【摘要】：目的： 通過分析飛秒制瓣LASIK手術(shù)患者術(shù)前、術(shù)后視疲勞評分及視功能變化的差異，來探索中度近視人群（非老視者）術(shù)后視覺疲勞的程度與術(shù)前戴鏡近視矯正狀態(tài)的關(guān)系。 方法： 選擇2012年12月~2013年3月來我院眼視光醫(yī)學(xué)中心行雙眼飛秒制瓣LASIK手術(shù)的近視患者共36例（72只眼），按術(shù)前配戴框架眼鏡的近視矯正狀態(tài)，分為相對足矯組和相對欠矯組，觀察視疲勞評分、調(diào)節(jié)幅度、遠/近距水平隱斜、AC/A，，遠/近距正/負融像性聚散（Distant/NearPositive/negativeFusionVergence）手術(shù)前后數(shù)值的變化，分析其與視疲勞評分的相關(guān)性。 結(jié)果： 1.視覺疲勞癥狀方面，術(shù)前相對足矯組和相對欠矯組評分無差異，術(shù)后相對足矯組評分小于相對欠矯組；相對足矯組術(shù)前評分小于術(shù)后，相對欠矯組術(shù)前評分小于術(shù)后。2.視功能參數(shù)方面。a.手術(shù)前后，相對足矯組患者單眼調(diào)節(jié)幅度均值均大于相對欠矯組；兩組術(shù)后調(diào)節(jié)幅度均值均大于術(shù)前。b.術(shù)前足矯組與欠矯組的遠距水平隱斜均值、近距水平隱斜均值無統(tǒng)計學(xué)差異(p0.05)；術(shù)后足矯組與欠矯組的遠距水平隱斜均值差異無統(tǒng)計學(xué)意義(p0.05)；但術(shù)后足矯組近距水平隱斜均值大于欠矯組；足矯組和欠矯組手術(shù)前后遠距水平隱斜均值差異均無統(tǒng)計學(xué)意義(p0.05)；足矯組術(shù)前近距水平隱斜均值與術(shù)后無統(tǒng)計學(xué)差異(p0.05)，欠矯組術(shù)前近距水平隱斜均值大于術(shù)后。c.術(shù)前足矯組AC/A均值小于欠矯組,術(shù)后足矯組AC/A均值仍小于欠矯組；手術(shù)前后足、欠矯兩組術(shù)后均值均小于術(shù)前。d.術(shù)前足矯組和欠矯組遠近融像性聚散均值無差異(p0.05)，術(shù)后足矯組和欠矯組遠近融像性聚散均值也無差異(p0.05)；但不管是足矯組還是欠矯組，它們手術(shù)后的遠距正融像性聚散均值、近距正融像性聚散均值均小于術(shù)前，遠距負融像性聚散、近距負融像性聚散均值改變均無統(tǒng)計學(xué)意義(p0.05)；3.LASIK術(shù)后調(diào)節(jié)幅度越小、近距外隱斜越大、AC/A越大、近距融像性儲備越小，術(shù)后視疲勞癥狀越明顯。 結(jié)論： 1、術(shù)前相對欠矯狀態(tài)人群，行飛秒LASIK術(shù)前及術(shù)后的視疲勞癥狀均較相對足矯狀態(tài)人群重。 2、LASIK手術(shù)后視覺疲勞癥狀程度，除去年齡、屈光度外，與術(shù)前調(diào)節(jié)幅度、近距離正融像儲備成負相關(guān)關(guān)系，與術(shù)前近距離外隱性斜視程度、調(diào)節(jié)與集合幅度成正相關(guān)關(guān)系。
[Abstract]:Objective: to analyze the difference of visual fatigue score and visual function in patients with femtosecond flap LASIK before and after operation. To explore the relationship between postoperative visual fatigue and preoperative correction of myopia in moderate myopia (non-presbyopia). Methods: from December 2012 to March 2013, 36 patients (72 eyes) with binocular femtosecond flap LASIK were selected. The patients were divided into two groups: relative foot correction group and relative undercorrection group. The changes of visual fatigue score, adjustment amplitude, distance / close-range horizontal oblique, and AC/A, distant / close-range positive / negative fusion astigmatism (Distant/NearPositive/negativeFusionVergence) before and after operation were observed. The correlation between visual fatigue score and visual fatigue score was analyzed. Results: 1. In terms of visual fatigue symptoms, there was no difference between the preoperative relative foot correction group and the relative undercorrection group, the preoperative score of the relative foot correction group was lower than that of the relative undercorrection group, the preoperative score of the relative foot correction group was smaller than that of the post-operative group, and the preoperative score of the relative undercorrection group was smaller than that of the post-operative group. 2. Visual functional parameters. A. Before and after operation, the mean value of monocular adjustment amplitude in the relative foot correction group was higher than that in the relative undercorrection group, and the mean value of postoperative adjustment amplitude in the two groups was higher than that in the preoperative group. There was no significant difference between preoperative foot correction group and undercorrection group (p0.05), but there was no significant difference between foot correction group and undercorrection group (p0.05). But there was no significant difference between the foot correction group and the undercorrection group before and after operation (p0.05), but the mean value of the close horizontal oblique in the foot correction group was higher than that in the undercorrection group after the operation, and there was no significant difference between the foot correction group and the undercorrection group before and after the operation. There was no significant difference between preoperative and postoperative close level oblique mean in foot correction group (p0.05), and the mean value of close level covert deviation in undercorrection group was higher than that in postoperation group (p0.05). The mean value of AC/A in the preoperative foot correction group was lower than that in the undercorrection group, and the AC/A value in the postoperative foot correction group was still lower than that in the undercorrection group, and the postoperative mean before and after operation in the foot correction group was lower than that in the preoperative foot correction group. There was no significant difference between preoperative foot correction group and undercorrection group (p0.05), and there was no significant difference between foot correction group and undercorrection group (p0.05). However, in the foot correction group and the undercorrection group, the mean values of the distant positive fusion astigmatism and the close-range positive melt astigmatism were lower than those of the preoperative, and the distant negative fusion astigmatism was lower than that before the operation. There was no significant difference in the mean value of close negative fusion aggregation (p0.05). The smaller the adjustment amplitude, the greater the close-distance oblique, the larger the AC/A, the smaller the accommodation reserve and the more obvious the symptoms of visual fatigue after 3.LASIK. Conclusion: 1. The symptoms of visual fatigue before and after femtosecond LASIK were more serious than those in patients with relative undercorrection. (2) the degree of visual fatigue after LASIK operation, except age and diopter, had a negative correlation with the preoperative adjustment amplitude and the reserve of close-range positive melt image, and had a positive correlation with the degree of recessive strabismus before operation, and the adjustment with the amplitude of set.
【學(xué)位授予單位】：南華大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R779.6

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