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目的:观察比较中低度近视军人行机械法激光上皮下角膜磨镶术(EPI-LASIK)与准分子激光原位角膜磨镶术(LASIK)后,裸眼视力(UCVA)、对比敏感度(CS)、眩光敏感度(GS)和视觉质量满意度。方法:选择中低度近视军人60例(120眼),按照手术方式分为LASIK术组(A组)和EPI-LASIK术组(B组)各30例(60眼)。测量两组术前和术后6个月、12个月、24个月UCVA、CS和GS;术后12个月、24个月随访,对视觉质量满意度进行调查。比较两组手术前后UCVA、CS、GS及视觉质量满意度分值。结果:(1)术后12个月、24个月,两组UCVA均较术前最佳矫正视力(BCVA)显著提高(P<0.05),且B组UCVA显著高于A组(P<0.05)。(2)术后6个月、12个月,两组CS和GS在3.0c/d、6.0c/d、12.0c/d和18.0c/d等4个频率上,均较术前显著降低(P<0.05)。术后24个月,A组CS恢复至术前水平(P>0.05),B组CS在18.0c/d频率上较术前显著提高(P<0.05);两组GS在18.0c/d频率上均较术前显著降低(P<0.05),两组间比较则差异不显著(P>0.05)。(3)术后12个月、24个月,B组视觉质量满意度分值均显著高于A组(P<0.05)。A组主诉暗环境下有眩光症状10例,占33.3%;B组为2例,占6.7%;两组比较,差异非常显著(P<0.01)。结论:中低度近视军人行EPI-LASIK术治疗,视觉质量较满意,且较安全。
Objective: To observe the changes of uncorrected visual acuity (UCVA) and contrast sensitivity (CS) after mechanical subepithelial keratomileusis (EPI-LASIK) and laser in situ keratomileusis (LASIK) ), Glare sensitivity (GS), and visual quality satisfaction. Methods: 60 moderate and low myopia soldiers (120 eyes) were selected and divided into 30 eyes (60 eyes) in LASIK group (A group) and EPI-LASIK group (B group) according to the operation method. UCVA, CS and GS at 6 months, 12 months and 24 months after operation were measured before and 12 months and 24 months after operation respectively. Satisfaction of visual quality was investigated. The scores of UCVA, CS, GS and visual quality satisfaction before and after operation were compared between the two groups. Results: (1) The UCVA of both groups increased significantly (P <0.05) at 12 months and 24 months after operation compared with preoperative BCVA (P <0.05), and UCVA of group B was significantly higher than that of group A (P0.05 ). (2) After 6 months and 12 months, the CS and GS of the two groups were significantly decreased at 4 frequencies of 3.0c / d, 6.0c / d, 12.0c / d and 18.0c / d (P <0.05). At 24 months after operation, CS in group A returned to preoperative level (P> 0.05), and CS in group B increased significantly at 18.0c / d (P <0.05) (P <0.05). There was no significant difference between the two groups (P> 0.05). (3) Satisfaction scores of visual quality in group B were significantly higher than those in group A at 12 months and 24 months after operation (P <0.05). Group A complained of glare symptoms in 10 cases (33.3%) in dark environment; Group B (2 cases) accounted for 6.7%. The difference between the two groups was significant (P <0.01). Conclusion: The middle and low myopia soldiers underwent EPI-LASIK, the visual quality was satisfactory and safer.