准分子激光原位角膜磨镶术后视野分析

目的探讨准分子激光原位角膜磨镶术（LASIK）对患者视野的影响。方法对实施LASIK的近视患者46例（92只眼）术前、术后1d、1个月、3个月、6个月用Humphrey视野计30-2SITA快速阈值检测程序行视野检查。统计学分析采用配伍组设计的两因素方差分析,分析各时间点视野指数。结果视野检查中术后各时间点平均缺损（MD）与术前相比,差异均有统计学意义（P〈0．05）,但术后各时间点MD之间差异无统计学意义（P〉0．05）,术前视力与MD无显著相关性（P〉0．05）,但MD与术后各次检测视力均呈显著负相关（P〈0．05）。而模式标准差（PSD）在手术前后差异无统计学意义（P〉0．05）,PSD与术前视力呈显著相关性（P〈0．05）,但术后各次检测视力与PSD均无显著相关性（P〉0．05）。手术前后MD和PSD平均差值与术前屈光度、切削厚度、激光脉冲数、激光切削时间、负压吸引时间做Person相关分析均无相关性（P〉0．05）。结论LASIK前后视野连续观测无显著变化,说明LASIK对视网膜结构和功能的影响还不足以导致临床上显著的形态和视功能改变,对视网膜正常生理功能无明显影响。

Visual field analysis after laser in situ keratomileusis

OBJECTIVE: To evaluate the effects of laser in situ keratomileusis (LASIK) on the patients' visual field. METHODS: 92 eyes of 46 patients with mild, moderate, and high degrees of myopia were undergone LASIK. Perimetry was performed before and 1 day, 1 month, 3 months, 6 months after LASIK surgery by Humphrey II-750 visual field analysis. The central 30 - 2 fast threshold program was used to examine the change in central 30 degree. Mean defect (MD) and pattern standard deviation (PSD) were record. All operations were performed by an experienced surgeon. Statistical analyses were performed by SPSS using the randomized complete block design ANOVA (two factors analysis of variance). Differences among variables were evaluated by q-test (Student-Newman-Kueuls method). RESULTS: 93.5% patients obtained estimated best correct visual acuity or better at six months after LASIK. No complications were found in the subjects. No difference was found in fundus examinations before and after surgery. Intraocular pressure was normal at all preoperative and postoperative examinations. MD was significant differences among preoperative and postoperative values (P < 0.05, for all comparisons) and was correlated with visual acuity post-LASIK significantly (P < 0.05). While PSD did not show significant differences before and after LASIK (P > 0.05) and was not correlated with visual acuity post-LASIK. The indexes of visual field were not correlated with the degree of myopia and the other surgical parameters (P > 0.05). CONCLUSION: In current research, no significant visual field change was demonstrated pre-LASIK and post-LASIK after 6 months follow-up. The study suggests that LASIK does not affect the retinal physiological functions.