LASIK术后视觉质量下降的调查分析及处理

Analysis and treatment of visual quality descending for patients post LASIK

目的探讨LASIK术后患者视觉质量下降的临床表现、发生原因、处理方法及效果。方法对650例(1276只眼)LASIK受术者进行问卷调查,对有视觉质量下降主诉的患者进行相关检查,并做相应治疗,随访半年～2年。结果有视觉质量下降的共45例(48只眼),占6.92%。分析与以下因素有关:(1)术后过矫及年龄偏大,占43.75%;(2)大度数散光,占10.42%;(3)手术前后主导眼变换,占20.83%;(4)切削偏心,占4.17%;(5)切削直径过小,占8.33%;(6)高阶像差增加和对比敏感度下降,占12.50%。部分患者症状可自行缓解,部分经过治疗可得以改善。结论LASIK术后视觉质量改变的发生与多种因素有关,其预后与发生原因和治疗有关,规范的手术程序可减少其发生率。

Objective To investigate the clinical manifestation、causation、treatment and results of visual quality descending for patients post LASIK. Method 650 patients (1276 eyes) were questioned. The correlated examination and treatment were done to the patients with visual quality descending, follow up from half to 2 years. Results Totally 45 cases (48 eyes) had visual quality descending, that is 6.92 %. The following factors are correlated:(1)Over correction and elder of the patients, 43.75%. (2)High degree of astigmatism, 10.42%.(3)The change of the main eye before and post operation, 20.83%. (4)Off center ablation, 4.17%. (5)Too small of the ablation diameter, 8.33%.6 The increase of high order aberration and decrease of contrast sensitivity, 12.50%. The symptoms of some patients could self-relieve, some could improve after treatment. Conclusion The occurrence of visual quality descending post LASIK was correlated to many factors. The prognosis was correlated to the causation and treatment. The normative operative procedure could reduce the occurrence.