近视眼LASIK术后相对调节的变化  

The changes in relative accommodation after LASIK for myopia

作　　者：周少博[1] 李辉[1] 洪海峰[1] 谭娟[1] 

机构地区：[1]广州医学院第一附属医院,510120

出　　处：《中国实用眼科杂志》2014年第4期462-465,共4页Chinese Journal of Practical Ophthalmology

基　　金：广东省医学科学技术研究基金（A2012244）,广州医学院科学研究（2012C81）

摘　　要：目的观察近视眼LASIK手术后相对调节的变化情况。方法临床病例对照研究。对2010年3-6月在广州医学院第一附属医院眼科就诊的年龄在18～40岁拟行LASIK手术的近视患者64例（128只眼），按近视程度分为：轻中度近视组（〈一6．0D）和高度近视组（≥一6．0D）；同时根据年龄分成年轻组（〈30岁）和年长组（≥30岁），统一行标准的LASIK手术，分别于术前与术后1周、1个月及3个月行负与正相对调节检查。统计采用重复测量的方差分析法比较手术前及术后3个时期相对调节的差异，对两不同组别间的比较采用独立样本的f检验。结果负相对调节：不同屈光度组手术前后各时期的负相对调节差异无统计学意义（P=0．565，0．117，P〉0．05）；不同年龄组手术前后各时期的负相对调节差异无统计学意义（P：0．074，0．237，P〉0．05）。正相对调节：轻中度近视组和高度近视组手术前后正相对调节差异有统计学意义（P=0．000，0．000，P〈0．05）；两个年龄组手术前后正相对调节差异有统计学意义（P=0．000，0．000，P〈0．05）。不同屈光度及年龄组均表现为术后1周正相对调节较术前下降差异有统计学意义（P均〈0．05），术后1个月逐渐恢复至术前水平差异无统计学意义（P均〉0．05），术后3个月高度近视组正相对调节均较术前升高，差异有统计学意义（P均〈0．05）。结论LASIK手术对近视眼的调节功能有一定影响，近视眼术后正相对调节早期呈一过性降低，1个月后可逐渐恢复或增强。Objective To investigate the changes in relative accommodation after laser in situ keratomileusis （LASIK） for myopia. Methods Sixty-four myopic patients （128 eyes） who were go- ing to receive standard LASIK were enrolled in this study with the age from 18 to 40 years and were divided into two groups： low to moderate myopic group （〉-6.0D）, and high myopic group （≤〈 -6.0D）. According to the age, the patients also were categorized into two groups： 〈30 years and ≥ 30 years. Negative and positive relative accommodation was measured before surgery and 1 week, 1 month and 3 months after surgery. Results Negative relative accommodation （NRA）： There was no significant difference in NRA in all groups between before and after surgery （all P 〉0.05）. Positive relative accommodation （PRA）： The mean PRA was decreased significantly in all groups at 1 week after LASIK （all P 〈0.05）, and recovered to preoperative level at one month after LASIK （all P 〉 0.05）. The PRA was significantly increased in high myopic group at 3 months after surgery com- pared with pre-operation （all P 〈0.05）. Conclusions The positive accommodation decreases in the early weeks after LASIK for myopia, and maybe it is the reason why some patients have difficulty for near work after LASIK.

关 键 词：近视 相对调节 角膜磨镶术 激光原位 

分 类 号：R779.6[医药卫生—眼科]