| Purpose: To investigate the difference of visual quality between small incision lenticule extraction(SMILE)and transepithelial photorefracrive keratectomy using Smart Pulse Technology(SPT-TransPRK)in the treatment of moderate myopia within6 months after surgery.Methods: Prospective non-randomized controlled studies.From November 2021 to May 2022,16 patients with 32 eyes of SPT-TransPRK surgery and 19 patients with38 eyes of SMILE surgery in Dalian Third People’s Hospital were selected for research.Within the 6-month postoperative follow-up,data of spherical equivalent,uncorrected visual acuity(UCVA),equivalent spherical diameter(SE)were recorded at 1 day,4days,7 days,1 month,3 months and 6 months postoperatively for both groups.Modulation transfer function cutoff(MTF cutoff),strehl ratio(SR),objective scatter index(OSI),total high-order aberrations(t HOAs),comas,spherical aberrations were also recorded at 7 days,1month,3months and 6 months postoperatively.Besides,patients’ subjective feelings of vision quality were also recorded by Quality of Vision(Qo V)questionnaire at 1 month,3 months,6 months postoperatively.The differences in questionnaire of visual acuity,SE,MTF cutoff,SR,OSI,t HOAs,spherical aberrations and comas between two groups at each postoperative time point were compared.The Shapiro-Wilk test method was used to test the normality of all collected data.For the normally distributed data,the independent sample t-test was used and for data with a skewed distribution,the rank sum test was used to compare.The difference of aberrations between each two time points in both groups was tested by generalized estimating equation.Results: There were statistically significant differences in UCVA between the two groups at 1 day,4 days,7 days postoperatively(P<0.05).The UCVA in the SMILE group was significantly better than in the SPT-TransPRK group.There was no statistical difference in UCVA between the two groups at 1 month,3 months and 6 months postoperatively(P > 0.05).There were statistically significant differences in SE between the two groups at 1 day,4 days,7 days,1 month,3 months and 6 months after surgery(P<0.05).The SE of SPT-TransPRK group fluctuated greatly within 1 week after operation,and was basically stable at about 0.75 D at 1month,3 months and 6months after operation,while the SE of SMILE group was stable and closer to 0D at 1day,4 days,7 days,1 month,3 months and 6 months after operation.There were statistically significant differences in MTF cutoff,SR and OSI between the two groups at 7 days and 1 month postoperatively(P<0.05)and these metrics in the SMILE group were significantly better than in the SPT-TransPRK group while there were no statistically significant differences between the two groups at 3 months and 6 months postoperatively(P>0.05).There were statistically significant differences in t HOAs and spherical aberrations between the two groups at 7 days,1 month,3 months and 6months postoperatively(P<0.05),while there was no statistical difference in comas between the two groups at 7 days,1 month,3 months and 6 months after surgery(P>0.05).Both in the SPT-TransPRK group and SMILE group,the aberrations at 7 days,1month,3 months and 6 months after operation were compared with the baseline values before operation respectively,and the t HOAs,spherical aberrations and comas at each time point after operation were higher than those before operation,and the differences were statistically significant(P<0.05).After comparing the the aberrations at different time points after operation,the t HOAs of SPT-TransPRK group at 6 months postoperatively were increased compared with 1 month postoperatively,the differences were statistically significant(P<0.05).The spherical aberrations were decreased at 1month postoperatively compared with 7 days after surgery the differences were statistically significant(P<0.05).In the SMILE group,the t HOAs of SMILE group increased at 6 months after surgery compared with 7 days,1 month,and 3 months postoperatively,the spherical aberrations of SMILE group increased at 6 months after surgery compared with 7 days after surgery,and the comas of SMILE group increased at 6 months after surgery compared with 7 days after surgery,the differences were all statistically significant(P<0.05).For the other time point postoperatively,there were no significant differences in t HOAs,spherical aberrations and comas between each two time points in both groups(P>0.05).Both in the SMILE group and the SPT-TransPRK group,visual quality issues were mainly on glare,halo,and astral light,and there was no statistical difference between the two groups at 1 month,3 months and 6 months postoperatively(P>0.05).Conclusion: For patients with moderate myopia,the visual acuity of patients who underwent SMILE surgery within 7 days after surgery recovered faster,the refractive status was more stable,and the objective visual quality was better.However,with the prolongation of recovery time,the refractive status of patients with 3 and 6m after surgery has reached a stable state,and the objective visual quality is similar.Therefore,SMILE is more recommended for patients with moderate myopia who have higher requirements for postoperative recovery time and early visual quality. |
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