暗环境下低对比度视力的相关研究

发布时间：2018-01-31 08:00

  本文关键词： 准分子激光原位角膜磨镶术 低对比度视力 Q值 高阶像差 Q值引导个体化LASIK 标准化LASIK 低对比度视力　出处：《华中科技大学》2011年硕士论文　论文类型：学位论文

【摘要】：【目的】研究近视患者行准分子激光原位角膜磨镶术前后,暗环境下低对比度视力(Low contrast visual acuity,LCVA)的分布特征及其相关因素,对比手术前后暗环境下LCVA值的变化及影响这种变化的相关因素。 【方法】随机选取行LASIK术的患者61例(122眼),按等效球镜度分为低度、中度及高度近视组。使用ZyQv视力表测量各组近视患者术前、术后一周、一月及三月暗环境下10%对比度视力,并同时测量裸眼视力、屈光度、角膜K值、Q值和波前像差等指标。使用SPSS13.0统计软件,研究患者LCVA值术前、术后的分布特征,对手术前后各屈光度组LCVA值的变化进行比较,并对影响LCVA值及其变化的相关因素进行分析。 【结果】⑴术前61例122眼暗环境下LCVA值呈正态分布,平均0.34±0.12logMAR(0.02logMAR~0.66logMAR);低度、中度及高度近视组的LCVA值分别为0.28±0.11logMAR、0.33±0.10logMAR和0.42±0.11logMAR,各组间LCVA值两两比较,差别均有统计学意义(P值均小于0.05)。术前LCVA值与瞳孔直径、球镜度绝对值、等效球镜度绝对值、总像差及总高阶像差正相关,与K值、柱镜度、Q值及球差不相关。⑵术后一周、一月及三月的LCVA值均呈正态分布,平均值分别为0.40±0.14logMAR ( 0.04logMAR~0.84logMAR )、0.38±0.13logMAR ( 0.1logMAR~ 0.82logMAR)、0.37±12logMAR(0.10logMAR~0.80logMAR)。⑶各组在术后一周时LCVA值均较术前显著增大(P值均小于0.05);术后一月,低度近视组LCVA值与术前无统计学差异(P0.05),中度及高度近视组LCVA值与仍较术前显著增大(P值均小于0.05);术后三个月时只有高度近视组LCVA值仍较术前显著增大(P0.05)。⑷术后三月所测LCVA值与Q值、总像差、总高阶像差及球差正相关,与瞳孔直径及K值不相关。术后三个月时ΔLCVA与Δ总高阶像差、Δ球差、ΔQ值及预矫屈光度绝对值正相关。 【结论】LASIK手术前后患者LCVA值均呈正态分布;高度近视患者LASIK术后暗环境下低对比度视力下降;在术前LCVA值主要受瞳孔、球镜度、等效球镜度、总像差和总高阶像差等因素的影响;术后LCVA值主要受总像差、总高阶像差、球差及Q值等多个因素影响。 第二部分不同手术方式对暗环境下低对比度视力的影响 【目的】比较Q值引导个性化LASIK(Q-value guide customized LASIK,Q-LASIK)与标准化的LASIK (standardized LASIK, S-LASIK)对患者暗环境下10%对比度视力的影响。 【方法】使用S-LASIK和Q-LASIK两种手术方法治疗近视,其中S-LASIK组37例71眼为S组,按等效球镜度分为低度近视组(S1组)、中度近视组(S2组)及高度近视组(S3组);Q-LASIK组32例62眼为Q组,同样按等效球镜度分为Q1、Q2及Q3组。术前和术后一周、一月及三月分别检查患者暗环境下低对比度视力、裸眼视力、屈光度、Q值及球差等指标,并使用SPSS13.0统计软件对S组及Q组患者手术前后的LCVA值及主观感受进行统计分析。 【结果】⑴S-LASIK组中,低度、中度及高度近视组在术后一周时LCVA值较术前显著增大(P值均小于0.05);术后一月时,低度近视组LCVA值与术前无统计学差异(P0.05),而中度及高度近视组所测值仍较术前显著增大(P值均小于0.05);术后三月时只有高度近视组所测值仍较术前显著增大(P0.05)。⑵Q-LASIK组中,低度、中度及高度近视组在术后一周、一月及三月所测LCVA值与术前均无统计学差异。⑶术后三月,S组患者的ΔQ值、Δ球差值及ΔLCVA值均较Q组大,其中S3与Q3组的差异有统计学意义(P0.05)。⑷针对患者术后夜间视力情况的问卷调查,一周、一月和三月时Q-LASIK组术后夜间视力较术前佩戴眼镜时差的主诉发生率均较S-LASIK组低,但差异无统计学意义(P0.05)。 【结论】Q-LASIK术较S-LASIK术对患者暗环境下低对比度视力的影响小,尤其在高度近视患者,能够相对减轻患者术后的夜视力下降。
[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，

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