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目的观察视网膜光凝术后糖尿病视网膜病变(DR)患者眼近期调节力的变化。设计前瞻性病例系列。研究对象15例(30眼)确诊须行眼底激光治疗的DR患者,平均年龄(57.4±13.4)岁。方法由同一操作者进行视网膜光凝术,观察患者同一只眼激光前、激光后第1、3、7、14天的调节功能指标和视力。主要指标调节幅度、正相对调节、负相对调节、最佳矫正远视力、近视力。结果激光后各时间点的单眼调节幅度、正相对调节均较激光前有所下降(F=34.19,P=0.00;F=23.68,P=0.00),差异有统计学意义。下降规律是从激光后第1天开始,第3天幅度最大,第7天稍有恢复,第14天的观察时间内未恢复到激光前。负相对调节在激光前后的比较差异无统计学意义(F=0.569,P=0.686)。激光后的近视力较激光前有所下降(F=5.54,P=0.00),且变化规律与单眼调节幅度、正相对调节相似。结论在激光后14天的观察时间内,视网膜光凝术会导致DR患眼近期调节力下降。
Objective To investigate the changes of accommodative capacity in patients with diabetic retinopathy (DR) after retinal photocoagulation. Design prospective case series. Fifteen patients (30 eyes) with DR diagnosed with fundus laser were diagnosed. The mean age was (57.4 ± 13.4) years old. Methods Retinal photocoagulation was performed by the same operator, and the regulatory function and visual acuity of the same eye on the 1st, 3rd, 7th and 14th days after the laser was observed. The main indicators of adjustment, is the relative regulation, negative relative regulation, the best correction of far vision, near vision. Results After laser, the amplitude of monocular adjustment and the relative regulation of laser were decreased compared with that before laser (F = 34.19, P = 0.00; F = 23.68, P = 0.00). The difference was statistically significant. Decline law is from the first day after laser, the third day the largest amplitude, a slight recovery on the 7th day, the first 14 days of observation did not recover to the laser before. Negative relative adjustment in the laser before and after the comparison was not statistically significant (F = 0.569, P = 0.686). The laser near-vision decreased compared with the pre-laser (F = 5.54, P = 0.00), and the change rule was similar to the monocular adjustment amplitude and positive relative regulation. Conclusion During the observation period of 14 days after laser, retinal photocoagulation will result in the decrease of accommodation power of DR in the near future.