高度近视患者准分子激光原位角膜磨镶术后视觉质量及满意度观察

Quality of vision and patient satisfaction for high myopia after laser in situ keratomileusis

目的:调查研究高度近视患者准分子激光原位角膜磨镶术(LASIK)后主观的视觉质量和满意度情况。方法对在广州医学院第一附属医院2005年4月至2005年10月间顺次接受LASIK手术的52位双眼高度近视患者(等值球镜-6.0D以上)术后至少6个月以上进行问卷调查和随访观察,用国际标准视力表检查记录术后裸眼视力(UCV)和最佳矫正视力(BCV)。问卷内容为包括总体满意度和主观视觉质量在内的多层次反应患者满意度的8个问题。结果在102只手术眼中,52%的术眼裸眼视力达到1.0以上,裸眼视力0.5以上者占99%;24.4%的患眼术后最佳矫正视力超过术前1行或更好,16.6%的患眼最佳矫正视力下降1行,没有患者术后BCV下降超过1行。52位患者中,术后发生明显视物不适者有30.8%的患者,曾经或始终存在夜间视觉异常者达57.7%,其中造成难以忍受或影响较大者占3.8%,80.8%的患者表示对手术的长期效果仍有顾虑,对手术效果总体表示满意或非常满意者达90.4%。结论大多数高度近视患者LASIK术后可以获得较理想的裸眼视力,对手术效果有较高的总体满意度,但值得注意的是有相当部分的患者因夜间视觉异常对生活造成不同程度的影响,且大多数患者对手术的长期效果仍存顾虑。

Purpose To investigate self-perceived quality of vision and patient satisfaction after laser in situ keratomileusis for high myopia. Methods A validated questionnaire consisting of 8 questions was self-administered by 52 consecutive patients who had LASIK for high myopia by a single surgeon at the first affiliate hospital of Guangzhou medical college from April 2005 to October 2005 with at lest 6 months since the first surgery, which covered global satisfaction , self-perceived quality of vision and some aspects of questions associated with satisfaction. The preoperative spherical equivalent ranged from -6.0 diopters (D) to -15.87 D (mean , -8.03 D; standard deviation ,2.01D).Uncorrected visual acuity(UCV) and best corrected visual acuity(BCV) were recorded by international standard vision chart at the last follow up .Results Among the 102 eyes, total of 52% achieved 1.0 or better in uncorrected visual acuity, 99% UCV was better than 0.5; 24.4% BCV was increased at less 1 line, 16.6% BCV was decreased 1 line, none was decreased more than 1 line. A total of 30.8% of 52 patients felt uncomfortable in vision, night vision disturbance had been happened or lasted in 57.7% of patients, and 3.8% felt the night vision disturbance unendurable or severe; 90.4 of patients were satisfacted or very satisfacted with the outcome , however ,80.8% were still worried about the future problem. Conclusions Majority of the high myopic patient could achieve good uncorrected visual acuity after LASIK, and have a very high level of global satisfaction. However , quite a few of patients postoperatively have suffered from the night vision disturbance, and most of patients were still concerned with the surgery.