高度近视LASIK术后双眼调节聚散及近立体视功能的变化  

Changes of accommodation,convergence and stereopsis for high myopia after laser in situ keratomileusis

作　　者：蔡洁[1] 李沁[1] 何剑[1] 赵必诚[1] 邱耀英[1] 谭少健[1] 

机构地区：[1]广西医科大学第一附属医院眼科,广西壮族自治区南宁市530021

出　　处：《眼科新进展》2013年第8期757-760,共4页Recent Advances in Ophthalmology

基　　金：广西2011年研究生教育创新计划资助项目(编号:2011105981002D36)~~

摘　　要：目的探讨高度近视患者准分子激光原位角膜磨镶术(laser in situ keratomileusis,LASIK)后双眼调节聚散及近立体视功能的变化。方法将34例高度近视患者于术前及术后1个月、3个月、6个月分别用综合验光仪和随机点立体视图检查双眼调节聚散及近距离立体视功能,双眼调节聚散指标包括调节幅度、正负相对调节(positive and negative relative accommodation,PRA/NRA)、调节滞后、水平隐斜视、调节性集合与调节的比率(accommodative convergence/accomodation,AC/A)。结果 LASIK术后1个月、3个月单眼调节幅度分别为(9.52±1.69)D、(11.53±3.48)D,低于术前(13.14±3.59)D,差异均有统计学意义(均为P<0.05);术后6个月(12.52±3.19)D恢复至术前水平,与术前比较,差异无统计学意义(P>0.05)。术后1个月、3个月PRA分别为(-2.13±1.18)D、(-2.36±1.17)D,与术前(-1.88±1.37)D比较,差异均无统计学意义(均为P>0.05);术后6个月(-2.82±1.36)D较术前提高,差异有统计学意义(P<0.05)。NRA及调节滞后两项指标手术前后比较差异均无统计学意义(均为P>0.05);术后不同时间远近距离隐斜度与术前比较差异均无统计学意义(P>0.05);术后不同时间AC/A比率均较术前降低(均为P<0.05)。术后不同时间近立体视锐度与术前比较差异均无统计学意义(均为P>0.05),而术后交叉视差锐度及非交叉视差锐度均高于术前(均为P<0.05)。结论 LASIK对高度近视患者双眼调节、集合及其相互作用协动参数无明显不良影响,同时可提高高度近视患者近立体视范围。Objective To investigate the changes of accommodation, conver- gence and stereopsis for high myopia after laser in situ keratomileusis（LASIK）. Meth- ods The binocular accommodation, convergence and stereopsis of 34 high myopia a- dult subjects were detected before surgery, 1 month, 3 months and 6 months after sur- gery by synthetic optometry uni and stochastic stereopsis. The binocular accommoda- tion, convergence included accommodation amplitud （AMP）, positive and negative rela- tive accommodation （ PRA/NRA）, lag of accommodation, phoria, and accommodative convergence/accomodation（AC/A）. Results AMP at postoperative 1 month（9.52 -i-- 1.69 ）D and 3 months（ 11.53 _＋ 3.48 ）D were significantly less than that before operation （ 13.14 _＋ 3.59 ） D （ both P 〈 0.05 ） ;it recovered at postoperative 6 months （ 12.52 _＋ 3.19 ） D and compared with preoperation, there was no significant difference （P 〉 0. 05 ）. PRA at postoperative 1 month（ -2.13 _＋ 1. 18）D and 3 months（ -2.36 -＋ 1. 17）D were not significantly different from that before operation （ - 1.88 _＋ 1.37 ） D （ both P 〈 0. 05 ） ; Compared with preoperation, it was significantly improved at postoperative 6 months （ -2.82 ＋ 1.36）D （P 〈 0. 05 ）. In NRA and lag of accommodation, there were no signifi- cant difference before and after operation（ both P 〉 0.05 ） ; The far and near phoria be- tween different time points after operation and preoperation were not significantly dif- ferent（ all P 〉 0. 05 ）. The ratios of AC/A at postoperative different time points were all significantly lower than that preoperaton（ all P 〈 0.05 ）. The differences of near stereop- sis acuity between oostooerative different time ooints and oreoDeration were not simfifi-cant（ all P 〉 0.05 ）. Crossed disparity and uncrossed disparity were better than that preoperation（ both P 〈 0.05 ）. Conelu- sion LASIK for the correction of high myopia may have no clear adverse influence on patient

关 键 词：准分子激光原位角膜磨镶术 高度近视 调节 

分 类 号：R779.6[医药卫生—眼科]