准分子激光角膜原位磨镶术后主导眼改变及其影响的研究  

Study of the effects of changes in ocular dominance in myopia patients after laser in situ keratomileusis

作　　者：刘磊[1] 王渝龙[1] 栗静[1] 徐曼[1] 

机构地区：[1]华中科技大学附属同济医院眼屈光中心,湖北武汉430030

出　　处：《中华眼视光学与视觉科学杂志》2011年第1期13-16,共4页Chinese Journal Of Optometry Ophthalmology And Visual Science

摘　　要：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.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 dominanc

关 键 词：角膜磨镶术 激光原位 主导眼 优势柱 可塑性 

分 类 号：R779.63[医药卫生—眼科]