云南昆明全飞SMILE 3.0临床应用简

全飞秒手术SMILE3.0临床应用Vision3.0ofSmileinClinicalApplicationTianjinEyeHospitalNankaiUniversityTianjinMedicalUniversity治疗模式1。标准模式（StandardMode)

2.快速模式(FastMode)*均有专家模式(ExpertMode)：微调谨慎！参数选择ParametersSelection1.治疗模式（TreatmentMode)2.点间距大小（SpotDistance)3.治疗区域大小（）不同于准分子切削，扫描时间与预矫正屈光度关系不大。发射频率1。200kHz

2.500kHz*目前多用500kHz，速度更快，扫描更平滑。更高度数？扫描时间SMILE1.0&2.0TianjinEyeHospitalNankaiUniversityTianjinMedicalUniversityPreviousNew临床主要区别—屈光度DifferenceInClinic:RefractiveDiopterTianjinEyeHospitalNankaiUniversityTianjinMedicalUniversity国内首例SMILE手术ThefirstSMILEinChinaSMILE1.0&2.0Attemptedvs.AchievedSEQ3month(377eyes)Highpredictabilitywithnomogram6month(197eyes)1year(105eyes)3yearspredictability预测性

2year(64eyes)overcorrectedundercorrected3years(34eyes)TianjinEyeHospitalNankaiUniversityTianjinMedicalUniversitySMILE1.0&2.0TianjinEyeHospitalNankaiUniversityTianjinMedicalUniversitySMILE1.0&2.0生物力学比较SMILE和FS-LASIK手术术后生物力学的变化TocomparethebiomechanicalpropertiesofthecorneaafterSMILEandFS-LASIKsurgerySMILEFS-LASIKMRSE(D)-5.71±1.19-5.80±1.14DiWu,YanWang,LinZhang,etal.Cornealbiomechanicaleffects:Small-incisionlenticuleextractionversusfemtosecondlaser–assistedlaserinsitukeratomileusis.JCataractRefractSurg,2014,40:954-962.Smile1.0&2.0角膜像差TianjinEyeHospitalNankaiUniversityTianjinMedicalUniversity李晓晶，王雁。2mm微切口SMILE术后近视矫正眼高阶像差的变化。中华实验眼科杂志,等效球镜度散光-3.75---9.00D0---4D球差SphericalaberrationTianjinEyeHospitalNankaiUniversityTianjinMedicalUniversitySMILE1.0&2.0Q值Table2QvalueschangesofanteriorofcorneaafterSMILEsurgeryDiamterPre-opPost-op3mQvaluetP6mm-0.24±0.090.79±0.281.02±0.27-23.558<0.001*7mm-0.28±0.080.75±0.251.02±0.24-26.661<0.001*8mm-0.32±0.080.64±0.220.94±0.20-28.366<0.001*9mm-0.36±0.080.47±0.200.81±0.17-28.788<0.001*术前球镜度术前柱镜度等效球镜度-3.50---7.25D0---3.73D-4.00---7.50D苏小连，王雁。SMILE术后角膜前表面非球面性与角膜高阶像差的关系。中华眼视光与视觉科学杂志,2014,16:416-420.TianjinEyeHospitalNankaiUniversityTianjinMedicalUniversitySMILE1.0&2.0Q值术前球镜度术前柱镜度等效球镜度-3.50---7.25D0---3.73D-4.00---7.50DTable3HOAschangesafterSMILEsurgery

HOAs(µm)Pre-opPost-op3mFold⊿HOAtPRMS0.39±0.120.84±0.252.170.46±0.25-11.815<0.001*Z3-30.02±0.090.01±0.090.650.10±0.080.2780.783Z3-1-0.07±0.20-0.39±0.395.76-0.38±0.246.470<0.001*Z31-0.08±0.10-0.27±0.263.51-0.27±0.184.835<0.001*Z330.03±0.060.04±0.071.580.08±0.06-1.0640.294Z400.21±0.090.46±0.132.190.25±0.13-11.813<0.001*Z600.01±0.020.10±0.0311.990.09±0.04-16.209<0.001*苏小连，王雁。SMILE术后角膜前表面非球面性与角膜高阶像差的关系。中华眼视光与视觉科学杂志,2014,16:416-420.TianjinEyeHospitalNankaiUniversityTianjinMedicalUniversitySmile1.0&2.0角膜敏感性Smile1.0&2.0散射Smile1.0&2.0显微镜观察FS-LASIKFLExSMILESMILEvsFS-LASIKSMILEvsFLEx前表面后表面后表面SMILE3.0？TianjinEyeHospitalNankaiUniversityTianjinMedicalUniversitySMILE3.0

病历举例TianjinEyeHospitalNankaiUniversityTianjinMedicalUniversity患者：XXX性别：男年龄：23岁手术时间：2016.3.15ODOSUCVA0.020.03球镜度（D）-10.00-9.25柱镜度（D）-0.50-1.00轴5170BCVA1.01.0-Km43.643.0CCT553546术前情况Pre-operativeConditionSmile3.0TianjinEyeHospitalNankaiUniversityTianjinMedicalUniversity术中参数Intra-operativeParametersSMILE3.0ODOSTianjinEyeHospital