屈光决明方围手术期干预SMART全激光术的客观视觉质量分析

Analysis of objective visual quality of Quguang Jueming Prescription intervention in SMART laser surgery during perioperative period

目的:观察中药屈光决明方围手术期干预SMART全激光术后患者的客观视觉质量。方法:回顾性、非随机性、对照研究,选取2017年6月至2018年5月期间在成都中医大银海眼科医院行SMART全激光术且符合纳入标准的患者,共70例,根据是否服用中药分为对照组(28例,56眼)和中药组(42例,84眼),分析两组术后裸眼视力(UCVA)、调制传递函数(MTF)截止频率、斯特列尔比(SR)值、角膜前表面高阶像差的均方根(RMS)值。使用SPSS 26.0分析数据。结果:两组患者大多数都在术后7 d恢复了良好的视力(UCVA≥1.0),分别占比87.5%(49/56)和89.3%(75/84)。术后7 d时中药组的平均UCVA显著优于对照组(P<0.05)。对照组MTF10、MTF20数值在术后7 d、1个月下降尤为显著(P<0.05),术后6个月及1年中药组的MTF10、MTF30显著高于对照组(P<0.05)。两组患者的SR值在术后1、3、6个月及1年均较术前显著增加(P<0.05)。两组患者术后3个月内角膜前表面高阶像差的RMS值显著增加(P<0.05),在术后7 d达到峰值,术后不同时间点,中药组RMS值均小于对照组,术后6个月及术后1年时差异显著(P<0.05)。结论:中药屈光决明方围手术期干预SMART全激光术能有效改善患者术后客观视觉质量。

Objective:To observe the objective visual quality of patients after SMART laser surgery with traditional Chinese medicine(TCM)Quguang Jueming Prescription intervention during perioperative period.Methods:A retrospective,nonrandomized,controlled study,selected patients who underwent SMART laser surgery in our hospital from June 2017 to May 2018and met the inclusion criteria.A total of 70 patients were divided into control groups(28 cases,56 cases)and traditional Chinese medicine group(42 cases,84 eyes),according to whether they took traditional Chinese medicine.The postoperative naked visual acuity,MTF cut-off frequency,SR value,and RMS value of high-order aberrations of the anterior corneal surface were analyzed in the control group and traditional Chinese medicine group.Use SPSS 26.0 to analyze the data.Results:Most of the patients in the control group and Chinese medicine group recovered good vision(UCVA≥1.0)on the 7th day after surgery[87.5%(49/56)and 89.3%(75/84)].The average UCVA of the traditional Chinese medicine group was significantly better than that of the control group on the 7th day after surgery(P<0.05).The values of MTF10 and MTF20 in the control group decreased significantly at 7 d and 1 month after surgery(P<0.05).The cut-off frequency of MTF in the Chinese medicine group at 6 month and 1 year after surgery was significantly higher than that of the control group(P<0.05).The SR values of the two groups were significantly higher than those before operation at 1,3,6 month and 1 year after operation(P<0.05).The RMS value of high-order aberrations on the anterior corneal surface of the two groups of patients increased significantly within 3 months after surgery(P<0.05),and reached a peak at 7 days after surgery.At different time points after surgery,the RMS value of the Chinese medicine group was lower than control group,the difference was significant at 6 month and 1 year after operation(P<0.05).Conclusion:Perioperative intervention of traditional Chinese medicine Quguang Jueming Prescription in SMART laser surgery can effectively improve the objective visual quality of patients after surgery.