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目的探讨LASIK手术矫治近视性屈光参差对视功能的远期影响.从双眼视觉方面评价其临床应用价值。设计回顾性病例系列。研究对象接受LASIK手术的近视性屈光参差(两眼屈光参差≥2.50 D)患者30例(57眼)。方法应用VISXSTAR-S4型准分子激光机行LASIK手术,随访24～44个月,平均(31.1±6.2)个月。主要指标手术前后裸跟视力(UCVA)、最佳矫正视力(BSCVA)以及双眼视功能。结果术后2年时的裸眼视力达到0.8以上者54眼(94.74%)。手术后双眼屈光参差度数(0.69±0.77 D)较手术前(5.17±2.50 D)明显降低(P=0.041)。手术前、后存在同时视、融合、远立体视者分别为24例、29例(P=0.059),8例、29例(P=0.000),1例、16例(P=0.000)。术前戴框架眼镜矫正与LASIK手术后比较,近立体视正常者分别为4例、11例,近立体视异常者分别为15例、15例,立体视缺失者分别为11例、4例,差异有统计学意义(P=0.038)。结论LASIK治疗近视性屈光参差的远期疗效稳定,不仅可以提高患者的裸眼视力,对其双眼视功能的恢复也有促进作用。
Objective To investigate the long-term effect of LASIK on the correction of myopia anisometropia, and to evaluate its clinical value from binocular vision. Design retrospective case series. Thirty patients (57 eyes) with myopic anisometropia (anisometropia ≥ 2.50 D) underwent LASIK. Methods The VISXSTAR-S4 excimer laser was used to perform LASIK. The patients were followed up for 24 to 44 months with an average of (31.1 ± 6.2) months. The main indicators before and after surgery with bare vision (UCVA), best corrected visual acuity (BSCVA) and binocular vision. Results The uncorrected visual acuity reached 0.8 and 54 eyes (94.74%) at 2 years after operation. The number of bilateral anisometropia (0.69 ± 0.77 D) after operation was significantly lower than that before operation (5.17 ± 2.50 D) (P = 0.041). There were 24 cases (29 cases) (P = 0.059), 8 cases, 29 cases (P = 0.000), 1 case and 16 cases (P = 0.000). There were 4 cases with near stereopsis, 11 cases with near stereopsis, 15 cases with near stereopsis, 15 cases with stereopsis, 11 cases with stereopsis, and 4 cases with stereopsis. The difference was statistically significant (P = 0.038). Conclusion The long-term efficacy of LASIK in the treatment of myopic anisometropia is stable, which not only improves the uncorrected visual acuity of the patients, but also promotes the recovery of binocular vision.