COVID-19对SMILE术后视力及干眼的影响

IF 3.4

Advances in ophthalmology practice and research Pub Date : 2025-01-02 DOI:10.1016/j.aopr.2025.01.001

Zhi Fang , Yan Li , Dejuan Song, Xiaoying He, Kai Zhang, Tiepei Zhu, Wei Han

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引用次数: 0

摘要

目的评价冠状病毒病2019（COVID-19）对小切口皮瓣摘除术（SMILE）患者术后视力、光学质量和干眼症严重程度的影响。研究纳入了在浙江大学附属第二医院眼科中心接受小切口人工晶体植入术（SMILE）的患者，并按时间分为两组。第一组包括在中国 COVID-19 大规模流行之前接受 SMILE 的患者（第一组）。第二组包括在大流行期间确诊感染 COVID-19 并接受 SMILE 的患者（第二组）。对两组患者的视力、干眼症严重程度、眼表疾病指数（OSDI）、眼球角膜造影分析和单个 Zernike 系数进行评估和比较。第 2 组的 OSDI 评分明显高于第 1 组（P < 0.01）。术后 3 个月时，第 1 组的矫正远视力（CDVA，logMAR）优于第 2 组（P < 0.001）。尽管 COVID-19 感染后 1 个月内视力有所改善，但第 2 组的 OSDI 评分仍高于第 1 组（P < 0.01）。在 1 个月和 3 个月时，第 2 组的眼球和角膜缘发红程度明显高于第 1 组（P < 0.05），而泪液破裂时间和泪液半月板高度则无明显差异。在 1 个月和 3 个月时，第 2 组 4 毫米区域的球差（SA）明显高于第 1 组（P < 0.001），而角膜总高阶像差没有明显变化。结论COVID-19感染损害了SMILE术后患者的视觉效果，并加重了干眼症的严重程度。

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The effect of COVID-19 on visual outcome and dry eye after SMILE

Purposes

To evaluate the impact of coronavirus disease 2019 (COVID-19) on postoperative visual acuity, optical quality, and severity of dry eye disease in patients after small incision lenticule extraction (SMILE).

Methods

This is a retrospective, comparative study. Patients who underwent SMILE were included and divided into two groups according to the period at the eye center of the Second Affiliated Hospital of Zhejiang University. The first group included patients who underwent SMILE before the large-scale COVID-19 pandemic in China (Group 1). The second group comprised patients who underwent SMILE during the pandemic with a confirmed infection of COVID-19 (Group 2). The visual acuity, the severity of dry eye, ocular surface disease index (OSDI), oculus keratography analysis, and individual Zernike coefficients were evaluated and compared between the 2 groups.

Results

A total of 43 eyes of 23 patients and 45 eyes of 26 patients were included in Groups 1 and 2, respectively. The OSDI score in Group 2 was significantly higher than Group 1 (P < 0.01). The corrected distance visual acuity (CDVA, logMAR) at 3 months postoperatively in Group 1 was better than in Group 2 (P < 0.001). Despite the improvement over 1 month after the COVID-19 infection, the OSDI score was still higher in Group 2 than in Group 1 (P < 0.01). The bulbar and limbal redness were significantly higher in Group 2 than in Group 1 at both 1 month and 3 months (P < 0.05), while no significant differences were found in tear breakup time or tear meniscus height. Spherical aberration (SA) at the 4 mm zone was significantly higher in Group 2 than in Group 1 both at 1 month and 3 months (P < 0.001), while no significant changes were observed in corneal total higher-order aberrations. No significant correlation was found between the bulbar/limbal redness index and SA.