近视眼LASIK术后AC/A比率的变化

Changes of AC/A ratio after laser in situ keratomileusis in myopia

目的研究近视眼患者准分子激光原位角膜磨镶术(laser in stiu keratomileusis,LASIK)后调节性集合(accom-modative convergence,AC)与调节(accommodation,A)比率的变化。方法将230眼按近视屈光度等效球镜值-1.50～-3.00D、-3.25～-6.00D和-6.25～-11.00D分为A、B、C3个组行LASIK手术。采用同视机测定患者术前戴镜、术后1个月、3个月裸眼AC/A值,并进行统计学分析。结果A、B、C3组术前戴镜AC/A值分别为3.02±0.79、3.03±0.69和2.71±0.47;术后1个月裸眼AC/A值分别为2.77±0.33、2.40±0.33和2.49±0.40;术后3个月裸眼AC/A值分别为3.04±0.74、2.79±0.58和2.74±0.60。术后1个月裸眼AC/A值明显低于术前戴镜和术后3个月,有显著性差异(P<0.01);术后3个月裸眼AC/A值与术前戴镜AC/A值比较无显著性差异(P>0.05);不同近视程度间各组AC/A值比较术前戴镜、术后1个月和术后3个月均无统计学差异(P>0.05)。结论对于长期戴镜患者,近视程度对术前戴镜、术后裸眼AC/A值均无影响;不同近视程度患者LASIK术后裸眼AC/A值的变化趋势相同,即均表现为先下降,后上升,至术后3个月时基本恢复到术前戴镜水平。

Objective To study the changes of accommodative convergence （ AC ）/accommodation （A） ratio after laser hi situ keratomileusis（LASIK） in the patients with myopia. Methods A total of 230 eyes were treated with LASIK. Based on the preoperative spherical equivalent refraction,they were divided into A,B and C groups（ - 1.50 - - 3.00D、 -3.25 - -6.00D and -6.00 - - 11.00D）.The AC/A ratio was measured with synoptophor wearing glasses before surgery and at 1 month,3 months after surgery,and analysis in statistic was made. Results In three groups, the AC/A ratio of wearong glasses before surgery was 3.02 ±0.79, 3.03±0.69 and 2.71 ±0 . 47,the AC/A ratio of naked eyes at 1 month postoperatively was 2.77 ±0. 33.2.40 ± 0.33 and 2.49 ±0. 40,and that at 3 months postoperatively was 3.04 ±0.74.2.79 ±0.58 and 2.74 ±0. 60. At 1 month postoperatively, the AC/A ratio of naked eyes was significantly smaller than that of wearing glasses before surgery and postoperative 3 months （P 〈0.01 ）. There was no significant difference between the AC/A ratio of wearing glasses before surgery and postoperative 3 months（P 〉 0.05 ）. There was a18o no significant difference among A, B and C groups before surgery, 1 and 3 months after surgery respectively （ P 〉 0.05 ）. Conclusion For the patients of long wearing ses,the AC/A ratio of both wearing glasses before surgery and postoperative naked eyes are not affected by myopic degree. The changing trends of postoperative AC/A ratios are same, namely, they are reduced at first and increased gradually, and regain their preoperative level of wearing glasses at 3 months after surgery. [Ree Adv Ophthalmol 2007;27（2） ：120-122]