本文選題：飛秒激光小切口基質(zhì)透鏡取出術(shù) + 飛秒激光準(zhǔn)分子激光原位角膜磨鑲術(shù)��； 參考：《北京協(xié)和醫(yī)學(xué)院》2016年博士論文

【摘要】：目的對(duì)飛秒激光小切口基質(zhì)透鏡取出術(shù)(Small-incision lenticule extraction, SMILE)與飛秒激光準(zhǔn)分子激光原位角膜磨鑲術(shù)(femtosecond laser-assisted laser in situ keratomileusis, FS-LASIK)術(shù)后早期視覺質(zhì)量進(jìn)行評(píng)價(jià)和比較。方法1.入選2015年12月至2016年4月于北京協(xié)和醫(yī)院眼科行SMILE和FS-LASIK術(shù)的54例(107只眼)患者進(jìn)行分析。2.利用視覺質(zhì)量分析系統(tǒng)(optical quality analysis system, OQAS)對(duì)患者術(shù)前、術(shù)后1周、術(shù)后1月進(jìn)行OSI、MTF cut off、SR、width at 50%、width at 10%、VA100%、 VA20%、VA9%、OV100%、OV20%、OV9%、mean OV、mean OSI等參數(shù)的測(cè)量。3.利用視覺質(zhì)量主觀評(píng)價(jià)問卷評(píng)估患者術(shù)后1周及1月光暈、眩光、夜間視力下降、視近物疲勞和眼部干澀等癥狀的有無和嚴(yán)重程度,以及術(shù)后滿意度程度。4.用SPSS19.0對(duì)數(shù)據(jù)進(jìn)行兩個(gè)獨(dú)立樣本的Mann-Whitney U檢驗(yàn)、K個(gè)相關(guān)樣本Friedman檢驗(yàn),Kruskal-Wallis秩和檢驗(yàn)和Spearman等級(jí)相關(guān)系數(shù)分析。結(jié)果1.術(shù)后1周SMILE組MTF cut off顯著高于FS-LASIK組,術(shù)后1月無顯著差異,而OSI值兩者無顯著差異。2. SMILE組與FS-LASIK組術(shù)后1周視覺質(zhì)量均較術(shù)前明顯下降,術(shù)后1月有所恢復(fù),但并未恢復(fù)到術(shù)前水平。3.OQAS參數(shù)中mean OSI值與視近物疲勞有顯著相關(guān)。mean OV與夜視力下降有顯著相關(guān)。4.SMILE組與FS-LASIK組均有較高的術(shù)后滿意度,兩組間無顯著差異。5.SMILE組術(shù)后1周眼干癥狀比FS-LASIK組更輕微,術(shù)后1月兩者無顯著性差異。結(jié)論1. SMILE組與FS-LASIK術(shù)后1周及術(shù)后1月散射均有增加,術(shù)后1月散射較術(shù)前1周顯著減小,但未恢復(fù)到術(shù)前水平。2.術(shù)后1周時(shí)SMILE組的視覺質(zhì)量顯著高于FS-LASIK,干眼癥狀較FS-LASIK更輕微。術(shù)后1月兩組均無顯著差異。
[Abstract]:Objective to evaluate and compare the early visual quality of Small-principle lenticule extraction (Small-principle lenticule extraction) and femtosecond laser-assisted laser in situ keratomileusis, FS-LASIKK (femtosecond laser-assisted laser in situ keratomileusis, FS-LASK) after femtosecond laser in situ keratomileusis (FS-LASIKK) with femtosecond laser in situ keratomileusis (FS-LASIKK). Method 1. A total of 54 patients with 107 eyes underwent Smile and FS-LASIK from December 2015 to April 2016 were analyzed. Visual quality analysis system (quality analysis system,) was used to measure the optical quality analysis system, OSI before operation, 1 week after operation, 1 month after operation, and 1 month after operation. The subjective evaluation questionnaire of visual quality was used to evaluate the severity and severity of the symptoms of halo glare nocturnal vision fatigue and ocular dryness in 1 week and 1 month after operation. Using SPSS 19.0, two independent samples were tested by Mann-Whitney U test. Friedman's test of Kruskal-Wallis rank sum and Spearman's rank correlation coefficient were carried out. Result 1. MTF cut off in Smile group was significantly higher than that in FS-LASIK group at 1 week after operation, but there was no significant difference at 1 month after operation. The visual quality in Smile group and FS-LASIK group decreased significantly 1 week after operation and recovered at 1 month after operation. However, there was no return to the preoperative level. 3. There was a significant correlation between mean OSI and visual proximal fatigue. There was a significant correlation between OV and visual acuity decline. 4. There was a higher degree of satisfaction between SMILE group and FS-LASIK group. There was no significant difference between the two groups. 5. The dry eye symptoms in the Smile group were more mild than those in the FS-LASIK group 1 week after operation, but there was no significant difference between the two groups at one month after operation. Conclusion 1. In Smile group and FS-LASIK group, the scattering increased 1 week after operation and 1 month after operation, and decreased significantly at 1 month after operation, but did not return to the preoperative level of 0.2. The visual quality of Smile group was significantly higher than that of FS-LASIK group 1 week after operation, and the dry eye symptom was more mild than FS-LASIK group. There was no significant difference between the two groups at 1 month after operation.
【學(xué)位授予單位】：北京協(xié)和醫(yī)學(xué)院
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2016
【分類號(hào)】：R779.63

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