中低度近视SMILE术后超早期视觉质量变化的研究

目的观察飞秒激光小切口角膜基质透镜取出术(SMILE)术后超早期患者视觉质量变化,探讨其变化发生的可能原因。方法选取中低度近视患者23例46眼行SMILE术,术前及术后24 h超早期行主观视觉质量问卷,测量最佳矫正视力的全程视力(远视力5 m,中视力60 cm,近视力33 cm)、对比敏感度(CS)、眩光敏感度(GS)及集合近点(NPC)和调节幅度(AA)。结果视觉质量主观问卷显示术后超早期主观视觉质量较术前下降(P=0.001)。术后裸眼视力(UCVA)明显提高(P=0.0001)。术前与术后最佳矫正视力(BCVA)中远视力没有变化(P=0.096),而中视力和近视力均较术前下降(P=0.039,0.003)。术后CS、GS降低(PCS=0.0001,PGS=0.04),NPC、AA较术前无明显变化(P=0.68,0.13)。结论SMILE术后超早期患者可获得预期理想远视力,但中、近视力尚未恢复。超早期中出现的异常视觉质量改变可能与对比敏感度和眩光敏感度的改变有关。

Changes in visual quality during the ultra-early stage of SMILE for middle and low myopia

Objective To observe the changes in visual quality within 24h(the ultra-early stage)after small incision lenticule extraction(SMILE)and explore the possible reasons behind these changes. Methods Forty-six eyes of 23 patients who underwent SMILE were chosen for this study. A subjective visual quality of questionnaire(SVQ)was competed by the patients before the procedure and 24 hours after treatment. The best-corrected visual acuity of the patients(distant vision 5 m, middle vision 60 cm, near vision 33 cm), contrast sensitivity(CS), glare sensitivity(GS), the near point of convergence(NPC)and the amplitude of accommodation(AA)were measured using a Binocular Vision Function Instrument(OCULUS Binoptometer 4p). Results The SVQ score illustrated a decrease in visual quality after SMILE at the ultra-early stage (P=0.001). However, uncorrected distance visual acuity(UCVA)significantly improved (P=0.000 1). When comparing best-corrected visual acuity(BCVA), there was no difference between the distant vision results (P=0.096), but both the middle vision and near vision results were lower than before treatment (P=0.039, 0.003). CS and GS decreased following treatment (P=0.000 1, 0.04), but there was no difference in the NPC and AA (P=0.68, 0.13). Conclusion Patients can expect improved distant vision in the ultra-early stage of SMILE. However, at the ultra-early stage, the middle vision and near vision have not yet recovered. The SVQ changes at the ultra-early stage of SMILE may be related to the changes in CS and GS.