LASIK术后AC/A的变化及其影响因素

目的研究近视患者准分子激光原位角膜磨镶术(LASIK)后调节性集合与调节比率(AC/A)的变化及其影响因素。方法将73例(146眼)接受LASIK手术的近视患者按近视屈光度等效球镜值分为低度、中度和高度3组,采用同视机测定患者术前戴镜及术后1周、1、3个月时裸眼AC/A值。结果术后1周和1个月时裸眼AC/A值明显低于术前戴镜AC/A值(P<0.05),术后3个月时裸眼AC/A值与术前戴镜AC/A值比较差异无统计学意义(P>0.05);LASIK术后裸眼AC/A值与术前戴镜AC/A值呈正相关(P<0.05),与眼轴长度及患者年龄呈负相关(P<0.05);不同屈光度组间比较,AC/A值在术前及术后1周、1和3个月时差异均无统计学意义(P>0.05)。结论 LASIK术后裸眼AC/A值先下降,之后逐渐上升,术后3个月时基本恢复到术前戴镜水平;LASIK术后AC/A值受术前戴镜AC/A值、眼轴长度及患者年龄的影响;对于长期佩戴合适眼镜的近视患者,近视程度对术前戴镜及术后裸眼AC/A值均无影响。

Changes and its related factors of AC/A ratio of myopia after LASIK

Objective To study the changes of accommodative convergence per unit of accommodation ratio(AC/A) of myopia after excimer laser in situ keratomileusis(LASIK).Methods A total of 73 myopia patients(146 eyes) accepted LASIK,and they were divided into groups of low myopia,medium myopia and high myopia by their preoperative spherical equivalent refraction.Their AC/A ratios were measured with synoptophore before surgery and one week,one month,three months after surgery.Results At one week and one month after operation,the naked AC/A ratios were significantly smaller than that of wearing glasses before operation(P<0.05),and at three months after operation,the naked AC/A ratios had no difference with that of wearing glasses before operation(P>0.05);At one week and one month after operation,the AC/A ratio had a positive correlation to the preoperative AC/A ratio of wearing glasses(P<0.05),and a negative correlation to ocular axis or age(P<0.05);The AC/A ratios had no difference in the three different myopic groups(P>0.05).Conclusion The changing trends of postoperative AC/A ratios are reduced at first,and then increased gradually,while recovered to their preoperative level of wearing glasses at three months after operation;Postoperative AC/A ratios are influenced by factors such as the preoperative AC/A ratios of wearing glasses,the length of ocular axis and the age.For the patients of long-term wearing suitable glasses,the AC/A ratios are not affected by myopic degree.