Bailey Melissa D, Mitchell G Lynn, Dhaliwal Deepinder K, Boxer Wachler Brian S, Zadnik Karla
College of Optometry, The Ohio State University, 338 West Tenth Avenue, Columbus, OH 43210, USA.
Ophthalmology. 2003 Jul;110(7):1371-8. doi: 10.1016/S0161-6420(03)00455-X.
To examine preoperative risk factors for decreased satisfaction and symptoms of glare, halos, and/or starbursts after laser in situ keratomileusis (LASIK).
Retrospective, case-control study.
Participants were 604 previously myopic patients who underwent LASIK at least six months prior to completing the questionnaire.
Questionnaires about satisfaction and night vision symptoms were mailed to 2100 patients from the Northeastern Eye Institute, UCLA, and the University of Pittsburgh. Preoperative and postoperative ocular variables were collected from the medical charts of the 841 subjects who returned the questionnaire.
Responses to various satisfaction and night vision symptom questions were compared to demographic and preoperative ocular variables using multivariate logistic regression.
The questionnaire return rate was 42.9%. The mean age for all subjects was 43.0 +/- 10.6 years, and 63% of the subjects were women. Overall, 97% of the subjects would recommend LASIK to a friend. Among subjects who would not recommend LASIK to a friend, a significantly larger percentage reported that they experienced glare, halos, or starbursts (13 of 16 (81.3%) vs. 206 of 388 (53.1%), chi(2) = 4.9, p = 0.03). Also, subjects with flatter preoperative minimum corneal curvature values were more likely to report that they would not recommend LASIK to a friend (OR = 0.71, 95% confidence interval (CI) = (0.52, 0.96), p = 0.03). The median score for satisfaction with vision was 100%, or the maximum value of 127 mm on the visual analog scale. Increasing age was significantly associated with dissatisfaction with vision after LASIK (OR = 1.68, 95% CI = (1.10, 2.56), P = 0.02). Halos were reported by 30%, glare by 27%, and starbursts by 25% of all subjects. Subjects who reported starbursts had a significantly flatter preoperative minimum corneal curvature (43.54 +/- 1.60 D versus 43.92 +/- 1.69 D, t = 2.15, p = 0.03). Also, subjects who had surgical enhancement were more likely to experience glare, halos, and/or starbursts (OR = 2.14, 95% CI = (1.33, 3.46), p = 0.002).
Most subjects are satisfied with their vision after LASIK. Our study suggests, however, that certain factors are associated with decreased satisfaction and night vision symptoms after LASIK. Some of these factors include: increasing age, flatter preoperative minimum corneal curvature, and surgical enhancement.
探讨准分子原位角膜磨镶术（LASIK）后满意度降低以及出现眩光、光晕和/或星芒症状的术前危险因素。
回顾性病例对照研究。
604名曾患近视的患者，他们在完成问卷调查前至少6个月接受了LASIK手术。
向来自东北眼科研究所、加州大学洛杉矶分校和匹兹堡大学的2100名患者邮寄了关于满意度和夜间视力症状的问卷。从841名返回问卷的受试者的病历中收集术前和术后的眼部变量。
使用多因素逻辑回归分析，将对各种满意度和夜间视力症状问题的回答与人口统计学和术前眼部变量进行比较。
问卷回复率为42.9%。所有受试者的平均年龄为43.0±10.6岁，63%为女性。总体而言，97%的受试者会向朋友推荐LASIK手术。在那些不会向朋友推荐LASIK手术的受试者中，报告经历眩光、光晕或星芒的比例明显更高（16人中有13人（81.3%），而388人中有206人（53.1%），χ² = 4.9，p = 0.03）。此外，术前最小角膜曲率值较平的受试者更有可能报告他们不会向朋友推荐LASIK手术（比值比（OR）= 0.71，95%置信区间（CI）=（0.52，0.96），p = 0.03）。视力满意度的中位数为100%，即视觉模拟量表上127毫米的最大值。年龄增加与LASIK术后视力不满意显著相关（OR = 1.68，95%CI =（1.10，2.56），P = 0.02）。所有受试者中，30%报告有光晕，27%报告有眩光，25%报告有星芒。报告有星芒的受试者术前最小角膜曲率明显更平（43.54±1.60 D对43.92±1.69 D，t = 2.15，p = 0.03）。此外，接受手术增强的受试者更有可能出现眩光、光晕和/或星芒（OR = 2.14，95%CI =（1.33，3.46），p = 0.002）。
大多数受试者对LASIK术后的视力满意。然而，我们的研究表明，某些因素与LASIK术后满意度降低和夜间视力症状有关。其中一些因素包括：年龄增加、术前最小角膜曲率较平以及手术增强。
