不同验光方法检测LASIK术后屈光度的临床比较

Clinical comparison of different methods for postoperative LASIK refractive detection

目的:探讨准分子激光原位角膜磨镶术(laser in stiu keratomileusis,LASIK)后不同验光方法的准确性。方法:对在我院接受LASIK手术48例96眼,在术前和术后1mo进行电脑验光、散瞳后检影验光和主观插片。对获得的数据进行统计学分析。结果:LASIK术前、电脑验光、散瞳后检影验光和主观插片验光得出的球镜和柱镜度数结果均没有统计学差异(F=4.32,P=0.69;F=0.57,P=0.57)。LASIK术后检影验光与主觉试片的结果相符(P=0.68;P=0.15),而电脑验光得出的度数与检影验光和插片结果均存在统计学差异(P=0.00)。结论:LASIK术前用自动验光仪进行客观验光与散瞳后检影验光法测得的屈光不正的结果接近;术后电脑验光的准确性较术前下降,不能有效评判术后的屈光状态。术后散瞳检影验光仍可获得较准确的屈光度值。

AIM： To compare the accuracy of different refraction measurements after laser in stiu keratomileusis （LASIK） for myopia and astigmatism.METHODS： Totally 48 cases 96 eyes with myopia were measured before and one month after LASIK, with auto refractor （TOPCOON） objectively, girdle-shaped scissors-shadow scope and subjectively trial lens. The data obtained were statistically analyzed.RESULTS： Both spherical power and astigmatism results of three measurements had no statistical difference preoperatively（F=4.32, P=0.69; F=0.57, P=0.57）. Postoperatively, refraction test with girdle-shaped scissors-shadow scope and trial lens had no statistical difference（P=0.68; P=0.15）. But refraction with auto refractor had statistical difference with the tests with the first two methods（P=0.00）.CONCLUSION： Preoperatively, the objective refraction with an auto refractor is approximate to the retinoscopy optometry and the subjective refraction. The postoperative objective refraction with an auto refractor is less accurate than that preoperatively. It is not sufficient to determine the accurate value of the ametropia. Cycloplegic dioptoscopy can get a relative accurate diopter values after LASIK.