目的:研究近视患者LASIK术后视疲劳的发生与融合范围的关系,为以后视疲劳的诊断提供又一证据,期待为视疲劳的治疗提供新的思路。方法:对60例120眼近视患者(-1.50～-8.00D)施行LASIK手术,于术前,术后1wk,1mo分别行小瞳及散瞳(美多丽)后电脑验光,检影检查及同视机法测定融合范围,AC/A,及进行视疲劳的问卷调查,进行统计学分析。结果:60例患者中有54例患者术后出现视疲劳症状,LASIK术后散瞳检查与小瞳下等效球镜度的差异具有显著意义(P<0.01),度数均降低,术后1wk,1mo散瞳验光等效球镜度的差值均明显大于术前差值(P<0.05)。术后1wk,1mo较术前的融合范围的改变有显著的意义(P<0.05),均比术前减小。术后1wkAC/A值的改变有显著的意义(P<0.05)较术前增大,术后1moAC/A值的改变有显著的意义(P<0.05)较术前减小。结论:近视眼LASIK术后眼的调节增加,集合功能减小。集合和调节功能的失衡是LASIK术后患者出现视疲劳的一个重要因素。这就提醒我们在设计手术的时候要考虑到患者的调节和集合功能。

AIM:To analyze the relationship between asthenopia and range of fusion after laser in situ keratomileusis(LASIK) in myopia patients,and to provide another evidence for the diagnosis of visual fatigue,and expect to provide new ideas for the treatment of asthenopia.·METHODS:Totally 60 myopia cases (120 eyes),whose diopter was from-1.50D to-8.00D,were determined the ratio of fusion range and AC/A by synoptophore and refracted by autorefractor and phoropter.Myd rin was used to disperse pupil then,refraction was performed again by autorefractor and phoropter before LASIK,1 week and 1 month after LASIK and visual fatigue questionnaire survey was conducted.The results were statistically analyzed.·RESULTS:There were 54 cases of postoperative occurr-ed visual fatigue symptoms in 60 patients.The discre-pancy of spherical equivalecce(SE) was significant different between large pupil and normal pupil 1 week,1 month after operation (P<0.01),all SE diminished.The discrepancy of SE 1 week,1 month after operation was significantly larger than that before operation (P<0.05).The fusion range 1 week,1 month after operation were lower than the preoperative one respectively,the result had significant difference (P<0.05).The radio of AC/A 1 week after operation was larger than the preoperative one,and the radio of AC/A 1 month after operation was lower than the preoperative one,the result had significant difference (P<0.05).·CONCLUSION:The accommodation of the myopia eyes increases and the convergence diminishes after LASIK.The imbalance of accommodation and convergence is an important factor in fatigue of patients after LASIK.This requires that we should take into account patient’s accommodation and convergence when we design surgery.

R779.63

南华大学附属郴州市第一人民医院科研资助项目(No.2009-053)~~