高度近视伴低视力患者LASIK术后远视力

Distance visual acuity after LASIK in high myopia patients accompany with low vision

目的 评价高度近视伴低视力患者在准分子激光原 位角膜磨镶术LASIK,后视力的改善情况。方法 选择接受LASIK手术的高度近视伴低视力患者17例34眼,术前平均屈光度(取有效等球镜度)为-17.50±4.30D,所有患眼最佳矫正视力(BCVA)均不高于4.5。LASIK采用美国SCMD公司的可调式气动微型角膜刀和Coherent公司的SchwindKeratomⅢ型准分子激光治疗仪,术后随访12个月以上,应用标准对数视力表作视力检查,采取五分记录法,进行LASIK术后裸眼视力(NCVA)和BCVA的评价。采用SPSS11.0软件的配对t检验对数据进行统计学处理。结果 术前NCVA为3.42±0.32,BCVA为4.36±0.13,2者差异有显著性(P<0.001)。术后1、3、6和12个月的NCVA和BCVA分别为4.44±0.15和4.46±0.13;4.48±0.16和4.50±0.14;4.49±0.17和4.55±0.13;4.43±0.12和4.57±0.11;术后各阶段NCVA和BCVA都较术前有显著性提高(P<0.001);术后1个月即有33眼(97％)NCVA达到或超过术前BCVA;但NCVA在术后第12个月较第6个月有显著性下降(t=3.806;P<0.05)。结论 LASIK治疗高度近视有显著性疗效,虽然术后存在一定的回退现象,但其BCVA仍较术前有较显著的提高。对于高度近视伴低视为患者,LASIK可以显著提高其NCVA和BCVA,甚至可以使其脱离低视为人群。

Objective To evaluate the improvement of distance visual acuity after laser in situ keratomileusis (LASIK) in high myopia patients accompany with low vision. Methods Seventeen high myopia patients (34 eyes) accompany with low vision who had LASIK by the same surgeon were retrospectively reviewed. Preoperative spherical equivalent manifest refraction ranged from -10.00 to -25.50D(incan, - 17.50D), and the BCVA of all eyes were lower than 4. 5. The equipment of LASIK was the Chiron Automatic Corneal Shaper and the Schwind Keratorn III excimer laser. The mean period of follow-up was morn than twenty monthes. We applied the Logarithmic visual acuity chart and 5-Grade notation to evaluate the NCVA and HCVA before and after LASIK. Results Preoperative NCVA was 3.42 + 0.32 (SD) and BCVA was 4.36 + 0.13 (SD); there were significant improvement of NCVA and HCVA in every postoperative phase (P<0.001); the NCVA of 33 eyes (97%) reached and exceeded the preopcrative BCVA in one month after LASIK ; but the BCVA decreased significantly in 12 months after LASIK compared with that in 6 months( t=3. 806;P <0.05). Conclusion LASIK am be used to treat high myopia effectively and safely. The postoperative BCVA is improved significantly compared with preoperative BCVA . For high myopia patients accompany with low vision, LASIK can improve their NCVA mid BCVA, but also it can make them to be separated from the low vision groups.