[1]刘晶,赵少贞.高度近视伴轻度干眼患者与非干眼患者FS-LASIK前后视觉质量变化的比较研究[J].眼科新进展,2021,41(5):461-465.[doi:10.13389/j.cnki.rao.2021.0096]
　LIU Jing,ZHAO Shaozhen.Comparison of visual quality changes in high myopia patients with mild dry eye and non-dry eye before and after femtosecond-assisted laser in situ keratomileusis[J].Recent Advances in Ophthalmology,2021,41(5):461-465.[doi:10.13389/j.cnki.rao.2021.0096]
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高度近视伴轻度干眼患者与非干眼患者FS-LASIK前后视觉质量变化的比较研究/HTML
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
41卷
期数:
2021年5期
页码:
461-465
栏目:
应用研究
出版日期:
2021-05-05

文章信息/Info

Title:
Comparison of visual quality changes in high myopia patients with mild dry eye and non-dry eye before and after femtosecond-assisted laser in situ keratomileusis
作者:
刘晶; 赵少贞
300384　天津市，天津医科大学眼科医院、眼视光学院、眼科研究所，国家眼耳鼻喉疾病临床医学研究中心天津市分中心，天津市视网膜功能与疾病重点实验室
Author(s):
LIU Jing; ZHAO Shaozhen
Tianjin Key Laboratory of Retinal Functions and Diseases,Tianjin Branch of National Clinical Research Center for Ocular Disease,Eye Institute and School of Optometry,Tianjin Medical University Eye Hospital,Tianjin 300384,China
关键词:
高度近视; 准分子激光原位角膜磨镶术; 干眼; 视觉质量
Keywords:
high myopia;  laser in situ keratomileusis;  dry eye;  visual quality
分类号:
R779.63
DOI:
10.13389/j.cnki.rao.2021.0096
文献标志码:
A
摘要:
目的　对比分析高度近视伴轻度干眼患者与非干眼患者飞秒激光辅助的准分子激光原位角膜磨镶术（FS-LASIK）前后视觉质量的变化。方法　本研究为前瞻性对照研究。选取2018年9月至2019年3月在天津医科大学眼科医院行FS-LASIK的高度近视患者70例（70眼），将有主观症状且标准干眼症状评估（SPEED）得分小于10分、泪膜破裂时间（BUT）≤5 s以及裂隙灯显微镜下未发现眼表损害体征的患者纳入轻度干眼组，共有36眼；将无干眼主观症状且5 s＜BUT≤10 s以及角膜荧光素染色阴性的患者纳入非干眼组，共有34眼。采用西班牙Visionetrics公司的双通道视觉质量分析系统(OQASⅡ)获取患者调制传递函数截止频率(MTF cut off），模拟对比度视力VA100％、VA20％、VA9％（分别代表对比度为100％、20％和9％时的模拟光学视力）。分别于术前及术后1周、1个月、3个月进行随访，记录患者裸眼视力、最佳矫正视力、BUT、MTF cut off和模拟对比度视力，计算有效性指数和安全性指数。有效性指数=术后平均裸眼视力/术前平均最佳矫正视力，安全性指数=术后平均最佳矫正视力/术前平均最佳矫正视力。对所测得的指标进行统计学分析。结果　两组患者术前性别构成、年龄、等效球镜度、裸眼视力、最佳矫正视力相比，差异均无统计学意义（均为P>0.05）。术后1周、1个月、3个月，两组患者组内及组间有效性指数和安全性指数相比，差异均无统计学意义（均为P>0.05）。术后1周，轻度干眼组患者BUT较术前缩短（P<0.05），术后1个月恢复至术前水平（P>0.05），术后3个月较术前延长（P<0.05）；术后1周、1个月、3个月，轻度干眼组患者MTF cut off均较术前提高（均为P<0.05）；术后1周，轻度干眼组患者VA100%与术前比较无明显变化（P>0.05），术后1个月、3个月均较术前提高（均为P<0.05）；术后1周、1个月，轻度干眼组患者VA20%和VA9%与术前比较均无明显变化（均为P>0.05），术后3个月较术前提高（均为P<0.05）。术后1周、1个月，非干眼组患者BUT均较术前缩短（均为P<0.05），术后3个月BUT恢复至术前水平（P>0.05）；术后1周，非干眼组患者MTF cut off较术前降低（P<0.05），术后1个月、3个月与术前比较均无明显变化（均为P>0.05）。术前及术后1周、1个月、3个月，轻度干眼组患者BUT均短于非干眼组，差异均有统计学意义（均为P<0.05）。术前轻度干眼组患者MTF cut off、VA100％、VA20％、VA9％均低于非干眼组，差异均有统计学意义（均为P<0.05）；术后1周、1个月、3个月时两组间MTF cut off、VA100％、VA20％、VA9％比较，差异均无统计学意义(均为P>0.05）。结论　与非干眼患者相比，FS-LASIK并未导致高度近视伴轻度干眼患者术后总体视觉质量下降。
Abstract:
Objective　To compare and analyze the changes in visual quality before and after femtosecond-assisted laser in situ keratomileusis (FS-LASIK) in high myopia patients with mild dry eye and non-dry eye.Methods　This study was a prospective controlled study. Totally 70 patients (70 eyes) with high myopia who underwent FS-LASIK surgery in Tianjin Medical University Eye Hospital from September 2018 to March 2019 were selected, patients with subjective symptoms and standard patient evaluation of eye dryness (SPEED) score less than 10 points, tear break-up time (BUT) ≤5 s and no sign of ocular surface damage under slit lamp microscope were included in the mild dry eye group (36 eyes), and patients without subjective symptoms of dry eyes with 5 sResults　There were no significant differences in preoperative gender composition, age, spherical equivalent, the uncorrected visual acuity or best corrected visual acuity between the two groups (all P>0.05). There were no significant differences in the efficacy indexes and safety indexes within or between groups in 1 week, 1 month and 3 months after surgery (all P>0.05). One week after surgery, the BUT in the mild dry eye group was shorter than that before surgery (P<0.05), the BUT recovered to the preoperative level 1 month after surgery (P>0.05), and the preoperative BUT was longer than that 3 months after surgery (P<0.05). The MTF cut off in the mild dry eye group at 1 week, 1 month and 3 months after surgery was higher than that before surgery (all P<0.05); 1 week after surgery, VA100% in the mild dry eye group had no significant change as compared with that before surgery (P>0.05), and increased 1 month and 3 months after surgery as compared with that before surgery (all P<0.05); 1 week and 1 month after surgery, VA20% and VA9% in the mild dry eye had no significant changes compared with those before surgery (all P>0.05), but significantly increased 3 months after surgery (both P<0.05). One week and 1 month after surgery, the BUT in the non-dry eye group was shorter than that before operation (both P<0.05), and recovered to the preoperative level 3 months after surgery (P>0.05). One week after surgery, the MTF cut off in the non-dry eye group was lower than that before surgery (P<0.05), and there were no significant differences 1 month and 3 months after surgery (both P>0.05). The BUT values in the mild dry eye group before surgery, 1 week, 1 month and 3 months after surgery were shorter than those in the non-dry eye group, and the differences were statistically significant (all P<0.05). The MTF cut off, VA100%,VA20% and VA9% in the mild dry eye group were lower than those in the non-dry eye group before surgery, and the differences were statistically significant (all P<0.05); but there were no significant differences in the MTF cut off, VA100%,VA20% and VA9% between the two groups at 1 week, 1 month and 3 months after surgery (all P>0.05). Conclusion　FS-LASIK does not lead to a decrease in postoperative overall visual quality in high myopia patients with mild dry eye when compared with high myopia patients with non-dry eye.

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更新日期/Last Update: 2021-05-05