摘要
目的:探讨术前不同瞳孔参数对伴老视的近视飞秒激光辅助的准分子激光角膜原位磨镶术(FS-LASIK)后视力的影响。方法:前瞻性病例对照研究。选取2020年1—12月于广西壮族自治区柳州市工人医院连续就诊的中度近视合并老视患者60例(120眼)。患者在中间视觉环境(1 cd/m^(2))按瞳孔大小分为3组:小瞳孔(SPG)组(≤5.5 mm)、中瞳孔(MPG)组(5.6~6.4 mm)和大瞳孔(LPG)组(≥6.5 mm)。各组分别于术前,术后1个月、3个月、6个月均行视力、瞳孔反应以及像差检查,比较3组裸眼视力(UCVA)、近视力(UCNVA)、瞳孔反应以及像差。采用重复测量方差分析比较不同时间点瞳孔参数、视力、像差的变化,术前不同组间各瞳孔反射参数比较采用ANOVA方差分析。结果:术后3、6个月时MPG组和SPG组的UCVA高于LPG组(术后3个月:F=10.62,P<0.001;F=14.21,P<0.001;术后6个月:F=14.88,P<0.001;F=14.81,P<0.001);SPG组和MPG组的UCNVA均优于LPG组(术后3个月:F=37.62,P<0.001;F=25.62,P<0.001;术后6个月:F=37.60,P<0.001;F=38.11,P<0.001)。在术后6个月的随访中,MPG组患者的满意度高于LPG组和SPG组。术后1、3、6个月,MPG组和SPG组患者的收缩幅度、收缩速度和瞳孔收缩持续时间均优于LPG组,差异均有统计学意义(均P<0.001);瞳孔扩张潜伏期MPG组和SPG组优于LPG组,差异有统计学意义(P<0.05);扩张持续时间和扩张速度在3组患者间比较差异无统计学意义;3组患者垂直彗差(C7),水平彗差(C8)和球差(C12)均增加,LPG组患者增加最多,差异有统计学意义(P<0.001)。结论:老视激光屈光手术后6个月,中、小瞳孔大小的患者均可以获得更好的视觉质量。
Objective:To evaluate the effect of pupil parameters on quality of vision after laser refractive surgery for presbyopia.Methods:In this prospective study,60 consecutive presbyopic patients(120 eyes)with moderate myopia were included from January to December 2020 at Liuzhou Workers’Hospital.Subjects were divided into three groups according to pupil size at an intermediate visual environment(1 cd/m^(2)):small pupil group(SPG)(≤5.5 mm),medium pupil group(MPG)(5.6-6.4 mm),and large pupil group(LPG)(≥6.5 mm).The uncorrected visual acuity(UCVA),near vision(UCNVA),pupil parameters and aberrations were examined and compared before surgery,and at 1,3,and 6 months after surgery.Repeated measurement analysis of variance was used to compare the changes in pupil parameters,visual acuity and aberration differences at different time points before and after surgery.ANOVA analysis of variance was used to compare the pupil parameters among the different groups before surgery.Results:The UCVA of the MPG and SPG groups was higher than that of the LPG group at 3 and 6 months after surgery(3 months after surgery:F=10.62,P<0.001;F=14.21,P<0.001;6 months after surgery:F=14.88,P<0.001;F=14.81,P<0.001).The UCNVA of the SPG and MPG groups was better than that of the LPG group(3 months after surgery:F=37.62,P<0.001;F=25.62,P<0.001;6 months after surgery:F=37.60,P<0.001;F=38.11,P<0.001).In the 6-month follow-up,patient satisfaction in the MGP group was higher than that in the LPG and SPG groups.At 1,3 and 6 months after surgery,the amplitude,velocity,and duration of contraction in the MPG and SPG groups were better than those in the LPG group,and the differences were statistically significant(P<0.001).The latency of pupil dilation in the MPG and SPG groups was better than that in the LPG group(P<0.05).There was no significant difference in duration or velocity of dilation among the three groups.The values of the vertical coma(C7),horizontal coma(C8)and spherical aberrations(C12)all increased in the three groups,and most significantly i
作者
林颖
苏焕钧
张霞
张泳
Ying Lin;Huanjun Su;Xia Zhang;Yong Zhang(Department of Ophthalmology,Liuzhou Workers’Hospital,Liuzhou 545005,China;Department of Ophthalmology,Shandong Provincial Hospital,Jinan 250000,China)
出处
《中华眼视光学与视觉科学杂志》
CAS
CSCD
2022年第6期423-428,433,共7页
Chinese Journal Of Optometry Ophthalmology And Visual Science
基金
广西壮族自治区卫生健康委员会自筹经费科研课题(Z20200556)。
关键词
瞳孔
老视
Q值调整
FS-LASIK
像差
pupil
presbyopia
Q-value adjustment
femtosecond assisted laser in situ keratomiluesis
aberration
