准分子激光角膜屈光手术后眼压升高对视觉质量的影响

目的 研究准分子激光角膜屈光手术后眼压升高对视觉质量的影响.方法 前瞻性观察研究.收集准分子角膜屈光术后高眼压患者41例（68眼）纳入观察组,术后无高眼压患者41例（68眼）为对照组.分别于术后1周与术后2周,测量裸眼视力、矫正球镜度、矫正柱镜度、像差（C7、C8、C12）、角膜厚度、角膜前表面曲率以及角膜后表面高度、对比敏感度,并记录患者主观感受.组间采用独立样本t检验,组内采用配对t检验,主观感受采用卡方检验进行比较,不符合正态分布的数据采用Wilcoxon检验.结果 在术后l周观察组视力（t=-2.43,P＜0.05）,矫正球镜度（t=-2.96,P＜0.05）,对比敏感度（12 c/d）（t=-0.33,P＜0.05）均低于对照组,而C7（t=-0.19,P＜0.05）、C12（t=5.08,P＜0.05）高于对照组,差异有统计学意义;在观察组中,术后1周视力（t=-3.66,P＜0.05）、矫正球镜度（t=-4.38,P＜0.05）、对比敏感度（12 c/d）（t=-0.32,P＜0.05）低于术后2周,C7（t=-0.17,P＜0.05）、C12（t=5.33,P＜0.05）高于术后2周,差异有统计学意义.结论 准分子激光角膜屈光术后高眼压可以导致对角膜前表面曲率、像差以及屈光状态的改变,并导致视觉质量的下降.

The influence of high intraocular pressure on quality of vision after excimer laser corneal refractive surgery

Objective To study the influence of high intraocular pressure （IOP） on visual quality after excimer laser corneal refractive surgery.Methods This was a prospective,observational study.The experimental group included 68 eyes of 41 patients with high IOP after corneal excimer laser refractive surgery,and the normal group included 68 eyes of 41 patients with normal IOP.Measurements included visual acuity,corrected spherical lens,corrected cylindrical lens,corneal aberrations （C7,C8,C12）,corneal thickness,corneal anterior surface curvature and corneal posterior surface elevation,contrast sensitivity and a record of subjective feelings at 1 week and 2 weeks after surgery.The differences between the groups were evaluated with a independent t test and a paired t test.Reports of subjective feelings were analyzed with a chi-square test,and a Wilcoxon test was used to analyze the abnormal distribution data.Results One week after surgery,visual acuity （t=-2.43,P〈0.05）,corrected spherical lens （t=-2.96,P〈0.05）,and contrast sensitivity （12 c/d） （t=-0.33,P〈0.05） in the experimental group were lower than in the normal group,but C7 （t=-0.19,P〈0.05）and C12 （t=5.08,P〈0.05） were higher.The differences were statistically significant.In the experimental group,visual acuity （t=-3.66,P〈0.05）,corrected spherical lens （t=-4.38,P〈0.05）,and contrast sensitivity （12 c/d） （t=-0.32,P〈0.05） were lower 1 week after surgery than at 2 weeks after surgery,but C7 （t=-0.17,P〈0.05） and C12 （t=5.33,P〈0.05） were higher.The differences were statistically significant.Conclusion After excimer laser corneal refractive surgery,high intraocular pressure can lead to curvature of the corneal anterior surface,aberrations and refractive changes,and lead to a decline in visual quality.