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目的分析准分子激光原位角膜磨镶术(LASIK)术后夜间视觉质量与角膜非球面性变化的关系。设计回顾性病例系列。研究对象在2007年9月至12月期间行LASIK手术的患者中,顺序选取术前最佳矫正视力(BCVA)≥1.0,术后裸眼视力≥1.0,随访资料完整患者72例(144眼),等效球镜度数-4.0～-8.0 D,平均(-5.80+1.04)D。方法术前及术后3个月行Orbscan检查、K/Q值、Mesotest暗视条件下对比敏感度检查。主要指标暗视下无眩光Mesotest对比敏感度通过等级、Q值。结果Mesotest对比敏感度检查:无眩光暗视条件下,术后3个月未通过各等级测试的例数比术前增加,72例患者中26例对比敏感度等级比术前降低1～2个等级。Q值的分布:术前平均(-0.16+0.12),术后3个月平均(0.49+0.24),差异有统计学意义。直线相关回归分析:术前与术后Q值差值与对比敏感度等级变化呈正相关(回归方程为y=0.068x+0.5965,pearson系数r=0.476,P=0.000, P<0.01)。结论LASIK术后暗环境下对比敏感度降低与角膜Q值改变有关,角膜前表面非球面性改变是影响LASIK术后夜间视觉质量的重要因素之一。
Objective To analyze the relationship between nighttime visual quality and corneal asphericity after laser in situ keratomileusis (LASIK). Design retrospective case series. Participants Among the patients undergoing LASIK surgery from September to December 2007, the preoperative best corrected visual acuity (BCVA) ≥1.0, postoperative uncorrected visual acuity ≥1.0, and follow-up data of 72 patients (144 eyes) Equivalent spherical degrees -4.0 ~ -8.0 D, the average (-5.80 +1.04) D. Methods The preoperative and postoperative 3 months Orbscan check, K / Q value, Mesotest dark contrast under the contrast sensitivity test. The main indicators of glare under no glare Mesotest contrast sensitivity by grade, Q value. Results Mesotest contrast sensitivity examination: no glare and scotopic conditions, the number of cases failed to pass the various levels of test 3 months after surgery increased compared with preoperative, 72 patients with contrast sensitivity in 26 cases compared with preoperative 1 to 2 grade. The distribution of Q value: preoperative average (-0.16 + 0.12), 3 months after surgery (0.49 + 0.24), the difference was statistically significant. Linear regression analysis showed that there was a positive correlation between preoperative and postoperative Q values and the change of contrast sensitivity (regression equation y = 0.068x + 0.5965, pearson coefficient r = 0.476, P = 0.000, P <0.01). Conclusion The decrease of contrast sensitivity in dark environment after LASIK is related to the change of corneal Q value. The change of anterior corneal asphericity is one of the important factors affecting the visual quality after LASIK.