Pop Mihai, Payette Yves
Michel Pop Clinics, Montreal, Canada.
Ophthalmology. 2004 Jan;111(1):3-10. doi: 10.1016/j.ophtha.2003.09.022.
To study the preoperative risk factors for night vision complaints (NVCs) after LASIK in a clinical setting.
Retrospective noncomparative case series.
Seven hundred ninety-five patients (1488 eyes) who underwent LASIK for myopia up to -9.75 diopters (D) (from January 1 to December 31, 1999).
Private clinic.
A complete preoperative examination was performed. Patients had bilateral LASIK surgery using the Nidek EC-5000 non-wavefront guided slit-scanning excimer laser and the Moria LSK One microkeratome. Patients were observed postoperatively for 12 months.
The reported NVCs for each eye were rated on a subjective scale based on functional visual comfort. Clinically important NVC odds ratios (ORs) were calculated.
Reports of NVCs decreased considerably from 25.6% at 1 month to 4.7% at 12 months postoperatively, at which time all patients reported similar NVCs in both eyes. Stratification of risk factors at 12 months postoperatively showed a 2.8-times increase in NVCs for initial myopia of >5 D, a 2.5-times increase for an optical zone of </=6.0 mm, and a 2.9-times increase for a postoperative spherical equivalent outside +/-0.5 D of emmetropia. The role of attempted spherical correction, age of the patient, and postoperative spherical equivalent had significant importance in logistic regression of the OR throughout the first postoperative year. In a stepwise logistic regression using 6- and 12-month data, attempted spherical correction and optical zone were the most predictive factors of NVCs (P<0.001). Pupil size at any month postoperatively was not statistically predictive of postoperative NVCs in any differential model involving it.
Attempted degree of spherical correction, age, optical zone, and postoperative spherical equivalent were major risk factors of NVCs throughout the first postoperative year, whereas pupil size was not. Future wavefront studies that characterize higher order aberrations might be helpful for understanding individual visual aberrations while predicting quality of vision.
在临床环境中研究准分子激光原位角膜磨镶术（LASIK）后出现夜间视力问题（NVCs）的术前危险因素。
回顾性非对照病例系列。
1999年1月1日至12月31日期间接受LASIK治疗近视度数达-9.75屈光度（D）的795例患者（1488只眼）。
私人诊所。
进行全面的术前检查。患者使用Nidek EC - 5000非波前引导裂隙扫描准分子激光和Moria LSK One微型角膜刀接受双眼LASIK手术。术后对患者进行12个月的观察。
根据功能性视觉舒适度，对每只眼报告的NVCs进行主观评分。计算具有临床意义的NVC优势比（ORs）。
NVCs的报告率从术后1个月时的25.6%大幅下降至12个月时的4.7%，此时所有患者双眼的NVCs报告相似。术后12个月对危险因素进行分层分析显示，初始近视度数>5 D时NVCs增加2.8倍，光学区≤6.0 mm时增加2.5倍，术后球镜等效度在正视眼±0.5 D范围之外时增加2.9倍。在术后第一年的OR逻辑回归中，尝试的球镜矫正、患者年龄和术后球镜等效度的作用具有显著意义。在使用6个月和12个月数据进行的逐步逻辑回归中，尝试的球镜矫正和光学区是NVCs最具预测性的因素（P<0.001）。在任何涉及术后瞳孔大小的差异模型中，术后任何月份的瞳孔大小对术后NVCs均无统计学预测意义。
在术后第一年，尝试的球镜矫正度数、年龄、光学区和术后球镜等效度是NVCs的主要危险因素，而瞳孔大小不是。未来表征高阶像差的波前研究可能有助于在预测视力质量时理解个体视觉像差。
