CAJ | 학술논문

目的观察波前像差引导的个体化切削治疗高度近视患者手术前后视力、对比敏感度、眩光以及波前像差的变化,评价其对视觉质量的影响.方法回顾性病例研究.对2007年10月至2008年10月在武警河南总队医院眼科就诊,选取屈光度为-6.0≤球镜≤-10.0D,柱镜≤-2.0D的高度近视患者200例(380只眼)行波前像差引导的个体化切削,手术治疗区直径均＞6.0mm.检查术前及术后1周、1月、3月及6月患者的裸眼视力、屈光度、对比敏感度和波前像差.统计分析使用SPSS11.0软件包的独立样本进行t检验.结果波前像差引导的个体化切削患者术后裸眼视力均达到术前矫正视力,部分患者比术前矫正视力提高2行;术后1周高阶像差增加,术后1月和3月逐渐降低,术后3月和术前比较差异仍有统计学意义(P＜0.05);术后1周各空间频率的对比敏感度及眩光敏感度与术前比较均明显下降,差异有统计学意义(P＜0.05),术后3月时各空间频率对比敏感度和眩光敏感度均有恢复,低频率段恢复至接近术前水平,中、高频率段恢复较慢.和术前比较差异仍有统计学意义(P＜0.05).结论波前像差引导的个体化切削有效地提高高度近视患者的远视力,部分患者可以获得超常视力,但是术后仍有高阶像差的增加和对比敏感度的下降.
목적 관찰파전상차인도적개체화절삭치료고도근시환자수술전후시력、대비민감도、현광이급파전상차적변화,평개기대시각질량적영향.방법 회고성병례연구.대2007년10월지2008년10월재무경하남총대의원안과취진,선취굴광도위-6.0≤구경≤-10.0D,주경≤-2.0D적고도근시환자200례(380지안)행파전상차인도적개체화절삭,수술치료구직경균＞6.0mm.검사술전급술후1주、1월、3월급6월환자적라안시력、굴광도、대비민감도화파전상차.통계분석사용SPSS11.0연건포적독립양본진행t검험.결과 파전상차인도적개체화절삭환자술후라안시력균체도술전교정시력,부분환자비술전교정시력제고2행;술후1주고계상차증가,술후1월화3월축점강저,술후3월화술전비교차이잉유통계학의의(P＜0.05);술후1주각공간빈솔적대비민감도급현광민감도여술전비교균명현하강,차이유통계학의의(P＜0.05),술후3월시각공간빈솔대비민감도화현광민감도균유회복,저빈솔단회복지접근술전수평,중、고빈솔단회복교만.화술전비교차이잉유통계학의의(P＜0.05).결론 파전상차인도적개체화절삭유효지제고고도근시환자적원시력,부분환자가이획득초상시력,단시술후잉유고계상차적증가화대비민감도적하강.
Objective To observe the pre and postoperative changes of visual quality, contrast sensitivity (CS), glare contrast sensitivity (GCS) and wavefront aberration in high myopic patients who received wave-front guided customized ablation (WAGCA). Methods It was a retrospective case series. High myopic patients were collected in Henan peoples armed police corps hospital from October,2007 to October, 2008. A total of 380 eyes in 200 high myopic patients with preoperative spherical refraction of -6.0 D to -10.0 D and astigmatism ＜2 D received WAGCA. The ablation zone was ＞6.0mm. The uncorrected visual acuity (UCVA), CS, GCS and corneal wave-front aberrations were analyzed before surgery and at 1 week, 1 month and 3 months postoperatively. Results After WAGCA,uncorrected visual acuity (UCVA) in all of the patients recovered to or better than the preoperative best spectacled-corrected visual acuity (BSCVA). High order aberrations (HOA) increased at 1 week and then decreased slowly at 1 month and 3 months postoperatively. But the statistical difference was still significant at 3 months (P＜0.05). The postoperative CS and GCS of every space frequency decreased after WAGCA. The difference between the preoperative and 1 week after operation was significant (P ＜0.05). At 3 months postoperatively, the low space frequency recovered nearly to preoperative level, but the difference of the medium and high space frequency was still statistically significant (P ＜0.05). Conclusions WAGCA is effective on correcting high myopia and some patients can gain super visual acuity, but the HOA increases and the CS and GCS decrease after WAGCA. The wave-front aberration, CS and GCS measurements combined with usual examination can more effec tively evaluate the changes of visual function after WAGCA.