超高度近视屈光性手术后主诉视觉质量下降原因分析  

Analysis of the causes of decreased visual quality by chief complaint after refractive surgery in super high myopia patients

作　　者：赵世强[1] 接英[1] 李蕾[1] 张莉[1] 卢红双[1] Zhao Shiqiang;Jie Ying;Li Lei;Zhang Li;Lu Hongshuang(Department of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Institute of Ophthalmology, Beijing 100005, China)

机构地区：[1]首都医科大学附属北京同仁医院眼科北京同仁眼科中心北京市眼科学与视觉科学重点实验室北京市眼科研究所,北京100730

出　　处：《首都医科大学学报》2018年第3期449-452,共4页Journal of Capital Medical University

摘　　要：目的分析超高度近视屈光性手术后视觉质量下降原因。方法采用回顾性病例系列研究,收集2009年1月-2015年12月在首都医科大学附属北京同仁医院眼科接受晶状体摘除联合人工晶状体植入或有晶状体眼人工晶状体植入手术后主诉视觉质量较差的超高度近视患者8例(16只眼)的资料。对术后视觉质量进行问卷调查,测量患者的术前、术后的屈光度、裸眼远视力、矫正远视力、裸眼近视力及矫正近视力的情况,分析患者术后视觉质量变差的原因。结果本组患者年龄30~60岁,平均年龄(44.88±10.32)岁,术前屈光度范围-29.0^-18.0 D,平均屈光度(-23.19±3.60)D,术后屈光度范围-3.0~1.75 D,平均屈光度(-0.73±1.31)D,术后屈光度比术前明显减小(P<0.001)。所有患者对术后裸眼远视力及矫正远视力满意,术前矫正远视力平均为0.19±0.07,术后平均矫正远视力为0.24±0.07,术后较术前明显提高(P<0.05),但对术后裸眼近视力和30 cm矫正近视力的满意度均较差,术后裸眼近视力明显低于术前裸眼近视力,术后30 cm矫正视力亦明显低于术前裸眼近视力,术后10 cm矫正视力有改善但依然低于术前裸眼近视力(P<0.05)。结论超高度近视患者接受屈光性手术后,主诉视觉质量下降,主要与术后裸眼近视力和术后矫正近视力下降有关。Objective To analyze the causes of decreased visual quality by chief complaint after refractive surgery in super high myopia patients. Methods Retrospective case series study was used. The subjects include 8 cases（ 16 eyes） of super high myopia patients who complained of a poor visual quality after receiving phacoemulsification of the crystalline lens and implantation of an intraocular lens or phakic intraocular lens implantation at Beijing Tongren Hospital,Capital Medical University from January 2009 to December 2015.Questionnaires were issued to investigate their postoperative visual quality. Patients＇ preoperative and postoperative diopter,preoperative and postoperative corrected distance visual acuity,uncorrected and corrected near visual acuity were measured in an effort to analyze the causes of the decrease of visual quality postoperatively. The mean age of super high myopia patients was（ 44. 88 ± 10. 32） years old,ranging from 30 to 60 years old. The mean preoperative diopter was（-23. 19 ± 3. 60） D,ranging from-29. 0 D to-18. 0 D. The mean postoperative diopter was（-0. 73 ± 1. 31） D,ranging from-3. 0 D to 1. 75 D. Most of super high myopia patients were satisfied with the postoperative corrected distance visual acuity,however,they showed poor satisfaction with the postoperative uncorrected near visual acuity and corrected intermediate 30 cm visual acuity（ P〈0. 05）. The mean postoperative corrected distance visual acuity is 0. 235,significantly higher than that prior to surgery,which was 0. 187（ P〈0. 05）. The postoperative uncorrected near visual acuity and corrected intermediate 30 cm visual acuity were much lower than that before surgery（ P〈0. 05）. With further vision correction,these patients could have their corrected near visual acuity equal to their preoperative uncorrected near visual acuity. Conclusion The major cause of the decline of visual quality in patients with super high myopia postoperatively was due to the decrease of near visual acuity,which mainly re

关 键 词：超高度近视 屈光手术 视觉质量 近视力 

分 类 号：R778.1[医药卫生—眼科]