高度近视LASIK术后远期视觉相关生活质量调查

Long-term Evaluation of High Myopia Patients' Vision-related Quality of Life after LASIK

【目的】研究高度近视患者LASIK术后远期视觉相关生活质量。【方法】应用视觉相关生活质量调查问卷对80例高度近视LASIK术后患者及80例术前高度近视患者进行调查,同时对术后患者进行视力、屈光度及近对比敏感度检查,评估术后远期视觉相关生活质量及了解术后常见视觉障碍,评分越高,视觉障碍越严重。【结果】LASIK术后患者生活质量得分为(8.6±8.2)分,低于术前对照组得分(16.2±8.9)分(P<0.05)。视觉障碍阳性率发生较高的前6项条目,依次为电脑使用和阅读容易疲劳(28.8%)、近视力感受变差(22.6%)、夜间视物模糊(22.6%)、眼干涩不适(20.1%)、眩光(20%)、夜间驾驶困难(17.5%)。其中电脑使用和阅读引发视疲劳与术后视力、高空间频率(18 cpd)呈负相关(r=-0.257、-0.265);近视力感受变差与术后视力呈负相关(r=-0.306),与术后屈光度存在正相关(r=0.270);夜间视物模糊与术后视力、低空间频率(3 cpd)存在负相关(r=-0.436,-0.226),与术后屈光度存在正相关(r=0.478);眩光与术后视力、各空间频率存在负相关(r=-0.265^-0.408),与术后屈光度存在正相关(r=0.342);夜间驾驶困难与术后视力、高空间频率(18 cpd)呈负相关(r=-0.351、-0.249),与术后屈光度存在正相关(r=0.369)。【结论】LASIK手术能有效改善高度近视患者远期的视觉生活质量。电脑使用和阅读容易疲劳是LASIK术后远期高度近视患者最常见视觉障碍。

[Objective] To measure the vision-related quality of life of high myopia patients after LASIK.[Methods] The visionrelated quality of life questionnaire was used to take a survey in 80 high myopia postoperative patients and 80 high myopia patients before LASIK to evaluate the vision-related rate of quality of life and get to know common dysopsia.The more score,the more dysopsia.Other measurements including vision,diopter,and contrast sensitivity test.[Results] The overall quality of life score of patients was reduced from （16.2 ± 8.9） to （8.6 ± 8.2） （P 〈 0.05） after LASIK surgery.The higher positive rate of dysopsia in the first 6 items：visual fatigue from computer and reading （28.8%）,vague in near vision （22.6%）,vague at night （22.6%）,dryness （20.1%）,glaring at night （20%）,driving difficulty at night （17.5%）.The scores of visual fatigue from computer and reading were significantly associated with postoperative visual acuity and high spatial frequency （18 cpd） （r =-0.257,-0.265）.The scores of vague in near vision was significantly associated with postoperative visual acuity and postoperative diopters （r =-0.306,0.270）.The scores of vague at night was significantly associated with postoperative visual acuity,low spatial frequency （3cpd） and postoperative diopters （r =-0.436,-0.226,0.478）.The scores of glaring at night was significantly associated with postoperative visual acuity,all spatial frequency and postoperative diopters （r =-0.265 to-0.408）.The scores of driving difficulty at night was significantly associated with postoperative visual acuity,high spatial frequency （18cpd） and postoperative diopters （r =-0.351,-0.249,0.369）.[Conclusions] Significant vision-related quality of life improvements were found in the majority of high myopia patients in the long-term after LASIK.Visual fatigue from computer and reading is the most common dysopsia.