Tuan Kuang-mon Ashley
Visx, Inc., Santa Clara, California 95051, USA.
J Cataract Refract Surg. 2006 Apr;32(4):577-83. doi: 10.1016/j.jcrs.2006.01.002.
To determine the correlation between patient perception and clinical measurements after wavefront-guided laser in situ keratomileusis (LASIK).
Multicenter clinical trial.
In this retrospective analysis of clinical study results in 274 eyes, wavefront-guided LASIK procedures were performed in 274 myopic-astigmatic eyes at 6 sites. Comprehensive evaluations of vision and ocular health were conducted preoperatively and for 6 months postoperatively. Visual acuity and contrast sensitivity were measured, and questionnaires were administered. Questionnaire responses were compared with clinical measurements.
The overall distribution shifted toward "more satisfied." The "very satisfied" population increased by as much as 70% in all areas. There was no significant change in frequency of visual symptoms. Patients were more expressive about visual decline than visual improvement. Perception of changes in vision appeared to be related to mesopic contrast sensitivity and mesopic contrast sensitivity under glare. Mesopic pupil diameter was not a major predictor of patient satisfaction. Contact lens wearers were more satisfied with postoperative vision than were spectacle wearers. Men were more likely to report visual symptoms and to complain about night vision, although their changes were the same as those of the women. Residual refractive error was a major predictor for most questionnaire items.
Most patients were as satisfied or more satisfied with their postoperative uncorrected visual acuity than with their preoperative best corrected visual acuity. By continuing to minimize postoperative refractive error through the use of nomograms and improved technology, visual complaints such as night glare and halo could be diminished or even eliminated. The study shows that subjective experience affected satisfaction with results. Some dissatisfaction might be mitigated by being sure patients are educated and have realistic expectations before surgery.
确定波前引导准分子原位角膜磨镶术（LASIK）后患者感知与临床测量之间的相关性。
多中心临床试验。
在对274只眼的临床研究结果进行的这项回顾性分析中，在6个地点对274只近视散光眼进行了波前引导LASIK手术。术前及术后6个月对视力和眼部健康进行了全面评估。测量了视力和对比敏感度，并发放了问卷。将问卷回答与临床测量结果进行比较。
总体分布向“更满意”方向转变。所有领域中“非常满意”的人群增加了多达70%。视觉症状的发生率没有显著变化。患者对视力下降的表达比视力改善更明显。视力变化的感知似乎与中间视觉对比敏感度以及眩光下的中间视觉对比敏感度有关。中间瞳孔直径不是患者满意度的主要预测因素。隐形眼镜佩戴者对术后视力比眼镜佩戴者更满意。男性更有可能报告视觉症状并抱怨夜间视力，尽管他们的变化与女性相同。残余屈光不正对于大多数问卷项目来说是一个主要预测因素。
大多数患者对术后裸眼视力的满意度与术前最佳矫正视力相同或更高。通过继续使用列线图和改进技术将术后屈光不正降至最低，可以减少甚至消除诸如夜间眩光和光晕等视觉问题。该研究表明主观体验会影响对结果的满意度。在手术前确保患者得到教育并抱有现实期望，可能会减轻一些不满情绪。
