Q值引导与标准化LASIK术后视觉质量的远期对照研究

Long-term Comparison of visual quality after Q-guided aspheric ablation versus standard ablation in LASIK

目的通过观察对比Q值引导和标准LASIK术后角膜Q值、视力和自觉症状的差异,来探讨Q值引导LASIK对维持角膜非球面状态及改善视觉质量的有效性。方法选择2008年12月至2013年12月在我院做Q值引导准分子激光手术(Q-LASIK)和标准准分子激光手术(S-LASIK)的近视患者各40例(40只眼),于术后1、3、6、12、24、36个月复查裸眼视力、角膜Q值、夜间眩光、夜视力满意度。结果术后1、3、6、12、24、36个月时,两组裸眼视力无显著差异(P>0.05);夜视力满意度随时间递增,视觉质量主诉评分随时间延长逐渐减少,术后1、3、6个月时,夜视力满意度两组组间比较差异均有统计学意义(均为P<0.05);术后1、3、6个月时,视觉主诉评分两组间比较差异有统计学意义(P<0.05),12个月之后,夜视力满意度和视觉主诉评分两组间比较差异无统计学意义(均P>0.05);两组在术后6个月内Q值变化明显,有显著差异,两组的Q值均向负值方向变化。6个月之后,两组角膜Q值均基本稳定。结论 Q-LASIK组较S-LASIK组能更好地提高术后视觉质量和维持角膜的非球面特性,效果稳定。

Objective To observe the difference of the Q value, visual acuity and self-reported symptoms after Q value guided LASIK versus standard LASIK, and to evaluate the role of Q-guided LASIK in maintaining corneal asphericity and improving visual acuity outcomes. Methods Totally eighty myopia patients who were treated in our hospital between December 2008 and December 2013 received either Q value guided excimer laser surgery （ Q-LASIK, n =40） or standard excimer laser surgery （S-LASKI）. Patients were followed with uncorrected visual acuity, corneal Q value, nocturnal glare, and night vision satisfaction for 36 months. Results There is no difference in uncorrected visual acuity ]~ween the two groups （ P 〉 0.05 ）. Night vision satisfaction increased and visual complaint scores gradually decreased over time after the surgery in beth groups, while significant difference in night vision satisfaction and complaint score were found between the two groups at 1 month, 3 months and 6 months （ P 〈0.05 ）. These differences diminished at 12 months after the surgery. Q values decreased significantly in beth groups within 6 months after the surgery, and there was a difference in Q values be- tween the two groups. Q values tended to be stable after 6 months after the surgery. Conclusion Q-LASIK improves the quality of postoperative vision and maintains corneal aspherieal status more effective than standard LASIK.