主视眼对LASIK术后视觉质量影响的研究

目的 探讨主视眼对准分子激光原位角膜磨镶术(laser in situ keratomileusis,LASIK)术后视觉质量的影响.方法 对66例(132只眼)近视患者行常规LASIK手术,术后随访3月.观察术前术后裸眼视力、最佳矫正视力、屈光度、像差、对比敏感度、眩光敏感度及主观视觉生活质量调查问卷评分并进行统计学分析.结果 ①主视眼发生改变的患者术后1月时有4例(6.06%)、术后3月时有3例(4.55%).②主视眼与非主视眼比较,裸眼视力、最佳矫正视力及眩光敏感度:术前、术后两者差异均无统计学意义(P>0.05);屈光度:术前主视眼低与非主视眼,差异有统计学意义(P<0.05),术后两者差异无统计学意义(P>0.05);高阶像差:术前两者差异无统计学意义(P>0.05),术后1周时彗差主视眼高于非主视眼,差异有统计学意义(P<0.05);对比敏感度:术前两者差异无统计学意义(P>0.05),术后1周时3.0c/d、12.0c/d频率对比敏感度主视眼高于非主视眼,差异有统计学意义(P<0.05,P<0.01).③术后主视眼未改变组主观视觉生活质量调查问卷各项结果均优于主视眼改变组,但这种优势只有在术后3月的视功能评价上有统计学意义(P<0.05).结论 ①LASIK术后极少数患者主视眼可发生改变.②除术后早期外,主视眼对LAISK术后的视觉质量无明显影响.③在LASIK手术时保持术前术后主视眼一致,能改善患者对视觉生活质量的主观评价.

Influence of the dominant eye on visual quality after LASIK

Objective To study the influence of the dominant eye on visual quality after LASIK.Methods This study comprised 132 eyes of 66 myope that had standard LASIK. Routine examinations includ-ed uncorrected visual activity, best-corrected visual activity, refraction, aberration, contrast sensitivity, glare sensitivity and subjective questionnaire responses. All patients were followed at least 3 months. Results ①The dominant eye changed in 4 cases at 1 month and still changed in 3 cases at 3 months after LASIK. ②Com-pared dominant eyes with non-dominant eyes, no significant difference was found in uncorrected visual activi-ty, best-corrected visual activity and glare sensitivity before and after LASIK (P>0.05). The degrees of refrac-tion was lower in dominant eyes than that in non-dominant eyes before LASIK (P<0.05). But alter LASIK, no significant difference was seen in residual refraction (P>0.05). Before LASIK, there was no significant differ-ence in high aberrations between dominant eyes and non-dominant eyes (P>0.05). At post-operative 1 week,the coma in dominant eyes was higher than that in non-dominant eyes (P<0.05) while other high aberrations were with no significant difference (P>0.05). Also there was no significant difference in contrast sensitivity between dominant eyes and non-dominant eyes before LASIK (P>0.05). At post-operative 1 week,the con-trast sensitivity at 3.0c/d、12.0c/d frequency in dominant eyes were better than that in non-dominant eyes (P< 0.05, P<0.01) while contrast sensitivity at other frequencies were with no significant difference (P>0.05).③The visual function of subjective questionnaire responses was better in the dominant-eye-unchanged group than that in the dominant-eye-changed group at post-operative 3 months (P<0.05). Conclusions ①The dom-inant eye may change in a few cases after LASIK. ②Besides in the early postoperative stage, the dominant eye has no significant influence on visual quality after LASIK. ③Maintaining the dominant eye unchanged can im-prove the subjective evaluation of the visual quality after LASIK.