CAJ | 학술논문

目的观察准分子激光原位角膜磨镶术(LASIK)后主导眼分布特点及其影响.方法前瞻性病例对照研究.选取行LASIK的近视患者190例(380眼),按屈光参差度数及主导眼眼别分为3组:A组,两眼等效球镜度差异＜1.75 D,共154例;B组,两眼等效球镜差异≥1.75 D,且主导眼为近视度数较高眼,共19例;C组,两眼等效球镜差异≥1.75 D,且主导眼为近视度数较低眼,共17例.术前和术后1个月分别检查裸眼视力、屈光度及确定主导眼(卡洞法),术后1个月接受远、近视觉满意度问卷调查.组间率的比较采用卡方检验,计量资料采用独立样本t检验.结果 LASIK术前右眼为主导眼125例(65.8%),左眼65例(34.2%);术后右眼为主导眼92例(48.4%),左眼98例(51.6%).59例(31.1%)患者在术后发生主导眼转变.B组患者中主导眼转变率(47%)高于A组(29%)和C组(29%)(x2=5.38,P＜0.05).屈光参差患者术前主导眼与非主导眼等效球镜度差异无统计学意义.术后主导眼的等效球镜度为(-0.29±0.89)D,较非主导眼[(-0.42±0.91)D]低,差异存在统计学意义(t=2.448,P=0.015).主导眼改变和未改变患者的远、近视觉满意度分别为2.33、2.40和3.62、3.95,差异均无统计学意义.结论 LASIK术后存在主导眼的改变,即关键期后,眼优势具有可塑性,尤其在术前有屈光参差且主导眼为近视度数较高眼的患者中发生率更高.术后非主导眼较主导眼更偏近视.但主导眼改变与否对术后视觉满意度无显著影响.
목적 관찰준분자격광원위각막마양술(LASIK)후주도안분포특점급기영향.방법 전첨성병례대조연구.선취행LASIK적근시환자190례(380안),안굴광삼차도수급주도안안별분위3조:A조,량안등효구경도차이＜1.75 D,공154례;B조,량안등효구경차이≥1.75 D,차주도안위근시도수교고안,공19례;C조,량안등효구경차이≥1.75 D,차주도안위근시도수교저안,공17례.술전화술후1개월분별검사라안시력、굴광도급학정주도안(잡동법),술후1개월접수원、근시각만의도문권조사.조간솔적비교채용잡방검험,계량자료채용독립양본t검험.결과 LASIK술전우안위주도안125례(65.8%),좌안65례(34.2%);술후우안위주도안92례(48.4%),좌안98례(51.6%).59례(31.1%)환자재술후발생주도안전변.B조환자중주도안전변솔(47%)고우A조(29%)화C조(29%)(x2=5.38,P＜0.05).굴광삼차환자술전주도안여비주도안등효구경도차이무통계학의의.술후주도안적등효구경도위(-0.29±0.89)D,교비주도안[(-0.42±0.91)D]저,차이존재통계학의의(t=2.448,P=0.015).주도안개변화미개변환자적원、근시각만의도분별위2.33、2.40화3.62、3.95,차이균무통계학의의.결론 LASIK술후존재주도안적개변,즉관건기후,안우세구유가소성,우기재술전유굴광삼차차주도안위근시도수교고안적환자중발생솔경고.술후비주도안교주도안경편근시.단주도안개변여부대술후시각만의도무현저영향.
Objective To investigate the distribution of ocular dominance in myopic patients before and after laser in situ keratomileusis (LASIK) surgery, and the effects of the change in ocular dominance. Methods A prospective study was performed on 190 myopic patients (380 eyes) who received LASIK treatment. The dominant eye was identified with the hole-in-the-card test. Before operation, the patients were divided into 3 groups based on anisometropia and ocular dominance.Group A, 154 cases, the spherical equivalent difference was less than 1.75 D between the two eyes;group B, 19 cases, the spherical equivalent difference was 1.75 D or more between the two eyes and the dominance eye with higher diopter; group C 17 cases, the spherical equivalent difference was 1.75 D or more between the two eyes and the dominance eye with lower diopter. Refraction, ocular dominance and visual acuity were evaluated in all patients preoperatively and 1 month postoperatively.As part of the investigation, patients answered questionnaires after the operation. Chi-square test was used to compare the rate of dominance change, independent samples t test was used to compare the difference of measurement data. Results Before LASIK, 125 patients (65.8%) had right-eye dominance and 65 patients (34.2%) had left-eye dominance. After the operation, 92 patients (48.4%)had right-eye dominance and 98 patients (51.6%) had left-eye dominance, with 59 patients (31.1%)changing dominance. In group B, there was a higher rate of change in ocular dominance in eyes with greater anisometropia (47%)compared to groups A (29%) and C (29%) (x2=5.38, P＜0.05).Before operation, the equivalent spherical between dominant eye and the other was without any significant difference. After the operation, the dominant eyes' refractive error was (-0.29±0.89)D,lower than the preoperative dominant eyes (-0.42±0.91)D (t=2.448, P=0.015). The questionnaires did not show any statistically significant differences between dominance change group and no change group. Conclusion This study shows there is a change in ocular dominance after LASIK surgery,especially in those the dominance eye with higher diopter before operation. But the change has few effects on euphoropsia. Therefore, ocular dominance has plasticity after the critical period. The nondominant eyes have a greater degree of myopia than dominant eyes in subjects who had the operation.