Q值优化的LASIK术后视觉质量问卷调查研究

Questionnaire survey of visual function and the quality of life after Q guided aspheric profile LASIK for myopia

目的:通过视觉质量调查问卷对比研究Q值优化的准分子激光原位角膜磨镶术(laser in situ keratomileusis,LASIK)术后患者视觉质量。方法:设计视觉质量调查问卷,123例245眼行Q值优化的LASIK手术患者为观察组,同期行标准LASIK手术患者152例304眼设为对照组,两组进行术后常规视力、屈光状态检查及主观视觉质量问卷调查、评分,统计分析对比。结果:术后3mo BCVA较术前提高者,观察组238眼(97.1%),对照组291眼(95.7%),差异无统计学意义(χ2=0.78,P=0.38);屈光度(等值球镜)观察组为0.15±0.58D,对照组为0.11±0.59D,差异无统计学意义(t=0.75,P=0.45);观察组中央角膜Q值(0.28±0.10)明显低于对照组Q值(0.67±0.13)(t=-38.71,P=0.00)。术后3mo观察组视觉质量综合评分高于对照组,差别具有高度统计学意义(t=3.01,P=0.00),观察组在夜视力、暗环境视野、精细辨别力、对比辨别力、夜间眩光及视疲劳症状项目上评分高于对照组,差别有统计学意义(P均<0.05)。结论:Q值优化与标准模式的LASIK术治疗近视及近视散光均安全有效,但采用Q值优化由于能够更好地维持角膜非球面形态,与标准模式比较其术后主观视觉质量更好,满意度更高。

AIM：To compare and research visual function （ VF ） and the quality of life （ QOL ） after Q value guided aspheric profile laser in situ keratomileusis （ LASIK ） by visual quality questionnaire. METHODS： One hundred and twenty-three patients （245 eyes） were performed LASIK with Q value guided aspheric profile ablation as the intervention group, and 152 patients （ 304 eyes ） were performed conventional LASIK as the control group. Uncorrected and best corrected visual acuity （ UCVA and BCVA ） , refractions, corneal Q-value of the patients in the two groups were measured at postoperative 1 and 3 mo respectively, and the differences of these examinations between the two groups were analyzed. Every patient was interviewed with a questionnaire concerning VF and QOL at 3mo postoperatively, the grades were measured and analyzed between two groups. RESULTS：At postoperative 3mo, UCVA was improved in 238 eyes （ 97. 1%） in the intervention group and 291 eyes （ 95. 7%） in the control group and there was no statistical difference between the two groups （χ2=0. 78, P=0. 38）. Meanwhile, there was no significant difference in term of postoperative refractions between the two groups（0.15±0. 58D vs 0. 11±0. 59D; t= 0. 75,P= 0. 45）. All patients＇ corneal central Q values increased postoperatively, but the Q value of 0. 28±0. 10 in the intervention group was obviously lower than that of 0. 67±0.13 in the control group （t= -38. 71,P= 0. 00）. The integrated VF was 50. 50±5. 60 in the intervention group and 48. 36±6. 15 in the control group, there was statistical significance between the two groups （t=3. 01,P=0. 00）. The scores in the terms of night vision, dark visual field, fine discrimination, contrastive discrimination, glaring and asthenopia in the intervention group were higher than those in the control group, and the differences were statistically significant （all P〈0. 05）. CONCLUSION：Q value guided aspheric profile and conventional LASIK are safe and efficient for the correction of myopia and astigmatism. Moreover, Q guided aspheric profile LASIK can better maintain the aspheric character of the corneal surface and obtain better VF and QOL than conventional LASIK.