机构地区:[1]东部战区海军医院眼科,舟山316000 [2]东部战区海军医院高压氧科,舟山316000
出 处:《中华航海医学与高气压医学杂志》2024年第1期63-68,共6页Chinese Journal of Nautical Medicine and Hyperbaric Medicine
基 金:舟山市医药卫生科技计划军地共建项目(2022JYB02)。
摘 要:目的调查分析2022年东部战区某舰艇支队官兵的近视矫正手术情况,为保障官兵视觉健康及部队战斗力提供依据。方法2022年3-5月采用目的抽样法对东部战区某舰艇支队246名官兵进行问卷调查。问卷包括个人基本信息和眼表疾病指数(QSDI)量表,同时结合视力检测、电脑验光、裂隙灯检查、泪液分泌量(Schirmer Ⅰ)、泪膜破裂时间(BUT)、角膜荧光素染色(FL)等临床检查结果,将调查对象分为正常视力组、佩戴框架眼镜组、行近视矫正术组,其中行近视矫正术组再以手术方式、术前屈光度数分组,对其眼部情况进行统计分析。结果被调查的246例官兵中,72例(144眼,29.3%)曾行近视矫正手术,其中飞秒激光小切口基质透镜取出术(SMILE)40例(80眼,55.6%)、飞秒激光辅助的LASIK术(FS-LASIK)22例(44眼,30.6%)、准分子激光原位角膜磨镶术(LASIK)7例(14眼,9.7%)、有晶状体眼后房型人工晶状体植入术(ICL)3例(6眼,4.2%);手术组干眼症高危率明显高于正常视力组和佩戴框架眼镜组(P<0.01),SMILE组与FS-LASIK组术后干眼高危率差异有统计学意义(P<0.05)。低度近视组(12例)和中高度近视组(60例)术后出现干涩、阅读疲劳感、夜视力下降、眩光及重影的发生率差异有统计学意义(P<0.05);未手术组和SMILE、FS-LASIK、LASIK手术组SchirmerⅠ、BUT、FL检查结果差异无统计学意义(P<0.05);LASIK组术后屈光回退发生率(14.29%)高于SMILE组(3.40%)、FS-LASIK组(4.54%),差异有统计学意义(P<0.05)。结论部队官兵近视矫正手术已由以LASIK为主转变为以SMILE为主,有助于减少术后干眼症及严重眼外伤后角膜瓣并发症的发生率。Objective To investigate and analyze the current status of refractive vision correcting surgery in officers and sailors of a flotilla of the Eastern Theater Command in 2022,so as to provide a scientific basis for supporting their visual health and promoting combat effectiveness of the troop.Methods A questionnaire survey,which included demographic data and ocular surface disease index(QSDI),was conducted in officers and soldiers of a flotilla of the Eastern Theater Command.The participants were divided into normal vision group,glasses wearing group,and refractive vision correcting surgery group,according to the results of vision testing,computerized optometry,slit lamp examination,Schirmer test of tear fluid volume(Schirmer I),tear film break-up time(BUT),corneal fluorescein staining(FL),and other clinical examinations.Then,those who received refractive vision correcting surgery were further divided into subgroups according to surgical modality and preoperative diopter.The results were statistically analyzed by comparing the ocular conditions.Results Among the 246 participants,72 cases(144 eyes)received refractive vision correcting surgery,accounting for 29.3%.Among them,femtosecond laser small-incision lenticule extraction(SMILE)was performed in 40 cases(80 eyes,55.6%),Femtosecond Laser-Assisted in situ Keratomileusis(FS-LASIK)in 22 cases(44 eyes,30.6%),Laser-Assisted in Situ Keratomileusis(LASIK)in 7 cases(14 eyes,9.7%),and posterior chamber phakic intraocular implantable collamer lens(ICL)in 3 cases(6 eyes,4.2%).In the meantime,the high-risk rate of dry eye in the refractive vision correcting surgery group was significantly higher than those in the normal vision group and the glasses wearing group(P<0.01).In addition,the difference of high-risk rates of dry eye between the post-SMILE operation subgroup and the post-FS-LASIK operation subgroup was also statistically significant(P<0.05).Before surgery,moderate myopia were 56 cases(112 eyes,77.8%)accounted for the highest percentage.Low myopia(12 cases)and modera
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