近视患者飞秒LASIK术后调节功能的变化

Changes of accommodative function in myopias after femtosecond laser-assisted in situ keratomileusis

目的探讨近视患者飞秒激光辅助准分子激光原位角膜磨镶术(femtosecond laser-assisted in situ keratomileusis,FS-LASIK)后调节功能的变化情况及规律。方法随机选择接受FS-LASIK治疗的近视患者40例(80眼),按照术前屈光度的不同分为2组:中度近视组20例(40眼)和高度近视组20例(40眼)。用电脑验光仪、综合验光仪及翻转拍等仪器分别测量40例近视患者术前、术后1周、术后1个月的调节反应(AR)、双眼调节幅度(AMP),相对调节和双眼调节灵活度(AF)的变化。结果2组患者组内比较,FS-LASIK术后1周时双眼调节幅度均低于术前(P<0.05),术后1个月时双眼调节幅度与术前差异无统计学意义(P>0.05)。与术前比较,2组患者术后1周及术后1个月时的负相对调节(NRA)、正相对调节(PRA)、调节反应及双眼调节灵活度的变化差异无统计学意义(P>0.05)。组间比较显示,2组患者的双眼调节幅度、相对调节、调节反应及双眼调节灵活度在各时间点的差异均无统计学意义(P>0.05)。结论FS-LASIK术后早期双眼调节幅度会出现一过性降低,然后逐渐恢复;FS-LASIK手术对患者双眼调节功能无明显不良影响。

Objective To investigate the changes of accommodation after femtosecond laser-assisted in situ keratomileusis(FS-LASIK)in myopic patients.Methods A total of 40 myopic patients(80 eyes)treated with FS-LASIK were randomly selected in this study.They were divided into two groups according to preoperative refractive status:20 cases in moderate myopia group(40 eyes)and 20 cases in high myopia group(40 eyes).Their accommodative function including the accommodative response(AR),amplitude of accommodation(AMP),relative accommodation and accommodative facility were measured before surgery,1 week and 1 month after surgery.Results In the two groups,the AMP was lower at 1 week after FS-LASIK than that before FS-LASIK(P<0.05).There was no significant difference between the AMP at 1 month after FS-LASIK and that before FS-LASIK(P>0.05).There was no significant difference in relative accommodation,accommodation response and binocular accommodative facility between the two groups at 1 week and 1 month after operation(P>0.05).There were no significant differences in accommodation amplitude,negative relative accommodation(NRA)and positive relative accommodation(PRA),accommodation response and accommodative facility between the two groups at different time points(P>0.05).Conclusions The amplitude of binocular accommodation will decrease temporarily in the early stage after FS-LASIK,and then will gradually recover.FS-LASIK has no significant adverse effect on binocular accommodation.