【摘要】：目的：通過對比術前術后視覺對比敏感度(CS值),探討LASIK與LASEK對中低度近視患者視覺質(zhì)量的影響。 方法：選中低度近視患者52人(104眼),根據(jù)手術方式隨機分為LASIK組和LASEK組,每組各26人(52眼)。術前行常規(guī)視力、客觀驗光、非接觸眼壓、眼前節(jié)、眼底和角膜地形圖檢查；術后1m、3m、6m、12m行視力、客觀驗光、非接觸眼壓、眼前節(jié)檢查；并應用Optec 6500視覺檢查儀對比敏感度測試卡(F.A.C.T)檢查術前及術后各時段夜、夜+周邊眩光、晝、晝+周邊眩光四種條件下的CSVA值。 結(jié)果：1.LASEK組術后有10.71%出現(xiàn)Haze; 2.術后視力：LASEK組和LASIK組內(nèi)患者術后BCVA與術前比較,在各時段的差異均無統(tǒng)計學意義(p0.05)；3.對比敏感度檢查：(1)與術前比較,LASIK組患者術后1m時各空間頻率段CSVA值均明顯低于術前(p0.01)；術后3m,在6頻率段降低(P＜0.05),其他空間頻率段均明顯低與術前水平(p0.01)；術后6m和12m,各空間頻率段CSVA值與術前差異無統(tǒng)計學意義(p0.05)；(2)與術前比較,LASEK組患者術后1m,各空間頻率段CSVA值均明顯低于術前(p0.01),術后3m,CSVA值在1.5頻率段明顯低于術前(p＜0.01),在3頻率段低于術前(p0.05),在其他空間頻率與術前無統(tǒng)計學意義(p0.05)；術后6m和12m,各空間頻率段CSVA值與術前差異無統(tǒng)計學意義(p0.05)；(3)LASIK組和LASEK組兩組間術前各空間頻率段CSVA值無差異(p0.05)；與LASEK組比較,LASIK組術后3m各空間頻率段CSVA值與術前的差異更大(p0.05)；術后1m、6m和12m,兩組在各空間頻率段CSVA值與術前的差異無統(tǒng)計學意義(p0.05)。 結(jié)論：(1)中低度近視LASEK術后有10.71%出現(xiàn)Haze,表明中低度近視患者做LASEK手術后存在Haze的風險。(2)中低度近視患者無論是選擇LASEK還是LASIK,術后的裸眼視力均與術前最佳矯正視力無明顯差異,術后視力能夠明顯提升；(3)中低度近視患者行LASIK術或LASEK術術后1個月、3個月視覺對比敏感度(CSVA值)均低于術前水平,6個月時恢復至術前水平；(4)與LASEK組比較,LASIK組術后1月時各空間頻率段視覺對比敏感度(CSVA值)波動無明顯差異。從術后1月開始,LASEK組對比敏感度各空間頻率上均高于LASIK組。LASIK組術后3月時各空間頻率段視覺對比敏感度(CSVA值)波動比LASEK組大。
[Abstract]:Objective: to investigate the effect of LASIK and LASEK on visual quality of patients with moderate and low myopia by comparing visual contrast sensitivity (CS) before and after operation. Methods: 52 patients (104 eyes) with low myopia were randomly divided into LASIK group and LASEK group with 26 eyes (52 eyes) in each group. Routine visual acuity, objective optometry, non-contact intraocular pressure, anterior segment, fundus and corneal topography were performed before operation, visual acuity, objective optometry, non-contact intraocular pressure and anterior segment examination were performed 1 m, 3 m, 6 m and 12 m after operation. The contrast sensitivity test card (F.A.C.T) of Optec 6500 visual examination instrument was used to examine the CSVA values of night, peripheral glare and diurnal glare before and after operation. Results: in the 1.LASEK group, Haze; was found in 10.71% of the patients after operation. Postoperative visual acuity: there was no significant difference in postoperative BCVA between LASEK group and LASIK group (p0.05). Contrast sensitivity test: (1) compared with pre-operation, the CSVA values of each spatial frequency range in LASIK group were significantly lower than those before operation (p0.01). At 3 m after operation, it decreased at 6 frequency range (P < 0.05), and the other spatial frequency segments were significantly lower than those before operation (p0.01), but there was no significant difference in CSVA between 6 m and 12 m after operation (p0.05). (2) compared with pre-operation, the CSVA value of each spatial frequency band in LASEK group was significantly lower than that before operation (p0.01), and at 3 m after operation, CSVA value in 1.5 frequency band was significantly lower than that before operation (p < 0.01). The frequency range of 3 was lower than that before operation (p0.05), but there was no significant difference between other spatial frequencies and preoperative frequency (p0.05). There was no significant difference in CSVA values between LASIK group and LASEK group (p0.05); (3) at 6 m and 12 m after operation (p0.05 CSVA). There was no significant difference in CSVA between LASIK group and LASEK group before operation (p0.05). Compared with LASEK group, the CSVA value of each spatial frequency segment in LASIK group was significantly different from that before operation at 3m after operation (p0.05), but there was no significant difference in CSVA value between the two groups at 1 m, 6 m and 12 m after operation (p0.05). Conclusion: (1) 10.71% of patients with moderate and low myopia have Haze, after LASEK, which indicates that there is a risk of Haze in patients with middle and low myopia after LASEK surgery. (2) whether LASEK or LASIK, is selected in patients with middle and low myopia. There was no significant difference between the uncorrected visual acuity after operation and the best corrected visual acuity before operation, but the postoperative visual acuity could be improved significantly. (3) the visual contrast sensitivity (CSVA) of patients with moderate and low myopia was lower than the preoperative level at 1 month and 3 months after LASIK or LASEK, and returned to the preoperative level at 6 months. (4) compared with LASEK group, there was no significant difference in visual contrast sensitivity (CSVA) between LASIK group and LASIK group at 1 month after operation. From 1 month after operation, the spatial frequency of contrast sensitivity in LASEK group was higher than that in LASIK group. The visual contrast sensitivity (CSVA) of each spatial frequency segment in LASIK group was larger than that in LASEK group at 3 months after operation.
【學位授予單位】：吉林大學
【學位級別】：碩士
【學位授予年份】：2011
【分類號】：R779.63

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