Hieda Osamu, Nakamura Yo, Wakimasu Koichi, Yamamura Kiyoshi, Suzukamo Yoshimi, Kinoshita Shigeru, Sotozono Chie
Department of Ophthalmology, Kyoto Prefectural University of Medicine.
Baptist eye Institute, Kyoto.
Medicine (Baltimore). 2020 Feb;99(7):e19113. doi: 10.1097/MD.0000000000019113.
To evaluate the long-term efficacy of refractive surgery of all cases in a single center via the use of a patient-reported outcome (PRO) refractive status questionnaire using descriptive statistics. This study was prospective, single-center, cohort study that involved 1422 patients who underwent refractive surgery (laser in situ keratomileusis, surface ablation, and phakic intraocular lens) at Baptist Eye Institute, Kyoto, Japan. The patients were asked to answer the Refractive Status and Vision Profile (RSVP) questionnaire before the surgery after 6 months (n = 1133 patients) and after 5.5 years (n = 232 patients). During the same period, examination by slit-lamp biomicroscopy and visual acuity tests were performed. Moreover, the patients were asked to rate their satisfaction with the surgery 6 months and 5.5 years after it. We examined overall RSVP scale (S), 8 RSVP subscales, rate of satisfaction with surgical outcome, slit-lamp biomicroscopy findings, and refractive error. The mean preoperative S was 36, yet that score significantly improved to 19 at 6 postoperative months postoperatively (P < .01), and basically remained the same (i.e., 20) throughout the 5.5-year postoperative period. During the 5-year follow-up period, mean refractive error became slightly myopic (0.3 D). No change in the rate of satisfaction was observed at both 6 months and 5.5 years postoperative period. The findings of this study help to clarify long-term PRO quality of vision (QOV) postrefractive surgery in a single center, and show that minor change in refractive error during 5 years postoperative period had no influence on the mean RSVP scores among outpatients. Nearly all patients reported short-term improvement of QOV, which continued throughout the long-term follow-up period.
通过使用患者报告结局(PRO)屈光状态问卷,采用描述性统计方法评估单中心所有病例屈光手术的长期疗效。本研究为前瞻性、单中心队列研究,纳入了1422例在日本京都浸信会眼科研究所接受屈光手术(准分子原位角膜磨镶术、表面切削术和有晶状体眼人工晶状体植入术)的患者。患者在手术前、术后6个月(n = 1133例患者)和术后5.5年(n = 232例患者)被要求回答屈光状态和视力概况(RSVP)问卷。在此期间,进行了裂隙灯生物显微镜检查和视力测试。此外,还要求患者对术后6个月和5.5年的手术满意度进行评分。我们检查了RSVP总评分(S)、8个RSVP子量表、手术结果满意度、裂隙灯生物显微镜检查结果和屈光不正情况。术前S的平均分为36分,但术后6个月时该评分显著提高至19分(P <.01),并且在术后5.5年期间基本保持不变(即20分)。在5年的随访期内,平均屈光不正变为轻度近视(0.3 D)。术后6个月和5.5年时,满意度均未观察到变化。本研究结果有助于阐明单中心屈光手术后长期的PRO视力质量(QOV),并表明术后5年期间屈光不正的微小变化对门诊患者的平均RSVP评分没有影响。几乎所有患者均报告QOV在短期内有所改善,且在长期随访期间持续存在。