单眼飞秒激光制瓣LASIK术矫正屈光参差疗效分析

Analysis of monocular laser in situ keratomileusis flap made by femtosecond laser for myopic anisometropia

目的 观察单眼行飞秒激光制瓣LASIK手术矫正屈光参差的临床疗效.方法 选择2011年6月至2012年12月在沈阳爱尔眼视光医院就诊的双眼屈光参差（双眼等效球镜度≥-2.50 D）患者54例（54只眼）,近视屈光度较高眼行Femto-LDV飞秒激光制作角膜瓣LASIK矫正屈光不正;对术前及术后6个月视力、屈光度及双眼视功能检测进行随访研究.结果 术中及术后未出现角膜瓣并发症.术前两眼屈光参差-3.00--4.75 D,平均为（3.66±0.62）D;术后屈光参差0.13-0.88 D,平均为（0.57±0.30）D.术前戴框架眼镜下近立体视正常者7例,术后6个月增至20例,差异有统计学意义（x2=12.98,P =0.001）;术前未戴框架眼镜三级视功能（同时视、融合功能、远立体视）正常者分别为46例次、15例次、2例次,术后6个月三级视功能正常分别为51例次、50例次、35例次,手术后获得融合功能和远立体视者较术前显著增加（x2=31.24,P＜0.001; x2=31.03,P＜0.001）.结论 飞秒激光制瓣LASIK手术治疗近视性屈光参差,不但能提高患眼的视力,同时还增加双眼物像的融合,对恢复双眼单视功能具有重要意义.

Objective To evaluate the clinical effect of monocular laser in situ keratomileusis flap made by femtosecond laser for myopic anisometropia.Methods Fifty-four patients with myopic anisometropia （binocular spherical equivalent of greater than 2.50D） had LASIK flap made by Femto-LDV femtosecond laser in all their myopic eyes for higher from June 2011 to December 2012 in Shenyang Aier Ophthalmic Hospital.Visual acuity,myopic spherical equivalent diopters and binocular visual function by synoptophore were analyzed preoperative and 6 months postoperative.Results The complications of corneal flap didn＆#39;t appear in operation and postoperative.Before LASIK,binocular myopic anisometropia diopters refraction was-3.00--4.75D,mean （3.66＆#177;0.62）D.After LASIK,binocular myopic anisometropia diopters refraction was 0.13-0.88D,mean （0.57＆#177;0.30）D.Before LASIK,7 cases of glasses-corrected patients obtained normal short distance stereopsis visions and 20 cases of LASIK-treated patients obtained normal short distance stereopsis visions （x2-12.98,P 0.001）.Forty-six cases of patients and 51 cases of LASIK-treated patients obtained simultaneous binocular vision; 15 cases of patients and 50 cases of LASIK-treated patients obtained combine visions; 2 cases of patients and 35 cases of LASIK-treated patients obtained long distance stereopsis visions.There was great significance among combined,and long distance stereopsis visions （x2-31.24,P 〈0.001; x2 31.03,P 〈0.001）.Conclusions For correction of monocular myopic anisometropia,LASIK not only improves the eyes with visual acuity,at the same time provides good visual results.It is very important to the recovery of the binocular visual function.