准分子激光屈光性角膜术治疗近视性屈光参差后的双眼影像不等和立体视

Binocular aniseikonic and stereopsis after photorefractive keratectomy or laser in situ keratomileusis for myopic anisometropia

目的：评估轴性和屈光性两组近视性屈光参差（ＭＡ）经准分子激光屈光性角膜术（ＰＲＫ／ＬＡＳＩＫ） 矫正后的双眼影像不等检查结果（ＢＡ） 与理论计算值（ ％ Ｓｉｚｅ Ｄｉｆｆｅｒｅｎｃｅ，％ ＳＤ） 的关系，了解ＭＡ患者术后ＢＡ 和立体视的状况。方法：对４０ 例屈光度差≥２．５０Ｄ的近视患者行ＰＲＫ／ＬＡＳＩＫ，术后作ＢＡ和立体视检查，分别将两组的ＢＡ与％ＳＤ作比较；按术前屈光度差１．００Ｄ分四组，就术后ＢＡ和立体视进行比较；以不同矫正视力分两组，分析视力与立体视的关系。结果：ＢＡ与％ ＳＤ差异有显著性；不同屈光度差的ＭＡ患者，术后ＢＡ 及立体视差异无显著性，矫正视力与术后立体视关系密切。结论：轴性ＭＡ，屈光度差越大，％ ＳＤ较ＢＡ增大越明显，屈光性ＭＡ，％ ＳＤ明显小于ＢＡ。屈光度差在２．５０ ～８．００Ｄ范围时，ＭＡ患者ＰＲＫ／ＬＡＳＩＫ术后的ＢＡ和立体视状况无明显差异。矫正视力越好。

Objective:By evaluating the relationship between actual test and theoretical(% size difference,%SD)of binocular aniseikonia(BA) for axial and refractive myopic anisometropia(MA) after photorefractive keratectomy or laser in situ keratomileusis(PRK/LASIK) to study the BA and stereopsis after operation of MA.Methods: BA and stereopsis were examined after PRK/LASIK in 40 patients with myopic anisometropia whose binocular diopter difference(BDD) is larger than 2.50D,the actual test BA and %SD for axial and refractive anisometropia were compared; Four groups with BDD of 1.00D step were divided to compare the post-operative BA and stereopsis;Two groups with corrected vision were divided to analyze the relationship between vision and stereopsis.Results:There is significant difference in the actual BA and %SD.For anisometropia with different BDD,there is no significant difference in the BA and stereopsis after operation.Stereopsis after operation was closely related to corrected vision.Conclusion: The axial MA:the larger the BDD,the greater of %SD than that of BA.The refractive MA: %SD is smaller than BA.There is no significant difference in the BA and stereopsis after operation while BDD within 2.50～8.00D.However the better the corrected vision,the finer the stereopsis.