■研究患者报告的视觉障碍对角膜屈光手术后近视患者动态视力的影响。
■这是一项前瞻性非随机研究。成人近视患者接受双侧激光辅助上皮下角膜磨镶术(LASEK),飞秒激光辅助原位角膜磨镶术(FS-LASIK),包括带平角靶的小切口微透镜提取(SMILE)。评估了八种类型的患者报告的视觉障碍的频率,术后3个月测量严重程度和令人困扰的动态视力(DVA)为每秒40度和80度(dps).
■该研究纳入了95名患者,平均年龄为27.6±6.4岁。最常报告的视觉障碍是视力波动(70.5%),其次是眩光(66.3%)和光晕(57.4%)。术后80dps的DVA与光环总分(p=0.038)和判断距离的难度(p=0.046)显着相关。在有光环的患者中,术后DVA在40dps时比没有光环的患者明显更差(p=0.024)。对于没有光环或难以判断距离的患者,80dps的DVA明显优于有症状的患者(光环,p=0.047;判断距离困难,p=0.029)。通过外科手术进行的亚组分析表明,仅在接受FS-LASIK的患者中观察到有和没有视力障碍的患者之间DVA的显着差异。
■术后,患有晕圈或难以判断距离的近视角膜屈光手术患者的低速和高速DVA明显比没有症状的患者差。本研究为患者有视觉障碍时涉及动态视觉的日常任务的术后指导提供了基础。
UNASSIGNED: To investigate the impact of patient-reported visual disturbance on dynamic visual acuity in myopic patients after corneal refractive surgery.
UNASSIGNED: This is a prospective nonrandomized study. Adult myopic patients receiving bilateral laser-assisted sub-epithelial keratomileusis (LASEK), femtosecond laser-assisted in situ keratomileusis (FS-LASIK), or small incision lenticule extraction (SMILE) with Plano target were included. Eight types of patient-reported visual disturbance were evaluated regarding frequency, severity and bothersome and dynamic visual acuity (DVA) of 40 and 80 degrees per second (dps) was measured postoperatively at 3 months.
UNASSIGNED: The study enrolled 95 patients with an average age of 27.6 ± 6.4 years. The most frequently reported visual disturbance was the fluctuation in vision (70.5%), followed by glare (66.3%) and halo (57.4%). Postoperative DVA at 80 dps was significantly associated with the total score of haloes (p = 0.038) and difficulty in judging distance (p = 0.046). Significant worse postoperative DVA at 40 dps was observed in patients with haloes than those without (p = 0.024). The DVA at 80 dps for patients without haloes or difficulty in judging distance was significantly better than that with the symptoms (haloes, p = 0.047; difficulty in judging distance, p = 0.029). Subgroup analysis by surgical procedures demonstrated that the significant difference in DVA between patients with and without visual disturbance was only observed in patients receiving FS-LASIK.
UNASSIGNED: Postoperatively, myopic patients undergoing corneal refractive surgery with haloes or difficulty in judging distance have significantly worse low and high-speed DVA than those without the symptoms. The present study provided the basis for postoperative guidance in daily tasks involving dynamic vision when patients have visual disturbances.