角膜地形图引导和非球面切削LASIK术后视觉质量问卷分析

Questionnaire analysis of visual quality after corneal topography guided and aspherical cutting laser in situ keratomileusis

目的分析角膜地形图引导个性化LASIK和非球面切削LASIK术后视觉质量问卷调查结果。方法选择在遵义医学院附属医院近视眼激光治疗中心进行LASIK的患者133例(257眼),根据自愿非随机方法分三组,其中35例(69眼)接受常规LASIK(常规组),51例(98眼)接受角膜地形图引导个性化LASIK(ORK-CAT组),另47例(90眼)接受非球面切削LASIK(ORK-Aph组)。设计主观视觉质量问卷(subjective visual quality questionnaire,SVQ)调查,分别于术后1周、1个月、3个月对患者进行SVQ调查,包括夜视力满意度和视觉质量主诉评分(视朦、眩光、光晕、复视、夜视模糊等)。结果 SVQ调查表明,在术后1周、1个月、3个月时,三组间夜视力满意度比较差异有统计学意义(P<0.05),术后1个月、3个月时视觉主诉评分三组间比较,差异有统计学意义(P<0.05);各时间段ORK-CAT组、ORK-Aph组均优于常规组(均为P<0.05),术后3个月时ORK-CAT组夜视力满意度和视觉主诉平均秩次分别为79.14分、50.62分,优于ORK-Aph组69.20分、65.28分(均为P<0.05)。按近视程度比较显示:低度近视术后各时间段夜视力满意度和视觉主诉平均秩次三组总体比较,差异均无统计学意义(均为P>0.05);中度近视ORK-CAT组(25例)平均秩次在各时间段均优于ORK-Aph组(23例)和常规组(13例,均为P<0.05);高度近视在术后1周、1个月、3个月时ORK-Aph组(11例)夜视力满意度优于ORK-CAT组(12例,均为P<0.05),各时间段视觉主诉平均秩次均低于ORK-CAT组(均为P<0.05)。结论 SVQ调查结果显示:不同的优化角膜切削方式对视觉质量的影响不同,在低度近视影响无差别,ORK-CAT在中度近视显示出优越性,而ORK-Aph对高度近视治疗效果更好。

Objective To analyze the questionnaire of visual quality after computer assisted corneal topography guide optimized refractive keratectomy（ORK-CAT）and the corneal aspherical cutting optimized refractive keratectomy（ORK-Aph）excimer laser in situ keratomileusis（LASIK）.Methods One hundred and thirty-three patients（257 eyes）from the myopia laser treatment center of the Affiliated Hospital of Zunyi Medical College were measured and randomly divided into three groups,in which 35 cases（69 eyes）were received routine LASIK（convention group）,51 cases（98 eyes）received ORK-CAT personality LASIK（ORK-CAT group）,another 47 cases（90 eyes）received ORK-Aph personality LASIK（ORK-Aph group）.The subjective visual quality questionnaire（SVQ）was designed and carried out at 1 week,1 month and 3 months after operation,the SVQ included the night vision satisfaction and visual quality complaint scores（visual vague,glare,halation,diplopia,blurred night vision）.Results SVQ showed there was statistical difference in night vision satisfaction among three groups at 1 week,1 month and 3 months after operation（all P0.05）,and there was also statistical difference in visual quality complaint scores among three groups at 1 month and 3 months after operation（all P0.05）,the ORK-CAT group and ORK-Aph group were better than the convention group（both P0.05）,the night vision satisfaction and visual quality complaint scores of ORK-CAT group at 3 months after operation were 79.14 and 50.62,which were better than 69.20 and 65.28 of ORK-Aph group（both P0.05）.At lower myopia,there was no statistical difference in the mean rank of visual quality complaint scores and night vision satisfaction among three groups（P0.05）;At medium myopia,the mean rank of ORK-CAT group（25 cases）were superior than that of ORK-Aph group（23 cases）and conventional group（13 cases）in visual quality complaint scores and night vision satisfaction（all P0.05）;At high myopia,the night vision satisfaction and visual quality complaint scores mean rank of the ORK-Aph group（11 cases）were sperior than that of ORK-CAT groups（12 cases）at 1 week,1 month and 3 months after operation（all P0.05）.Conclusions The visual quality is different in different customized cutting ways,there is no difference in low myopia,corneal topography guided LASIK is better for medium myopia and corneal aspherical cutting LASIK for hign myopia treatment.