高度近视患者LASIK术后夜间眩光危险因素

Risk Factors for Night Glare after LASIK for High Myopia

【目的】探讨高度近视患者LASIK术后发生夜间眩光的手术前危险因素。【方法】对接受LASIK手术术后至少6月以上的55位(108眼)双眼高度近视患者(等值球镜-6.0D以上)进行夜间眩光发生情况的调查。患者术前等值球镜(SE)-8.32(s=1.96)D(-6.0D～-15.87D),所有手术均为标准的LASIK手术,调查时间为术后6～12月间,平均8.8(s=1.6)月。采用病例对照的方法分析患者发生术后夜间眩光的危险因素。【结果】55位患者中,18(32.7%)位患者发生了夜间眩光,几乎所有的眩光患者均为双眼对称性发生。发生眩光眼和无眩光眼在暗瞳孔直径、拟矫正的等值球镜和是否采用过渡区切削上有显著差异(P=0.00,0.01,0.04)。对上述因素进行Logistic回归分析发现,暗瞳孔直径、拟矫正的等值球镜以及无过渡区切削是发生夜间眩光的显著危险因素(P均<0.05)。其中,瞳孔直径为最显著的危险因素,相对危险度达3.23倍。而最小光区直径对术后的夜间眩光的预测性不大(P>0.05)。【结论】对于非波前引导的LASIK手术,暗瞳孔直径、试图矫正的屈光度以及是否采用过渡区切削为高度近视患者术后夜间眩光的显著危险因素,当最小光区直径在5mm以上时,光区大小与夜间眩光没有显著关系。

[Objective ] To investigate the preoperative risk factors for night glare after LASH（ for high myopia. [Methods] A total of 108 eyes of 55 high myopic patients who underwent a standard LASH（ were investigated, with the preoperative spherical equivalent （SE） ranged from -6.0 diopters （D） to -15.87 D, mean-8.32 （s=1.96）D. The patients were observed postoperatively 6 to 12 months, mean 8.8 （s=1.6） months. The self-perceived night glare of each eye was investigated. The risk factors of night glare such as preoperative scotopic pupil size, attempted correction of spherical equivalent, minimum optical zone, and transition zone were analyzed by case-control study. [Results] Among the 55 patients, 18 patients （32.7%） had complained night glare,all patients reported similar glare symptoms in both eyes. There were significant difference in pupil size, attempted correction of SE and the number of eyes with transition zone between eyes with night glare and without night glare （P=0.00, 0.01, and 0.04, respectively）. Using logistic regression of the odds ratio （OR）, scotopic pupil size, attempted correction of spherical equivalent and transition zone were the significant risk factors （all P〈 0.05）, and the pupil size was the most important risk factor with a 3.23-thnes increase in night glare. Whereas the optical zone was not statistically predictive of postoperatively nitht glare （P 〉0.05）. [Conclusions] Pupil size, attempted correction of spherical equivalent and using transition ablation were significant risk factors for none-wave front guided LASH（ for high myopic, however, the optical zone was not significant risk factor when the minimum optical zone was not less than 5 mm.