七叶洋地黄双苷滴眼液及视觉训练对中高度近视LASIK术后视功能恢复的疗效观察

Clinical effect of esculin and digitalisglycosides eyes drops and visual training in recovering visual function of patients with medium and high myopia after LASIK

目的通过观察七叶洋地黄双苷滴眼液及视觉训练对中高度近视激光原位角膜磨镶术(LASIK)术后视功能恢复疗效,探讨LASIK术后改善视疲劳的有效方法。方法前瞻、随机选取飞秒激光LASIK手术的中高度近视患者,根据治疗方式分为对照、药物及药物训练组各40例(80眼,中高度近视例数各半)。对照组常规药物治疗,药物组常规药物加七叶洋地黄双苷滴眼液治疗,药物训练组常规药物加七叶洋地黄双苷滴眼液及个性化视觉训练。七叶洋地黄双苷滴眼液治疗及个性化视觉训练于术后1周开始。分别进行术前,术后1周及1、3个月的视疲劳问卷评分和视功能检查。结果术后1周视疲劳问卷评分分数增加,调节反应有所超前,单眼调节幅度及正/负相对调节下降。术后1个月视疲劳问卷调查评分分数开始下降;调节反应逐渐恢复正常;单眼调节幅度恢复幅度药物及药物训练组好于对照组(P<0.05);正相对调节药物及药物训练组比术前好转,治疗效果药物训练组好于药物组(P<0.05);负相对调节药物训练组恢复快于药物及对照组;单眼调节灵敏度各组均比术前好转,药物训练组好于药物及对照组(P<0.05)。术后3个月单眼调节幅度恢复幅度药物训练组好于药物组(P<0.05)。结论七叶洋地黄双苷滴眼液能恢复和改善LASIK术后患者的眼部调节功能,而结合个性化的视觉训练能缩短恢复调节功能时间和增加改善调节功能效果。

Objective To evaluate the effective methods of improving visual fatigue after laser in stiu keratomileusis (LASIK) by observing the effect of esculin and digitalisglycosides eyes drops and visual training in recovering visual function of patients with medium and high myopia after LASIK. Methods The patients with medium and high myopia treated by LASIK with Femtosecond Laser were prospectively and randomly divided into control group, drug group and drug training group. Each group contained 40 patients (80 eyes), which medium and high myopia patients were even. Control group was given routine drug, while esculin and digitalisglycosides eyes drops was added in Drug group. Drug training group added personalized visual training in addition to the treatment above. Different treatments started at 1 week after surgery. Visual fatigue questionnaire score and visual function were measured before surgery, 1 week, 1 month and 3 months after surgery. Results After surgery visual fatigue questionnaire score increased, adjusting reaction advanced, the monocular accommodative amplitude and positive/ negative relative accommodation descended after 1 week. But visual fatigue questionnaire score began to decline and adjusting reaction returned to normal gradually after 1 month. The recovery changes of the monocular accommodative amplitude of drug group and drug training group were significantly larger than that of control group (P<0. 05). The positive relative accommodation of drug group and drug training group were better than that of before surgery. The changes of drug training group were significantly larger than that of drug group (P<0. 05). The negative relative accommodation of drug training group recovered faster than the other groups. However the monocular accommodative sensitivity were all better than before. The effect of drug training group was significantly better than the others (P<0. 05). After 3 months, the recovery changes of the monocular accommodative amplitude of drug training group was significantly better than that of drug group (P<0. 05). Conclusion Esculin and digitalisglycosides eyes drops can recover and improve the patients' accommodative functions. Furthermore personalized visual training can shorten the recovery time and improve the effect.