近视眼LASIK术后早期单眼调节幅度的变化  

Changes in amplitude of accommodation in the early stages after LASIK for myopia

作　　者：马小力[1] 刘汉强[1] 马长荣[1] 张慧[1] 靳瑛[1] 

机构地区：[1]中国医科大学第一附属临床医院眼科,辽宁沈阳110001

出　　处：《眼视光学杂志》2002年第3期141-144,147,共5页Chinese Journal of Optometry & Ophthalmology

摘　　要：目的 :探讨准分子激光原位角膜磨镶术 (LASIK)后早期单眼调节幅度的变化及其与近距离工作视疲劳症状的关系。方法 :近视眼行LASIK 6 4例 (12 8眼 )为近视组 ,又按术前屈光度不同分为中低度近视组 (76眼 )和高度近视组(5 2眼 ) ,正视眼 30例 6 0眼为正视组。正视组和近视组分别在术前、术后第 1周、术后第 2周、术后第 1个月、术后第 2个月和术后第 6个月测定单眼调节幅度 ,同时行近距离工作视疲劳症状调查。结果 :LASIK术后近视组的单眼调节幅度有暂时性下降 (P <0 .0 0 1) ,高度近视组的降低幅度明显高于中低度近视组 (P <0 .0 5 ) ,调节幅度的降低程度与术前屈光度呈正相关 (r=0 .5 2 ,P <0 .0 0 1) ;LASIK术后 1～ 2个月调节幅度逐渐恢复并超过术前水平 (P <0 .0 0 1) ,且与正视组差异无显著性 (P >0 .0 5 )。LASIK术后 1w患者的近距离工作视疲劳症状明显加重 (P <0 .0 0 1) ,1～ 2个月后逐渐恢复 ,并较术前有显著的改善 (P <0 .0 0 1) ;LASIK术后的近距离工作疲劳症状与调节幅度呈负相关 (r =- 0 .5 6 ,P <0 .0 0 1)。结论 :LASIK术后早期患者的单眼调节幅度有一过性降低 ,然后逐渐恢复 ;LASIK手术对单眼调节幅度和近距离用眼活动无明显不良影响 ;Objective:To investigate changes in the amplitude of accommodation in the early stages after excimer laser in situ keratomileusis(LASIK) and the relationship between postoperative accommodative amplitude and asthenopia.Methods:64 myopic patients(128 eyes) who underwent myopic LASIK were included in this study. The average age of patients was(23.80±5.08)years (18～46 years),30 patients(60 eyes) were male and 34 patients(68 eyes) were female. The pre-operative spherical equivalent(SE) was(-5.57±2.00)D,astigmatism for all myopic patients in this study was less than 2.00 D and best corrected visual acuity(BSCVA) was more than 0.8 D. The myopes were divided into 2 groups according to pre-operative refractive status:medium and low myopes with pre-operative SE ≤-6.00 D(38 cases 76 eyes) and high myopes with pre-operative SE >-6.00 D(26 cases 52 eyes). 30 emmetropes[60 eyes,average age(23.64±3.65)years,SE -0.50～+0.50,BSCVA ≥0.8] were selected as controls. Accommodative amplitudes for emmetropes and myopes before surgery,1 week,2 weeks,1 month,2 months and 6 months after surgery were measured at near point and symptoms of asthenopia were assessed by questionnaire. The TOPCON 8100 autorefractor was used for refractions. The corneal flap was created using Moria 2 microkeratome followed by stromal ablation using Visx Star S 2 excimer laser. One surgeon performed all surgeries. Data was analyzed by the F test,q test,t test,H test,etc.,with SPSS statistics software.Results:Before LASIK,accommodative amplitudes for the myopes were significantly lower than for the emmetropes(P<0.001). There was a sudden drop in the accommodative amplitude(P<0.001) 1 week postoperatively,and the range of the decrease was positively correlated with pre-operative refractive power(r=0.52,P<0.001). 1～2 months after LASIK,accommodative amplitude recovered to or surpassed the pre-operative level(P<0.001),stabilized at 6 months,and there was no significant difference between the myopes and emmetropes(P>0.05) after 1 month. The accommodative

关 键 词：近视 LASIK 单眼调节幅度 准分子激光原位角膜磨镶术 

分 类 号：R779.63[医药卫生—眼科]