摘要
目的 观察比较角膜表层LASEK与基质层的LASIK、飞秒LASIK屈光手术后患者主观视觉感受与视觉质量检查的相关性.方法 回顾性分析.160例（320眼）行准分子激光治疗且随诊1年以上的患者,接受表层LASEK手术40例,基质层LASIK、飞秒LASIK手术各60例.LASEK组术前SE平均为（-4.35＆#177; 1.07）D;LASIK组平均为（-5.05＆#177;1.13）D;飞秒LASIK组平均为（-5.11＆#177;1.25）D.术前及术后1年检查UCVA、BCVA、球镜及柱镜度、SE以及术后总体评价、术后与术前最佳矫正时的视觉质量及视觉症状对比采用ANOVA、两个独立样本的Mann-Whitney U检验和x2检验.结果 术后1年以上,白天及夜间开车容易程度、生活方便、白天远视力、夜间视力、总体视力的评分由高到低依次是飞秒LASIK组、LASEK组和LASIK组.同术前戴镜相比,白天远视力、生活方便是患者认为优于术前的最显著项目;眩光和夜视质量下降是患者术后最主要主诉;视近物疲劳、夜间开车眩光、夜间视力评分最差,夜视症状随时间延长明显好转,但是视觉疲劳随着时间加重.女性视近物疲劳主诉最多,男性夜视力差主诉最多.结论 准分子术后患者视觉质量评分飞秒LASIK高于LASEK和LASIK.视近物疲劳、夜视力差为手术后的长期问题.
Objective To observe and compare the relationship between subjective visual perception and objective examination results of visual quality after LASEK,LASIK and femtosecond laser LASIK （FS-LASIK）.Methods This retrospective study included 320 eyes of 160 patients in a 1-year follow-up after refractive surgery.Eighty eyes of 40 patients underwent LASEK,120 eyes of 60 patients underwent LASIK,and 120 eyes of 60 patients underwent FS-LASIK.The average preoperative spherical equivalent （SE） of the LASEK group was-4.35＆#177;1.07 D,of the LASIK group was-5.05＆#177;1.13 D,of the FS-LASIK group was-5.11＆#177;1.25 D.Uncorrected visual acuity （UCVA）,best corrected visual acuity （BCVA）,spherical and cylindrical values,and SE were recorded before and 1 year after surgery; meanwhile,a general evaluation and a comparison of pre-and postoperative visual quality and symptoms were performed.Using SPSS 17 software,descriptive statistics,ANOVA,two independent samples Mann-Whitney U test and a x2 test were used for statistical analysis.P〈0.05 indicated a significant statistical difference.Results Postoperative rating scores for driving and life,diurnal distant sight vision,nocturnal vision and general vision were higher in the FS-LASIK group than in the LASEK and the LASIK groups.Patients thought the diurnal distant sight vision and scales of life improved most after surgery but they complained about glare and nocturnal vision,especially tiredness when staring at close objects,glare in nocturnal driving and low nocturnal vision scores.There was an obvious improvement in nocturnal symptoms over time but tiredness became worse.The female patients complained most about tiredness when staring at close objects,while the male patients complained most about bad nocturnal vision.Conclusion Postoperative visual quality scores for the Femto-LASIK group are higher than for the LASEK and LASIK groups.Tiredness when staring at close objects and bad nocturnal vision are postoperative problems in the long term.
出处
《中华眼视光学与视觉科学杂志》
CAS
2014年第1期10-14,共5页
Chinese Journal Of Optometry Ophthalmology And Visual Science
关键词
角膜磨镶术
激光原位
角膜切削术
上皮下
激光
飞秒激光
视觉质量
Keratomileusis,laser in situ
Keratectomy,subepithelial,laser-assisted
Femtosecond laser
Quality of vision
作者简介
通信作者：李莹，Email：liyingpumch@sohu．com
