本文關(guān)鍵詞： 準分子激光原位角膜磨鑲術(shù) 低對比度視力 Q值 高階像差 Q值引導(dǎo)個體化LASIK 標準化LASIK 低對比度視力　出處：《華中科技大學(xué)》2011年碩士論文　論文類型：學(xué)位論文

【摘要】：【目的】研究近視患者行準分子激光原位角膜磨鑲術(shù)前后,暗環(huán)境下低對比度視力(Low contrast visual acuity,LCVA)的分布特征及其相關(guān)因素,對比手術(shù)前后暗環(huán)境下LCVA值的變化及影響這種變化的相關(guān)因素。 【方法】隨機選取行LASIK術(shù)的患者61例(122眼),按等效球鏡度分為低度、中度及高度近視組。使用ZyQv視力表測量各組近視患者術(shù)前、術(shù)后一周、一月及三月暗環(huán)境下10%對比度視力,并同時測量裸眼視力、屈光度、角膜K值、Q值和波前像差等指標。使用SPSS13.0統(tǒng)計軟件,研究患者LCVA值術(shù)前、術(shù)后的分布特征,對手術(shù)前后各屈光度組LCVA值的變化進行比較,并對影響LCVA值及其變化的相關(guān)因素進行分析。 【結(jié)果】⑴術(shù)前61例122眼暗環(huán)境下LCVA值呈正態(tài)分布,平均0.34±0.12logMAR(0.02logMAR~0.66logMAR);低度、中度及高度近視組的LCVA值分別為0.28±0.11logMAR、0.33±0.10logMAR和0.42±0.11logMAR,各組間LCVA值兩兩比較,差別均有統(tǒng)計學(xué)意義(P值均小于0.05)。術(shù)前LCVA值與瞳孔直徑、球鏡度絕對值、等效球鏡度絕對值、總像差及總高階像差正相關(guān),與K值、柱鏡度、Q值及球差不相關(guān)。⑵術(shù)后一周、一月及三月的LCVA值均呈正態(tài)分布,平均值分別為0.40±0.14logMAR ( 0.04logMAR~0.84logMAR )、0.38±0.13logMAR ( 0.1logMAR~ 0.82logMAR)、0.37±12logMAR(0.10logMAR~0.80logMAR)。⑶各組在術(shù)后一周時LCVA值均較術(shù)前顯著增大(P值均小于0.05);術(shù)后一月,低度近視組LCVA值與術(shù)前無統(tǒng)計學(xué)差異(P0.05),中度及高度近視組LCVA值與仍較術(shù)前顯著增大(P值均小于0.05);術(shù)后三個月時只有高度近視組LCVA值仍較術(shù)前顯著增大(P0.05)。⑷術(shù)后三月所測LCVA值與Q值、總像差、總高階像差及球差正相關(guān),與瞳孔直徑及K值不相關(guān)。術(shù)后三個月時ΔLCVA與Δ總高階像差、Δ球差、ΔQ值及預(yù)矯屈光度絕對值正相關(guān)。 【結(jié)論】LASIK手術(shù)前后患者LCVA值均呈正態(tài)分布;高度近視患者LASIK術(shù)后暗環(huán)境下低對比度視力下降;在術(shù)前LCVA值主要受瞳孔、球鏡度、等效球鏡度、總像差和總高階像差等因素的影響;術(shù)后LCVA值主要受總像差、總高階像差、球差及Q值等多個因素影響。 第二部分不同手術(shù)方式對暗環(huán)境下低對比度視力的影響 【目的】比較Q值引導(dǎo)個性化LASIK(Q-value guide customized LASIK,Q-LASIK)與標準化的LASIK (standardized LASIK, S-LASIK)對患者暗環(huán)境下10%對比度視力的影響。 【方法】使用S-LASIK和Q-LASIK兩種手術(shù)方法治療近視,其中S-LASIK組37例71眼為S組,按等效球鏡度分為低度近視組(S1組)、中度近視組(S2組)及高度近視組(S3組);Q-LASIK組32例62眼為Q組,同樣按等效球鏡度分為Q1、Q2及Q3組。術(shù)前和術(shù)后一周、一月及三月分別檢查患者暗環(huán)境下低對比度視力、裸眼視力、屈光度、Q值及球差等指標,并使用SPSS13.0統(tǒng)計軟件對S組及Q組患者手術(shù)前后的LCVA值及主觀感受進行統(tǒng)計分析。 【結(jié)果】⑴S-LASIK組中,低度、中度及高度近視組在術(shù)后一周時LCVA值較術(shù)前顯著增大(P值均小于0.05);術(shù)后一月時,低度近視組LCVA值與術(shù)前無統(tǒng)計學(xué)差異(P0.05),而中度及高度近視組所測值仍較術(shù)前顯著增大(P值均小于0.05);術(shù)后三月時只有高度近視組所測值仍較術(shù)前顯著增大(P0.05)。⑵Q-LASIK組中,低度、中度及高度近視組在術(shù)后一周、一月及三月所測LCVA值與術(shù)前均無統(tǒng)計學(xué)差異。⑶術(shù)后三月,S組患者的ΔQ值、Δ球差值及ΔLCVA值均較Q組大,其中S3與Q3組的差異有統(tǒng)計學(xué)意義(P0.05)。⑷針對患者術(shù)后夜間視力情況的問卷調(diào)查,一周、一月和三月時Q-LASIK組術(shù)后夜間視力較術(shù)前佩戴眼鏡時差的主訴發(fā)生率均較S-LASIK組低,但差異無統(tǒng)計學(xué)意義(P0.05)。 【結(jié)論】Q-LASIK術(shù)較S-LASIK術(shù)對患者暗環(huán)境下低對比度視力的影響小,尤其在高度近視患者,能夠相對減輕患者術(shù)后的夜視力下降。
[Abstract]:[Objective] to study the patients with myopia after laser in situ keratomileusis, dark environment, low contrast visual acuity (Low contrast visual acuity, LCVA) distribution characteristics and related factors, dark environment LCVA value contrast before and after surgery. The changes and influence factors related to this change.
[Methods] randomly selected LASIK were performed in 61 patients (122 eyes), according to the spherical equivalent divided into low, moderate and high myopia group. Using ZyQv visual acuity measured in myopic patients before operation, one week after operation, and in March January dark environment 10% contrast visual acuity, and simultaneous measurement of the naked eye visual acuity, diopter, corneal K value, Q value and wavefront aberration index. Using SPSS13.0 statistical software, study the LCVA value of patients with preoperative and postoperative distribution characteristics, compares the changes before and after surgery the diopter group LCVA value, and the value of relevant factors and its impact on LCVA analysis.
[results] the preoperative 61 cases 122 eyes in dark environment LCVA value of normal distribution, the average 0.34 + 0.12logMAR (0.02logMAR~0.66logMAR); low, moderate and high myopia group LCVA = 0.28 + 0.11logMAR, 0.33 + 0.10logMAR and 0.42 + 0.11logMAR, 22 more than the LCVA value of each group, there was significant difference (the P values were less than 0.05). The LCVA value and the pupil diameter before operation, the absolute value of the ball lens, spherical equivalent absolute value of total aberrations and total higher-order aberrations correlated with K value, Q value and cylinder lens, spherical aberration is not relevant. One week after the operation, January and LCVA in March the value of normal distribution, the average values were 0.40 + 0.14logMAR, 0.38 + 0.13logMAR (0.04logMAR~0.84logMAR) (0.1logMAR~ 0.82logMAR), 12logMAR (0.37 + 0.10logMAR~0.80logMAR). The groups within one week after operation when the LCVA value was significantly increased (P < 0.05); postoperative January, low myopia Group LCVA had no significant difference with the preoperative (P0.05), moderate and high myopia group and LCVA value is still significantly increased (P < 0.05); after three months only myopia group LCVA value is still significantly increased (P0.05). The postoperative March measured by LCVA the value and the Q value of total aberrations and total higher-order aberrations and spherical aberration are related, not related with pupil diameter and K value. After three months of delta LCVA and delta delta total high order aberration, spherical aberration, Delta Q value and refractive errors is positively correlated to the absolute value.
[Conclusion] LASIK before and after surgery in patients with LCVA value of normal distribution; patients with high myopia after LASIK in dark environment of low contrast visual acuity decreased; in preoperative LCVA was mainly influenced by the pupil, spherical, spherical equivalent, effects of total aberrations and total higher-order aberrations and other factors; postoperative LCVA value the total aberration, total higher order aberration, spherical aberration and Q value and many other factors.
The effect of different surgical methods on low contrast visual acuity under dark environment in the second part
[Objective] to compare the effect of Q value guided LASIK Q-value guide customized (Q-LASIK) and standardized LASIK (standardized LASIK, S-LASIK) on the 10% contrast vision of patients under dark environment.
[method] the use of S-LASIK and Q-LASIK two kinds of surgical methods in the treatment of myopia, 37 cases in S-LASIK group and 71 eyes in group S, according to the spherical equivalent divided into low myopia group (group S1), moderate myopia group (group S2) and high myopia group (group S3); group Q-LASIK 32 cases 62 eyes of Q the same group, according to the spherical equivalent is divided into Q1, Q2 and Q3 group. After a week before and during operation, January and March respectively were examined under dark conditions of low contrast visual acuity, uncorrected visual acuity, refractive index, and Q value of S and spherical aberration, and the group and Q group patients the value of LCVA using SPSS13.0 statistical software and subjective feeling were analyzed.
銆愮粨鏋溿，

本文編號：1478652