMART group (P<0.05); the total high-or?der aberrations in the ICL group were lower than those in the SMART group at 1 week, 1 month, and 6 months after surgery (P<0.05); there was no significant difference in ocular hemodynamic indexes between the two groups before operation, 1 week, 1 month and 6 months after operation (P>0.05); within 6 months after surgery, there was no significant difference in the incidence of complications such as haze, halo, and intraocular pressure increase between the two groups (P>0.05).Conclusion Both ICL and SMART have good corrective effects on low to moderate myopia, especially ICL, which helps increase contrast sensitivity and improve visual quality. |
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