准分子激光角膜屈光手术后检影验光中光影形态与矫正视力关系的研究

Study of the relationship between the shadow shape in retinoscopy and the corrected visual acuities after excimer photorefractive operation

目的 探讨准分子激光角膜屈光手术后 ,不同时期检影验光中的光影形态与矫正视力的关系及其机理。方法 对 1998年 5月至 1999年 12月在我院接受准分子激光角膜屈光手术 (PRK和 L ASIK) ,并随诊 6个月以上 ,资料完整的 2 35例 (其中 PRK89例 ,175只眼 ;L ASIK146例 ,2 87只眼 ,共 46 2只眼 )患者术后检影验光中的光影形态与矫正视力进行了动态观察分析。结果 手术后检影验光中光影分为规则 (光带直而等宽且边界清晰 )与不规则 (光带弯曲或边界不清晰或不等宽或兼有之 )两种类型。准分子激光角膜屈光手术后同时期内检影光影形态规则眼最佳矫正视力下降百分比明显低于光影不规则眼 ;准分子激光角膜屈光手术后检影中光影随时间推移有逐渐变规则的趋势 ,最佳矫正视力下降百分比也同时下降 ;PRK术后光影形态及矫正视力下降百分比的变化与 L ASIK相比较为明显。结论 检影验光中光影形态反映了角膜等屈光组织的光学性能及状态 ,是评价角膜屈光手术疗效及预后的独特、简便、有效的方法。

Objective To discuss the relationship between the shadow shape in retinoscopy and the corrected visual acuities different period after excimer photorefractive operation.Methods We made a movement observetion and analysis of 235 cases treated with excimer photorefractive operation in our hospital between May 1998 and Dec.1999,all the patients were followed up 6 monthes.Results The shadow shape after the operation were divided into two types,one was regular(the belt of light was straight and equal width and clear border),the other one was irregular (the belt of light was curved or unclear border or undqual width or all of the above).The decrease percentages of the corrected visual acuities in the eyes with regular shadow shape were obvious lower than in the eyes with irregular shadow shape the same period after the operation,The shadow shape after the operation have the tendency to turn regular with the time going.At the same time the decrease percentages of the corrected visual acuities were decreased.The changes of the shadow shape and the decrease percentage of the corrected visual acuities after PRK were obvious compared with that after LASIK.Conclusion The shadow shape in retinoscopy after the operation express the optic character and refractive state of the refrative media such as cornea,it is an particular,simple,effective method to evaluate the curative effect and outcome of eximer photorefractive operation.