中华眼视光学与视觉科学杂志
中華眼視光學與視覺科學雜誌
중화안시광학여시각과학잡지
CHINESE JOURNAL OF OPTOMETRY OPHTHALMOLOGY AND VISUAL SCIENCE
2014年
1期
10-14
,共5页
王忠海%李莹%王若蛟%金玉梅
王忠海%李瑩%王若蛟%金玉梅
왕충해%리형%왕약교%금옥매
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
角膜磨鑲術,激光原位%角膜切削術,上皮下,激光%飛秒激光%視覺質量
각막마양술,격광원위%각막절삭술,상피하,격광%비초격광%시각질량
Keratomileusis,laser in situ%Keratectomy,subepithelial,laser-assisted%Femtosecond laser%Quality of vision
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± 1.07)D;LASIK组平均为(-5.05±1.13)D;飞秒LASIK组平均为(-5.11±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.
目的 觀察比較角膜錶層LASEK與基質層的LASIK、飛秒LASIK屈光手術後患者主觀視覺感受與視覺質量檢查的相關性.方法 迴顧性分析.160例(320眼)行準分子激光治療且隨診1年以上的患者,接受錶層LASEK手術40例,基質層LASIK、飛秒LASIK手術各60例.LASEK組術前SE平均為(-4.35± 1.07)D;LASIK組平均為(-5.05±1.13)D;飛秒LASIK組平均為(-5.11±1.25)D.術前及術後1年檢查UCVA、BCVA、毬鏡及柱鏡度、SE以及術後總體評價、術後與術前最佳矯正時的視覺質量及視覺癥狀對比採用ANOVA、兩箇獨立樣本的Mann-Whitney U檢驗和x2檢驗.結果 術後1年以上,白天及夜間開車容易程度、生活方便、白天遠視力、夜間視力、總體視力的評分由高到低依次是飛秒LASIK組、LASEK組和LASIK組.同術前戴鏡相比,白天遠視力、生活方便是患者認為優于術前的最顯著項目;眩光和夜視質量下降是患者術後最主要主訴;視近物疲勞、夜間開車眩光、夜間視力評分最差,夜視癥狀隨時間延長明顯好轉,但是視覺疲勞隨著時間加重.女性視近物疲勞主訴最多,男性夜視力差主訴最多.結論 準分子術後患者視覺質量評分飛秒LASIK高于LASEK和LASIK.視近物疲勞、夜視力差為手術後的長期問題.
목적 관찰비교각막표층LASEK여기질층적LASIK、비초LASIK굴광수술후환자주관시각감수여시각질량검사적상관성.방법 회고성분석.160례(320안)행준분자격광치료차수진1년이상적환자,접수표층LASEK수술40례,기질층LASIK、비초LASIK수술각60례.LASEK조술전SE평균위(-4.35± 1.07)D;LASIK조평균위(-5.05±1.13)D;비초LASIK조평균위(-5.11±1.25)D.술전급술후1년검사UCVA、BCVA、구경급주경도、SE이급술후총체평개、술후여술전최가교정시적시각질량급시각증상대비채용ANOVA、량개독립양본적Mann-Whitney U검험화x2검험.결과 술후1년이상,백천급야간개차용역정도、생활방편、백천원시력、야간시력、총체시력적평분유고도저의차시비초LASIK조、LASEK조화LASIK조.동술전대경상비,백천원시력、생활방편시환자인위우우술전적최현저항목;현광화야시질량하강시환자술후최주요주소;시근물피로、야간개차현광、야간시력평분최차,야시증상수시간연장명현호전,단시시각피로수착시간가중.녀성시근물피로주소최다,남성야시력차주소최다.결론 준분자술후환자시각질량평분비초LASIK고우LASEK화LASIK.시근물피로、야시력차위수술후적장기문제.
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±1.07 D,of the LASIK group was-5.05±1.13 D,of the FS-LASIK group was-5.11±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.
