标准及波前像差引导LASIK手术前后明暗环境下对比敏感度变化

Changes of contrast sensitivity under photopic or mesopic circumstance between before and after standardized LASIK or wavefront-guided LASIK

目的比较标准LASIK和波前像差引导LASIK手术前后在明、暗环境下对比敏感度变化。方法选取接受标准LASIK或波前像差引导LASIK的中高度近视患者各30例,行明环境下和暗环境下对比敏感度检查,观察2组对比敏感度的变化。结果明环境下对比敏感度,术前2组在各个空间频率下无差异(P>0.05),术后波前组各个空间频率下对比敏感度均显著高于标准组(P<0.05);在有眩光干扰情况时1.0deg、0.7deg空间频率下波前组术后对比敏感度增加幅度分别为0.2004±0.3771、0.1639±0.3151,显著大于标准组(0.0584±0.2951、0.0560±0.2348)(P<0.05)。暗环境下对比敏感度,术后波前组各等级通过率均大于标准组,但仅在有眩光时差异有统计学意义(P<0.05)。术后6个月,明环境对比敏感度有眩光情况下,波前组均显著超过术前水平(P<0.05);标准组在6.3deg(1.7518±0.2072)、4.0deg(1.7235±0.1901)、2.5deg(1.5680±0.3009)、1.6deg空间频下显著超过术前水平,在1.0deg、0.7deg空间频率下高于术前水平,但差异无统计学意义(P>0.05)。术后6个月,明环境对比敏感度在无眩光情况下,2组对比敏感度均未恢复至术前水平,但差异无统计学意义(P>0.05)。结论波前像差引导的LASIK手术视觉质量优于标准LASIK。

Objective To investigate changes of contrast sensitivity under photopic or mesopic circumstance between before and after standardized LASIK or wavefront-guided LASIK.Methods There were 30 medium or high myopic cases performed standardized LASIK,the other 30 medium or high myopic cases performed with wavefront-guided LASIK.Contrast sensitivity was detected under photopic and mesopic circumstances.Changes of contrast sensitivity were compared.Results Under photopic circumstance,contrast sensitivity had no difference in each spatial frequency between the two groups before operation（all P0.05）.Contrast sensitivities in wavefront-guided LASIK group were higher than those in standardized LASIK group at different spatial frequencies after operation（all P0.05）.With glare interference,contrast sensitivity of wavefront-guided LASIK increased more obvious（0.200 4±0.377 1 and 0.163 9±0.315 1）than standardized LASIK group（0.058 4±0.295 1 and 0.056 0±0.234 8）at spatial frequencies of 1.0 deg and 0.7 deg（both P0.05）.Under mesopic circumstance,contrast sensitivities in wavefront-guided LASIK group were higher than those in standardized LASIK group at different spatial frequencies after operation,but only have differences with glare interference（all P0.05）.At postoperative 6 months,contrast sensitivity of wavefront-guided LASIK was higher than those at pre-operation under photopic circumstance with glare interference（P0.05）.Contrast sensitivities were 1.751 8±0.207 2 at spatial frequency of 6.3 deg,1.723 5±0.190 1 at spatial frequency of 4.0 deg,1.568 0±0.300 9 at spatial frequency of 2.5 deg,which were obviously higher than those at pre-operation,and also at spatial frequency of 1.6 deg.Contrast sensitivities at spatial frequencies of 1.0 deg and 0.7 deg were higher than those at pre-operation,but no difference was found（both P0.05）.At postoperative 6 months,contrast sensitivities of both two groups were not recovered to the levels at pre-operation under photopic circumstance without glare.No difference was found（both P0.05）.Conclusion Wavefront-guided LASIK is with better visual quality than standardized LASIK.