军事飞行人员角膜屈光手术后视力和屈光变化的随访研究  

Visual outcomes after PRK and LASEK in military pilots

作　　者：齐林嵩 张乔悦 姚璐 于东睿 王权 赵晨 陈威 刘勇 QI Lin-song;ZHANG Qiao-yue;YAO Lu;YU Dong-rui;WANG Quan;ZHAO Chen;CHEN Wei;LIU Yong(Department of Ophthalmology,Air Force Medical Center,Beijing 100142,China;Department of Medicine and Research,Air Force Medical Center,Beijing 100142,China)

机构地区：[1]空军特色医学中心眼科,北京100142 [2]空军特色医学中心医研部,北京100142

出　　处：《军事医学》2022年第4期258-262,共5页Military Medical Sciences

基　　金：国防科技创新特区联合创新项目(2016315ZT00100101,2016315ZT00100108,2016315ZT00100110);全军后勤科研重点课题(BKJ13J002);空军军医大学效能提升项目(2021HKYX24)。

摘　　要：目的 通过分析军事飞行人员角膜屈光手术后的视力和屈光变化,探讨我军飞行人员实施屈光手术后视功能及屈光的稳定性和军事航空医学关注点。方法 回顾性收集近10年(2012年1月至2021年6月)于空军特色医学中心眼科完成角膜屈光手术的现役军事飞行人员病例,共10例,均为男性,年龄24~44(30.3±5.2)岁。统计和分析飞行员术前术后视力及屈光度数据,及术后对比敏感度、立体视觉等检查结果。结果 军事飞行人员手术方式均为准分子激光角膜表层屈光手术,术后视力和屈光度均有明显提高(P<0.05)。在术后7 d,5/10人员的视力水平可达≥1.0,术后1个月为2/3,术后2、3、6个月及6个月以后分别为4/4、7/7、3/3和2/2,术后2~3个月时视力已基本稳定;屈光度水平在术后1个月即处于正视及轻度远视状态,且变化不显著(P>0.05)。术后随诊期间均未出现如圆锥角膜等术后严重并发症;部分人员术后发生轻度干眼,使用人工泪液后于术后6个月体征和症状改善。结论 准分子激光角膜表层屈光手术能显著改善军事飞行人员术后视力和屈光度,且具有一定的有效性、稳定性及安全性,飞行人员飞行适应性良好;可进一步规范术后随访的监测指标及建立长期随访机制。Objective To retrospectively analyze the visual acuity and refractive changes of military pilots after photorefractive keratectomy(PRK)and laser assisted subepithelial keratomileusis(LASEK)surgery,and to explore the stability and concerns of refractive surgery in military aviation medicine. Methods A total of 10 cases of active pilots who completed refractive surgery in the Department of Ophthalmology of Air Force Medical Center between January 2012 and June 2021were collected retrospectively. All the patients were males,aged 24 to 44(30.3 ± 5.2). The pre-and post-operation data on visual acuity and refractive error,as well as the post-operative results of contrast sensitivity and stereopsis of pilots were collected and analyzed. Results All the pilots underwent laser surface corneal refractive surgery including PRK and LASEK,and their visual acuity and refractive error were significantly improved(P<0.05). Seven days after operation,the proportion of pilots whose visual acuity level reached 1.0 and above was 5/10,and was 2/3 at 1 month,but 2,3,6 months and 6 months later,the proportion were 4/4,7/7,3/3,2/2,respectively. The visual acuity was basically stable at 2-3 months after operation,and the refraction returned to emmetropia and mild hyperopia 1 month after operation,but the change was not significant(P>0.05). There were no serious postoperative complications such as keratoconus. Several pilots developed mild dry eyes after operation,and the symptoms improved 6 months after operation by using artificial tears. Conclusion Laser corneal refractive surgery can significantly improve the visual acuity and refractive error of military pilots in the early stage,and ensure effectiveness,stability and safety. There is the need to standardize the post-operative monitoring indicators of pilots and establish a long-term follow-up mechanism.

关 键 词：军事人员 航天医学 准分子激光屈光性角膜切削术 准分子激光上皮下角膜磨镶术 角膜屈光手术 飞 

分 类 号：R856.77[医药卫生—航空、航天与航海医学]