近视眼准分子激光原位角膜磨镶术后双眼调节变化的研究

A study of the changes in binocular accommodation after LASIK for myopes

目的了解准分子激光原位角膜磨镶术(laser in situ keratomileusis,LASIK)对近视眼双眼调节的影响。方法随机抽取接受LASIK手术的近视眼患者54例(108只眼)分为高度近视组和中低度近视组。患者术前戴框架眼镜矫正屈光不正,并阅读离角膜顶点35cm的视标,用自行研制的分光检影装置测定双眼调节距离;术后1月复查。仍戴框架眼镜矫正剩余屈光不正,检查方法同术前。正视眼20例(40只眼)为对照组。结果术后双眼调节反应大于术前(P<0·001),调节滞后小于术前(P<0·01)。高度近视组眼调节反应的改变量大于中低度近视组(P<0·01),双眼调节反应的改变量与等效球镜度呈正相关(r=0·345,P<0·05);与正视眼相比,双眼调节反应术前小于正视眼(P<0·001),术后与正视眼差异无显著性(P>0·05);调节滞后术前大于正视眼(P<0·01),术后与正视眼差异无显著性(P>0·05)。结论LASIK术后双眼调节反应大于术前,双眼调节反应的改变量与等效球镜度的改变量呈正相关;术后调节滞后小于术前,调节状态趋同于正视眼。

OBJECTIVE To find out the effect of laser in situ keratomileusis （LASIK） on eye accommodation.METHODS Fifty - four myopic patients （one hundred and eight eyes） who underwent myopic LASIK were included in this study. The patients with myopes were divided into two groups （high myopia group and mild- moderate myopia group） according to pre- operative refractive status. The subject wore correcting lens according to their refractive error.The binocular accommodative responses to accommodation targets （35cm distance from their eyes） were measured using dynamic retinoseopy apparatus with semi- reflective mirror before refractive surgery and at one month after refractive surgery.Twenty emmetropes （forty eyes） were recruited as control group. RESULTS The binocular eye accommodation response was significantly greater after - LASIK than before - LASIK （ P 〈 0. 001 ） . The accommodative lag of postoperative eyes was smaller than that of preoperative eyes （ P 〈 0.01 ） .The change of eye accommodative response for high myopia group was lager than for mild - moderate myopia group （ P 〈 0.01 ）, and had a positive correlation to refraction change （ r = 0. 345, P 〈 0.05） . The binocular accommodation response did significantly differ between preoperative myopia and emmetropes （ P 〈 0.01 ）, and did not differ between postoperative myopia group and emmtropes group （P 〉 0.05） . The lag of accommodation did significantly differ between preoperative myopia and emmetropes group （P 〈 0.01 ）, and did not differ between postoperative myopia and emmtropes （P 〉 0.05） . CONCLUSIONS The binocular accon,nodation response of after - LASIK was lager than that of before - LASIK. The change of eye accommodation response had a positive correlation to refraction change. The lag of accommodation after refractive surgery was significantly smaller than that before refractive surgery.The binocular accommodation of postoperative myopes converge towards emmetropes.