CAJ | 학술논문

目的：研究准分子激光角膜屈光手术治疗成人或大龄的青少年远视性屈光参差性弱视的疗效。 　　方法：选取2010-09/2013-03在我院行准分子激光角膜屈光手术的伴有弱视的远视性屈光参差患者共11例16眼，年龄15岁以上，随访6 mo以上。记录患者术前术后裸眼视力、最佳矫正视力、睫状肌麻痹后屈光度以及立体视等情况，并询问患者主觉视觉质量改善的状况以及对手术的满意度。 　　结果：手术眼16只平均睫状肌麻痹后屈光度的等效球镜从术前的5．76±1．71D降到术后1．42±1．22D（t＝13．6，P＝0.00）。11例患者双眼间屈光参差从术前的3．78±2．39 D降到手术后1．14±1．50D（t＝6．08．P＝0．00）。手术后患者看远裸眼视力从0．35±0．27上升到0．45±0．29（t＝-4．76，P＜0．001），看近裸眼视力从0．26±0．24上升至0．49±0．27（t＝5．43，P＝0．00）；术前worth四孔灯检查4例显示弱视眼抑制。手术后均恢复了正常。同视机检查6例有立体视，术后为10例。 Titmus立体视检查立体视锐度也明显提升（ t＝-2．97，P＝0．003）。没有术中、术后明显并发症发生。所有患者主诉生活中视觉质量明显改善并对手术效果感到满意。 　　结论：准分子激光角膜屈光手术是治疗过了视觉敏感期的成人或大龄青少年远视性屈光参差性弱视，尽管对弱视眼视力提升有限，但依然提高患者的裸眼视力和立体视功能，改善患者生活质量，是一种值得采用的方法。
목적：연구준분자격광각막굴광수술치료성인혹대령적청소년원시성굴광삼차성약시적료효。 　　방법：선취2010-09/2013-03재아원행준분자격광각막굴광수술적반유약시적원시성굴광삼차환자공11례16안，년령15세이상，수방6 mo이상。기록환자술전술후라안시력、최가교정시력、첩상기마비후굴광도이급입체시등정황，병순문환자주각시각질량개선적상황이급대수술적만의도。 　　결과：수술안16지평균첩상기마비후굴광도적등효구경종술전적5．76±1．71D강도술후1．42±1．22D（t＝13．6，P＝0.00）。11례환자쌍안간굴광삼차종술전적3．78±2．39 D강도수술후1．14±1．50D（t＝6．08．P＝0．00）。수술후환자간원라안시력종0．35±0．27상승도0．45±0．29（t＝-4．76，P＜0．001），간근라안시력종0．26±0．24상승지0．49±0．27（t＝5．43，P＝0．00）；술전worth사공등검사4례현시약시안억제。수술후균회복료정상。동시궤검사6례유입체시，술후위10례。 Titmus입체시검사입체시예도야명현제승（ t＝-2．97，P＝0．003）。몰유술중、술후명현병발증발생。소유환자주소생활중시각질량명현개선병대수술효과감도만의。 　　결론：준분자격광각막굴광수술시치료과료시각민감기적성인혹대령청소년원시성굴광삼차성약시，진관대약시안시력제승유한，단의연제고환자적라안시력화입체시공능，개선환자생활질량，시일충치득채용적방법。
AIM: To study the efficacy and safety of excimer laser corneal refractive surgery in treatment of hyperopic anisometropia amblyopia in adults and adolescents. METHODS:From September 2010 to March 2013 in our hospital, 11 patients ( 16 eyes ) with hyperopic anisometropia amblyopia were performed excimer laser corneal refractive surgery and followed up for 6mo or more, all patients age were 15 years or older. Uncorrected or best corrected visual acuity, cycloplegic refraction and stereoscopic before and after surgery were recorded.After surgery, all patients were asked if they feel visual quality was improved after surgery in everyday life and satisfied to the operation. RESULTS:The average of 16 eyes cycloplegic refraction error (equivalent spherical) was from preoperative 5.76± 1.71D reduced to postoperative 1.42±1.22D (t=13.6, P=0.00 ). The anisometropia of 11 patients was from preoperative 3.78±2.39D dropped to 1.14±1.50D after the operation ( t =6.08, P =0.00 ). After surgery, the uncorrected visual acuity for distant from 0.35 ±0.27 rose to 0.45 ±0.29 ( t=-4.76, P<0.001 ); uncorrected visual acuity for near increased from 0.26±0.24 to 0.49±0.27 (t=5.43, P =0.00 ). Preoperative worth four hole lamp examination 4 cases showed the amblyopic eye suppression. After surgery all of them were back to normal. Examined by Synoptophore, 6 cases had stereoscopisis before surgery and 10 cases after surgery. Tested by Titmus fly, the stereopsis improved significantly before and after surgery ( t =-2.97, P =0.003).No obvious complications were observed during and after surgery.All patients argued of visual quality significantly improved and satisfaction to the surgery. CONCLUSION: Excimer laser corneal refractive surgery for adults or older adolescent patients with hyperopic anisometropia amblyopiais is effective and safe, through the corrected visual acuity is improved limitedly, but the uncorrected visual acuity and stereopsis was improved obviously.This surgery improves patient visual quality and is worth to approach.