武汉大学人民医院眼科中心 湖北 武汉 430060
王盈利,女,2001—,医学硕士生,主要从事眼表及角膜疾病的研究,E⁃mail:whuwangyingli@163.com
杨燕宁,女,1968—,医学博士,主任医师,主要从事眼表及角膜疾病的研究,E⁃mail:ophyyn@163.com
收稿:2024-10-26,
纸质出版:2025-12-25
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王盈利,张少维,杨燕宁.飞秒激光小切口透镜取出术和其他屈光手术对角膜生物力学影响的研究进展[J].武汉大学学报(医学版),2025,46(12):1653-1660.
WANG Yingli,ZHANG Shaowei,YANG Yanning.Research progress on the effects of femtosecond small incision lenticule extraction and other refractive surgeries on corneal biomechanics[J].Medical Journal of Wuhan University,2025,46(12):1653-1660.
王盈利,张少维,杨燕宁.飞秒激光小切口透镜取出术和其他屈光手术对角膜生物力学影响的研究进展[J].武汉大学学报(医学版),2025,46(12):1653-1660. DOI: 10.14188/j.1671-8852.2024.0810.
WANG Yingli,ZHANG Shaowei,YANG Yanning.Research progress on the effects of femtosecond small incision lenticule extraction and other refractive surgeries on corneal biomechanics[J].Medical Journal of Wuhan University,2025,46(12):1653-1660. DOI: 10.14188/j.1671-8852.2024.0810.
近年来,飞秒激光小切口透镜取出术(SMILE)在临床上得到广泛应用,其有效性、安全性和可预测性均得到国内外研究证实。角膜生物力学与屈光手术的多个环节密切相关,其关乎到手术方案选择、手术效果、手术安全乃至角膜长期稳定性,在屈光手术中具有重要意义。本篇综述将比较SMILE和其他屈光手术对角膜生物力学的影响,以期为临床及科研提供参考依据。
In recent years
small incision lenticule extraction (SMILE) has been widely used in clinical practice. Its effectiveness
safety
and predictability have been confirmed by both domestic and international studies. Corneal biomechanics is closely related to multiple aspects of refractive surgery
including surgical plan selection
surgical outcomes
surgical safety
and even long⁃term corneal stability. It is of great significance in refractive surgery. This review aims to compare the effects of SMILE and other refractive surgeries on corneal biomechanics to provide a basis for both clinical practice and scientific research.
HOLDEN B A , FRICKE T R , WILSON D A , et al . Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050 [J ] . Ophthalmology , 2016 , 123 ( 5 ): 1036 ‑ 1042 .
ZHENG K , HAN Y N , WANG J , et al . Impact of unintended initial dissection of the posterior plane during SMILE surgery on surgery time and visual outcomes [J ] . BMC Ophthalmol , 2022 , 22 ( 1 ): 108 .
PNIAKOWSKA Z , JUROWSKI P , WIERZBOWSKA J . Clinical evaluation of corneal biomechanics following laser refractive surgery in myopic eyes: A review of the literature [J ] . J Clin Med , 2022 , 12 ( 1 ): 243 .
ANG M , GATINEL D , REINSTEIN D Z , et al . Refractive surgery beyond 2020 [J ] . Eye , 2021 , 35 ( 2 ): 362 ‑ 382 .
JI Y , WAN W J , ZHANG Q , et al . Analysis of the effectiveness of SMILE, FS‑LASIK, and SBK in myopic patients and the impact in UCVA and tear film stability [J ] . Contrast Media Mol Imaging , 2022 , 2022 : 6233232 .
SACHDEV G S , RAMAMURTHY S . Decade ‑ long journey with small incision lenticule extraction: The learnings [J ] . Indian J Ophthalmol , 2020 , 68 ( 12 ): 2705 ‑ 2710 .
王雁 , 宋一 , 牟博琨 . 角膜生物力学基础 [J ] . 中华眼科杂志 , 2021 , 57 ( 2 ): 156 ‑ 160 .
WANG Y , SONG Y , MOU B K . Fundamentals of corneal biomechanics [J ] . Chin J Ophthalmol , 2021 , 57 ( 2 ): 156 ‑ 160 .
MA J N , WANG Y , WEI P H , et al . Biomechanics and structure of the cornea: Implications and association with corneal disorders [J ] . Surv Ophthalmol , 2018 , 63 ( 6 ): 851 ‑ 861 .
KLING S , HAFEZI F . Corneal biomechanics — A review [J ] . Ophthalmic Physiol Opt , 2017 , 37 ( 3 ): 240 ‑ 252 .
HE S Y , LUO Y Q , YE Y M , et al . A comparative and prospective study of corneal biomechanics after SMILE and FS‑LASIK performed on the contralateral eyes of high myopia patients [J ] . Ann Transl Med , 2022 , 10 ( 13 ): 730 .
ABAHUSSIN M , HAYES S , KNOX CARTWRIGHT N E , et al . 3D collagen orientation study of the human cornea using X‑ray diffraction and femtosecond laser technology [J ] . Invest Ophthalmol Vis Sci , 2009 , 50 ( 11 ): 5159 ‑ 5164 .
HASHEMI H , ASGARI S , MORTAZAVI M , et al . Evaluation of corneal biomechanics after excimer laser corneal refractive surgery in high myopic patients using dynamic scheimpflug technology [J ] . Eye Contact Lens , 2017 , 43 ( 6 ): 371 ‑ 377 .
LEE H , ROBERTS C J , KIM T I , et al . Changes in biomechanically corrected intraocular pressure and dynamic corneal response parameters before and after transepithelial photorefractive keratectomy and femtosecond laser‑assisted laser in situ keratomileusis [J ] . J Cataract Refract Surg , 2017 , 43 ( 12 ): 1495 ‑ 1503 .
CHONG J , DUPPS W J . Corneal biomechanics: Measurement and structural correlations [J ] . Exp Eye Res , 2021 , 205 : 108508 .
ESPORCATTE L P G , SALOMÃO M Q , LOPES B T , et al . Biomechanical diagnostics of the cornea [J ] . Eye Vis , 2020 , 7 : 9 .
LEE H , KANG D S Y , HA B J , et al . Biomechanical properties of the Biomechanical diagnostics of the cornea using a dynamic scheimpflug analyzer in healthy eyes [J ] . Yonsei Med J , 2018 , 59 ( 9 ): 1115 ‑ 1122 .
HON Y , LAM A K C . Corneal deformation measurement using Scheimpflug noncontact tonometry [J ] . Optom Vis Sci , 2013 , 90 ( 1 ): e1 ‑ e8 .
LU N J , HAFEZI F , ROZEMA J J , et al . Repeatability of a Scheimpflug tonometer to measure biomechanical parameters before and after myopic refractive surgery [J ] . J Cataract Refract Surg , 2022 , 48 ( 9 ): 1057 ‑ 1062 .
任胜卫 , 杨凯丽 , 徐丽妍 , 等 . Corvis ST测量近视患者新型角膜生物力学参数的重复性及其影响因素 [J ] . 中华实验眼科杂志 , 2019 , 37 ( 12 ): 990 ‑ 994 .
REN S W , YANG K L , XU L Y , et al . Repeatability of new Corvis ST parameters and influencing factors in myopia patients [J ] . Chin J Exp Ophthalmol , 2019 , 37 ( 12 ): 990 ‑ 994 .
宋爽 , 梁涛 , 冷林 , 等 . SMILE术后眼前节变化对眼压测量值的影响 [J ] . 中华眼视光学与视觉科学杂志 , 2022 , 24 ( 7 ): 522 ‑ 529 .
SONG S , LIANG T , LENG L , et al . Influence of changes in anterior segment parameters on intraocular pressure measurement after SMILE [J ] . Chin J Optom Ophthalmol Vis Sci , 2022 , 24 ( 7 ): 522 ‑ 529 .
肖明 , 张晓宇 , 王曙亮 . 应用Corvis ST新参数分析圆锥角膜生物力学特性 [J ] . 中华眼视光学与视觉科学杂志 , 2021 , 23 ( 9 ): 641 ‑ 646 .
XIAO M , ZHANG X Y , WANG S L . Assessment of corneal biomechanical properties in keratoconus using the new parameters of corvis ST [J ] . Chin J Optom Ophthalmol Vis Sci , 2021 , 23 ( 9 ): 641 ‑ 646 .
PEYMAN A , SEPAHVAND F , POURAZIZI M , et al . Corneal biomechanics in normal and subclinical keratoconus eyes [J ] . BMC Ophthalmol , 2023 , 23 ( 1 ): 459 .
LI Y X , TIAN L , GUO L L , et al . In vivo corneal biomechanical properties in a selected Chinese population, measured using the corneal visualization scheimpflug technology [J ] . Front Bioeng Biotechnol , 2022 , 10 : 863240 .
CHANG J Y , LIN P Y , HSU C C , et al . Comparison of clinical outcomes of LASIK, Trans‑PRK, and SMILE for correction of myopia [J ] . J Chin Med Assoc , 2022 , 85 ( 2 ): 145 ‑ 151 .
YILDIRIM Y , ÖLÇÜCÜ O , BAŞCI A , et al . Comparison of changes in corneal biomechanical properties after photorefractive keratectomy and small incision lenticule extraction [J ] . Turk J Ophthalmol , 2016 , 46 ( 2 ): 47 ‑ 51 .
CHEN S H , LOPES B T , HUANG W , et al . Effectiveness of 4 tonometers in measuring IOP after femtosecond laser‑assisted LASIK, SMILE, and transepithelial photorefractive keratectomy [J ] . J Cataract Refract Surg , 2020 , 46 ( 7 ): 967 ‑ 974 .
GUO H , HOSSEINI‑MOGHADDAM S M , HODGE W . Corneal biomechanical properties after SMILE versus FLEX, LASIK, LASEK, or PRK: A systematic review and meta‑analysis [J ] . BMC Ophthalmol , 2019 , 19 ( 1 ): 167 .
SPIRU B , TORRES‑NETTO E A , KLING S , et al . Biomechanical properties of human cornea tested by two‑dimensional extensiometry ex vivo in fellow eyes: PRK versus SMILE [J ] . J Refract Surg , 2019 , 35 ( 8 ): 501 ‑ 505 .
CHEN M J , YU M R , DAI J H . Comparison of biomechanical effects of small incision lenticule extraction and laser‑assisted subepithelial keratomileusis [J ] . Acta Ophthalmol , 2016 , 94 ( 7 ): e586 ‑ e591 .
SHANG J M , SHEN Y , JHANJI V , et al . Comparison of corneal biomechanics in post‑SMILE, post‑LASEK, and keratoconic eyes [J ] . Front Med , 2021 , 8 : 695697 .
DOU R , WANG Y , XU L L , et al . Comparison of corneal biomechanical characteristics after surface ablation refractive surgery and novel lamellar refractive surgery [J ] . Cornea , 2015 , 34 ( 11 ): 1441 ‑ 1446 .
YU M R , CHEN M J , DAI J H . Comparison of the posterior corneal elevation and biomechanics after SMILE and LASEK for myopia: A short‑ and long‑term observation [J ] . Graefes Arch Clin Exp Ophthalmol , 2019 , 257 ( 3 ): 601 ‑ 606 .
YU M R , CHEN M J , WANG B J , et al . Comparison of visual quality after SMILE and LASEK for mild to moderate myopia [J ] . J Refract Surg , 2015 , 31 ( 12 ): 795 ‑ 800 .
VESTERGAARD A H , GRAUSLUND J , IVARSEN A R , et al . Central corneal sublayer pachymetry and biomechanical properties after refractive femtosecond lenticule extraction [J ] . J Refract Surg , 2014 , 30 ( 2 ): 102 ‑ 108 .
EINIGHAMMER J , OLTRUP T , BENDE T , et al . Real ray tracing simulation versus clinical outcomes of corneal excimer laser surface ablations [J ] . J Refract Surg , 2010 , 26 ( 9 ): 625 ‑ 637 .
WANG B J , ZHANG Z Y , NAIDU R K , et al . Comparison of the change in posterior corneal elevation and corneal biomechanical parameters after small incision lenticule extraction and femtosecond laser‑assisted LASIK for high myopia correction [J ] . Cont Lens Anterior Eye , 2016 , 39 ( 3 ): 191 ‑ 196 .
ELMOHAMADY M N , ABDELGHAFFAR W , DAIFALLA A , et al . Evaluation of femtosecond laser in flap and cap creation in corneal refractive surgery for myopia: A 3‑year follow‑up [J ] . Clin Ophthalmol , 2018 , 12 : 935 ‑ 942 .
王锐 , 赵静静 , 陈元兵 , 等 . 三种不同角膜屈光手术对角膜生物力学影响的评估 [J ] . 临床眼科杂志 , 2018 , 26 ( 3 ): 212 ‑ 216 .
WANG R , ZHAO J J , CHEN Y B , et al . Evaluation of corneal biomechanical properties after different types of corneal refractive surgery [J ] . J Clin Ophthalmol , 2018 , 26 ( 3 ): 212 ‑ 216 .
WANG C Y , LI X N , GUO Y , et al . Effects of laser In situ keratomileusis and small‑incision lenticule extraction on corneal biomechanical behavior: A finite element analysis [J ] . Front Bioeng Biotechnol , 2022 , 10 : 855367 .
SHETTY R , FRANCIS M , SHROFF R , et al . Corneal biomechanical changes and tissue remodeling after SMILE and LASIK [J ] . Invest Ophthalmol Vis Sci , 2017 , 58 ( 13 ): 5703 ‑ 5712 .
ABD EL‑FATTAH E A , EL DORGHAMY A A , GHONEIM A M , et al . Comparison of corneal biomechanical changes after LASIK and F‑SMILE with CorVis ST [J ] . Eur J Ophthalmol , 2021 , 31 ( 4 ): 1762 ‑ 1770 .
REINSTEIN D Z , ARCHER T J , BRADLEY RANDLEMAN J . Mathematical model to compare the relative tensile strength of the cornea after PRK, LASIK, and small incision lenticule extraction [J ] . J Refract Surg , 2013 , 29 ( 7 ): 454 ‑ 460 .
KHAMAR P , SHETTY R , VAISHNAV R , et al . Biomechanics of LASIK flap and SMILE cap: A prospective, clinical study [J ] . J Refract Surg , 2019 , 35 ( 5 ): 324 ‑ 332 .
YAN H , GONG L Y , HUANG W , et al . Clinical outcomes of small incision lenticule extraction versus femtosecond laser‑assisted LASIK for myopia: A meta‑analysis [J ] . Int J Ophthalmol , 2017 , 10 ( 9 ): 1436 ‑ 1445 .
WANG D Y , LIU M L , CHEN Y L , et al . Differences in the corneal biomechanical changes after SMILE and LASIK [J ] . J Refract Surg , 2014 , 30 ( 10 ): 702 ‑ 707 .
KANELLOPOULOS A J . Comparison of corneal biomechanics after myopic small‑incision lenticule extraction compared to LASIK: An ex vivo study [J ] . Clin Ophthalmol , 2018 , 12 : 237 ‑ 245 .
李福生 , 陶冶 , 尹鸿芝 , 等 . SMILE与FS‑LASIK术后眼压和角膜生物力学指标的变化比较 [J ] . 国际眼科杂志 , 2018 , 18 ( 1 ): 185 ‑ 187 .
LI F S , TAO Y , YIN H Z , et al . Comparison of IOP and corneal biomechanical changes after SMILE and FS‑LASIK [J ] . Int Eye Sci , 2018 , 18 ( 1 ): 185 ‑ 187 .
WU D , WANG Y , ZHANG L , et al . Corneal biomechanical effects: Small‑incision lenticule extraction versus femtosecond laser‑assisted laser in situ keratomileusis [J ] . J Cataract Refract Surg , 2014 , 40 ( 6 ): 954 ‑ 962 .
AGCA A , OZGURHAN E B , DEMIROK A , et al . Comparison of corneal hysteresis and corneal resistance factor after small incision lenticule extraction and femtosecond laser‑assisted LASIK: A prospective fellow eye study [J ] . Cont Lens Anterior Eye , 2014 , 37 ( 2 ): 77 ‑ 80 .
EL‑MAYAH E , ANIS M , SALEM M , et al . Comparison between Q‑adjusted LASIK and small‑incision lenticule extraction for correction of myopia and myopic astigmatism [J ] . Eye Contact Lens , 2018 , 44 ( Suppl 2 ): S426 ‑ S432 .
REZNICEK L , MUTH D , KAMPIK A , et al . Evaluation of a novel Scheimpflug‑based non‑contact tonometer in healthy subjects and patients with ocular hypertension and glaucoma [J ] . Br J Ophthalmol , 2013 , 97 ( 11 ): 1410 ‑ 1414 .
BOIKO E V , TOGO E S , SUETOV A A , et al . Direct assessment of changes in biomechanical properties of the cornea after ReLEx SMILE and FemtoLASIK surgeries [J ] . Vestn Oftalmol , 2023 , 139 ( 3 ): 41 ‑ 48 .
XIN Y , LOPES B T , WANG J J , et al . Biomechanical effects of tPRK, FS‑LASIK, and SMILE on the cornea [J ] . Front Bioeng Biotechnol , 2022 , 10 : 834270 .
WEI P H , CHENG G P , ZHANG J M , et al . Changes in corneal volume at different areas and its correlation with corneal biomechanics after SMILE and FS‑LASIK surgery [J ] . J Ophthalmol , 2020 , 2020 : 1713979 .
LIU M , LI N , CHEN T , et al . Comparison of corneal biomechanics treated with femtosecond laser‑assisted in situ keratomileusis and small‑incision lenticule extraction by new corneal biomechanical parameters of corvis ST II [J ] . Cornea , 2023 , 42 ( 11 ): 1384 ‑ 1390 .
CAO K W , LIU L N , YU T , et al . Changes in corneal biomechanics during small‑incision lenti cule extraction (SMILE) and femtosecond‑assisted laser in situ keratomileusis (FS‑LASIK) [J ] . Lasers Med Sci , 2020 , 35 ( 3 ): 599 ‑ 609 .
SPIRU B , TORRES‑NETTO E A , KLING S , et al . Hyperopic SMILE versus FS‑LASIK: A biomechanical comparison in human fellow corneas [J ] . J Refract Surg , 2021 , 37 ( 12 ): 810 ‑ 815 .
SPIRU B , KLING S , HAFEZI F , et al . Biomechanical properties of human cornea tested by two‑dimensional extensiometry ex vivo in fellow eyes: Femtosecond laser‑assisted LASIK versus SMILE [J ] . J Refract Surg , 2018 , 34 ( 6 ): 419 ‑ 423 .
HASHEMI H , ROBERTS C J , ELSHEIKH A , et al . Corneal biomechanics after SMILE, femtosecond‑assisted LASIK, and photorefractive keratectomy: A matched comparison study [J ] . Transl Vis Sci Technol , 2023 , 12 ( 3 ): 12 .
MOHAMED‑NORIEGA K , TOH K P , POH R , et al . Cornea lenticule viability and structural integrity after refractive lenticule extraction (ReLEx) and cryopreservation [J ] . Mol Vis , 2011 , 17 : 3437 ‑ 3449 .
王瑞平 . 随机对照临床试验设计中的样本量估算方法 [J ] . 上海医药 , 2023 , 44 ( 1 ): 48 ‑ 52 .
WANG R P . Methods of sample size estimation in randomized controlled clinical trial design [J ] . Shanghai Med Pharm J , 2023 , 44 ( 1 ): 48 ‑ 52 .
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