准分子激光原位角膜磨镶术后视野改变

Visual field changes after laser in situ keratomileusis in myopic eyes

目的:探讨准分子激光原位角膜磨镶术(laser in situ keratom ileusis,LASIK)对近视及近视散光患者30°中心视野的影响。方法:将实施LASIK的近视患者45例89眼分为两组:中低度近视组和高度近视组。Ⅰ组:中低度近视组60眼,近视-1.50～-6.00D;Ⅱ组:高度近视组29眼,近视-6.00～10.00D。用Humphrey视野计30-2SITA快速阈值检测程序对所有患者的术前、术后1wk;1,3,6mo的视野进行检查,观察其视野改变情况。观察指标为平均缺损(mean defect,MD)和模式标准差(pattern standard deviation,PSD)。统计学分析采用重复测量的方差分析和非参数分析的秩和检验,分析各时间点视野指数。结果:中低度近视组:术后1wk;1,3mo的MD与术前相比,差异有统计学意义(P<0.05),术后6mo时MD值与术前相比差异无统计学意义;PSD值术后各时间点与术前相比差异无统计学意义。高度近视组:术后1wk;1,3mo时的MD均较术前增加,并且随时间变化的差异有统计学意义(P<0.05);其中,1wk时MD值上升最明显,以后逐渐下降,但仍高于术前水平;术后6mo时恢复至术前水平(P>0.05);术后1wk时的PSD与术前相比差异有统计学意义(P<0.05),其余各时间点PSD值与术前相比差异无统计学意义。结论:LASIK手术对高度近视眼患者1wk的视野有影响,对中低度近视患者的视野改变无影响。

AIM：To evaluate the effects of laser in situ kerato-mileusis（LASIK） on the patients’ central 30-degree visual field. ·METHODS：Eighty-nine eyes of 45 patients with mild,moderate,and high degrees of myopia underwent LASIK. They were divided into two groups according to the magnitude of the refractive error. Group Ⅰ（mild and moderate degrees of myopia,60 eyes） -1.50--6.00D,group Ⅱ（high degrees of myopia,29 eyes） -6.00--10.00D. Perimetry was performed before and 1 day,1 month,3 months,6 months after LASIK surgery by Humphrey II-750 visual field analysis.The central 30-2 fast threshold program was used to examine the change in central 30-degree.Mean defect（MD） and pattern standard deviation（PSD） were recorded. All operations were performed by an experienced surgeon. Statistical analysis were performed by SPSS using ANOVA（analysis of variance） of repeated measurement data. Differences among variables were evaluated by NPAR（nonparametric test） .·RESULTS：MD of groupⅠandⅡhad significant differences among preoperative and postoperative values（P〈0.05,for all comparisons） . PSD of groupⅠdid not show significant differences before and after LASIK（P〉0.05） . While PSD of groupⅡ showed significant differences 1 week postoperatively. PSD had no significant differences 1 month,3 months,and 6 months postoperatively.·CONCLUSION：The study suggests that LASIK does not affect the retinal physiological functions of mild,moderate degrees of myopia. While it possibly affects the visual field 1 week postoperative values of high degree of myopia.