不同戴镜情况的近视患者LASIK术后AC/A值的变化

目的探讨准分子激光原位角膜磨镶术（LASIK）对不同戴镜情况的近视患者调节聚散功能的影响,为术后双眼视功能的评估提供临床依据。方法双眼近视及近视散光的患者84例168只眼,男性40例,女性44例;年龄（26±6）岁。按等效球镜度分为低度近视组、中度近视组和高度近视组。根据术前戴镜情况各组分为持续戴镜组、间断戴镜组和未戴镜组。随诊3个月,比较不同屈光度组,不同戴镜组的术前裸眼、术前戴镜、术后10 d和术后3个月的AC/A值的变化。选取年龄性别均与实验组匹配的屈光正常者30例作为正常对照组。结果各组术前裸眼的AC/A值均低于正常对照组（P〈0.05）。低、中度近视组中,持续戴镜组术前戴镜及术后AC/A值与正常对照组无差异（P〉0.05）;间断戴镜组、未戴镜组术前戴镜及术后10 d AC/A值大于正常对照组（P〈0.05）,术后3个月AC/A值与正常对照组相比差异无显著意义（P〉0.05）。高度近视组中,持续戴镜组术前戴镜及术后AC/A值均与正常对照组无差异（P〉0.05）,但间断戴镜组和未戴镜组未完全恢复正常。结论近视患者不坚持配戴合适的眼镜会出现调节聚散关系失衡。LASIK术后调节聚散功能渐趋正常,特别是对于间断戴镜组、未戴镜组的近视患者,有利于调节聚散功能的协调、眼位的平衡。

Study on Changes of AC/A Ratios of Myopia Patients Having Different Glasses-Wearing Habits after LASIK

Objective To investigate the effects of LASIK on the AC/A ratios of myopic patients with different glasses-wearing habits and provide clinical basis for evaluating the binocular vision function of patients having received LASIK. Methods Thirty emmetropes and 84 myopia patients that were at the age of(26±6)and received LASIK from March to August 2008,were enrolled for the study.One hundred and sixty-eight eyes of 84 myopia patients were divided into 3 groups by equivalent spherical power.Depending on their habits to wear glasses before the operation,they were further divided into three groups: the continued wearing group,interrupted wearing group and glasses-free group.The AC/A ratios before and 3 months after the surgery were compared in turn for the groups of different glasses-wearing habits and groups of different diopters. Results The AC/A ratios of naked eyes in all the experimental groups before the operation were lower than those in normal control group(P<0.05).In low and moderate myopia groups,there was no significant difference in AC/A ratio between the emmetropes and the patients wearing glasses continually before the operation when they wore glasses or after the operation(P>0.05);the ratios of the patients in both the glasses-free group and interrupted-wearing group are higher than those of the normal control group before the operation when they wore glasses or 10 days after the operation(P<0.05),but the difference disappeared 3 months after the therapy(P> 0.05).In high myopia group,no significant difference was observed in AC/A ratio between the emmetropes and the patients wearing glasses continually before the operation when they wore glasses or after the operation(P>0.05),but the patients in the interrupted wearing group and glasses-free group failed to recover completely. Conclusions Failure to wear glasses continually may damage accommodative and vergent parameters,leading to such problems as abnormal AC/A ratio.LASIK can correct myopia effectively.After LASIK,the AC/A ratio of the patient would become normal gradually,especially for myopia patients in the habit of wearing glasses interruptedly or not wearing glasses.