LASIK术后角膜像差和视觉功能临床观察  

Analyze of corneal aberrations and visual functions of myopic patients after LASIK

作　　者：刘太祥[1] 令狐绍容 许小英[1] 但婷婷[1] 李海祥[1] 廖一露[1] 石容[1] 陈琳[1] 

机构地区：[1]遵义医学院附属医院近视眼白内障治疗中心,贵州省遵义市563003

出　　处：《眼科新进展》2016年第2期169-171,共3页Recent Advances in Ophthalmology

基　　金：贵州省卫生厅课题基金资助(编号:gzwkj2008-1-032)~~

摘　　要：目的观察LASIK术后远期的角膜高阶像差变化及对日常生活中视觉功能的影响。方法对67例(134眼)接受非球面切削程序引导的LASIK的患者随访4 a。收集术前及术后6个月、4 a患者的视力、角膜地形图、球差和彗差资料,并由同一名医师完成患者术后视觉功能的评价。结果术后4 a随访中无一例患者最佳矫正视力较术前视力下降;术后6个月和4 a的有效性指数、安全性指数分别达1.08±0.16、1.11±0.17和1.12±0.16、1.13±0.14。不管是术后6个月还是4 a的角膜球差和彗差均较术前显著增加,但术后两个时间点间角膜像差的差异均无统计学意义(均为P>0.05)。大部分患者对日常生活中的各项视觉功能感到满意或很满意(94.3%、92.4%)。术后4 a随访中有7.4%患者诉夜间开车困难。进一步分析视觉功能评分与角膜像差的关系,发现夜间开车困难与角膜球差呈负相关(术后6个月:r=-0.66,P=0.040;术后4 a:r=-0.69,P=0.039),而且并没有随时间延长而显著改善。结论近视患者LASIK术后有远期稳定的角膜像差和日常生活中的视觉功能感受。Objective To report the changes of corneal higher-order aberrations and daily visual functions of myopic patients after laser in situ keratomileusis （ LASIK） . Methods A total of 67 patients （ 134 eyes） who underwent LASIK guided by aspherical ablation were included in the study , all cases were followed up for 4 years. The vision . corneal spherical aberration （ SphA） and coma were recorded before LASIK and at 6 months and 4 years after LASIK. The evaluation of the questionnaire about visual functions was performed by the same physician after LASIK. Results The best corrected visual acuity in no eye decreased in 4 years follow-up. The effect index and safety index at 6 months and 4 years after LASIK were l. 08 ＋ 0. 16, 1. 11 ＋0. 17 and l. 12 ＋0. 16. 1. 13 ＋0. 14 , respectively. After LASIK, the corneal SphA and coma were significantly increased,however the difference between 6 months and 4 years after LASIK was not statistically sigruficant （ all P 〉 0. 05 ） . Most patients felt satisfaction （ 94. 3% ） or very satisfaction （92. 4% ） about the ability to perform each visual function after LASIK. Meanwhile , there was still about 7. 4% patients complained that they could not drive at rught. Further study found that the score of driving at night was negative correlation with corneal SphA （ At 6 months ：r = - 0. 66 .P = 0. 040 ;At 4 years ：r = - 0. 69 .P = 0. 039） . Conclusion The myopic patients have the long-term stable corneal aberration and satisfaction of daily visual functions after LASIK.

关 键 词：近视 LASIK 高阶像差 视觉功能 

分 类 号：R779.6[医药卫生—眼科]