摘要
目的探讨激光融合视觉(LBV)手术矫正近视眼伴老视的术后手术效果和视觉质量。方法前瞻性研究。纳入于2021年8月至2022年3月在首都医科大学附属北京同仁医院采用LBV方案矫正近视眼伴老视的患者50例(100只眼),在术前及术后1、3、6、12、24个月时分别检查主视眼、非主视眼及双眼的裸眼远视力、裸眼近视力(UNVA)、最佳矫正远视力、显然验光等效球镜度数(MRSE),并计算有效性指数(EI)和安全性指数(SI),以评价术后屈光效果;检查调节功能及对比敏感度以评价功能性视力;通过高阶像差和双通道视觉质量分析系统评价客观视觉质量,并进行主观视觉质量问卷调查。结果LBV手术后24个月主视眼EI和SI分别为1.04±0.23和1.14±0.14;非主视眼的EI和SI分别为0.85±0.21和1.06±0.08,主视眼、非主视眼及双眼UNVA尽管在术后1和3个月时差异有统计学意义(均P<0.05),但自术后6个月开始,各眼别间的差异无统计学意义(均P>0.05)。术后6个月时,主视眼和非主视眼UNVA分别为0.07±0.13和0.03±0.13,差异无统计学意义(P>0.05)。MRSE在术后24个月各随访时间差异无统计学意义。术后1、3、6、12、24个月随访时调节功能与术前相比未见下降。术后高阶像差的增加以球差为主,手术前后客观视觉质量检查结果的差异无统计学意义。术后24个月对比敏感度相较于术前明显提高。术后24个月时,11/12的患者问卷结果显示视觉质量良好。结论LBV手术能够在术后6个月内逐渐形成良好的双眼融合视觉,术后24个月具有良好的安全性、有效性及稳定性,能够维持较好的功能性视力和视觉质量。患者术后满意度较高。
Objective To investigate the postoperative outcomes and visual quality following laser blended vision(LBV)surgery for the correction of myopia with presbyopia.Methods This is a prospective study.A total of 50 patients(100 eyes)who underwent LBV surgery for myopia with presbyopia at Beijing Tongren Hospital,Capital Medical University,between August 2021 and March 2022 were included.Uncorrected distance visual acuity(UDVA),uncorrected near visual acuity(UNVA),best-corrected distance visual acuity(BCDVA),manifest refraction spherical equivalent(MRSE)were measured preoperatively and at 1,3,6,12,and 24 months postoperatively for the dominant eye,non-dominant eye,and both eyes.Effectiveness Index(EI)and Safety Index(SI)were calculated to evaluate refractive outcomes.Accommodation function and contrast sensitivity were assessed to evaluate functional vision.Objective visual quality was assessed using higher-order aberrations(HOAs)and a dual-channel visual quality analysis system.Subjective visual quality was evaluated using a questionnaire.Results At 24 months postoperatively,the EI and SI for the dominant eye were 1.04±0.23 and 1.14±0.14,respectively,while for the non-dominant eye,they were 0.85±0.21 and 1.06±0.08,respectively.Although there were statistically significant differences in UNVA between the eyes at 1 and 3 months postoperatively(all P<0.05),no significant differences were observed from 6 months onward(all P>0.05).At 6 months postoperatively,the UNVA for the dominant and non-dominant eyes were 0.07±0.13 and 0.03±0.13,respectively,with no significant difference(P>0.05).MRSE showed no significant differences at any follow-up time points up to 24 months.Accommodation function did not decrease compared to preoperative levels at any postoperative follow-up.Increases in HOAs were primarily due to spherical aberrations,and there were no significant differences in objective visual quality before and after surgery.Contrast sensitivity improved significantly at 24 months postoperatively compared to preoperative
作者
宋彦铮
徐玉珊
张丰菊
吕晓彤
付彩云
翟长斌
Song Yanzheng;Xu Yushan;Zhang Fengju;Lyu Xiaotong;Fu Caiyun;Zhai Changbin(Beijing Tongren Eye Center,Beijing Tongren Hospital,Capital Medical University,Beijing Institute of Ophthalmology,Beijing Key Laboratory of Ophthalmology&Visual Sciences,Beijing 100730,China)
出处
《中华眼科杂志》
CAS
CSCD
北大核心
2024年第8期665-673,共9页
Chinese Journal of Ophthalmology
基金
北京市科技计划(Z201100005520043)
首都医科大学附属北京同仁医院青年拔尖人才种子基金项目(2021-YJJ-ZZL-017)。
关键词
近视
老视
屈光外科手术
角膜磨镶术
激光原位
激光
准分子
视敏度
Myopia
Presbyopia
Refractive surgical procedures
Keratomileusis,laser in situ
Lasers,excimer
Visual acuity
