标准与规范
ENGLISH ABSTRACT
中国激光角膜屈光手术术前验光及单眼视模拟专家共识(2023)
《中国激光角膜屈光手术术前验光及单眼视模拟专家共识(2023)》专家组
中国民族卫生协会眼学科分会屈光学组
作者及单位信息
·
DOI: 10.3760/cma.j.cn115989-20230809-00064
Expert consensus on preoperative refraction and simulation of monocular vision for laser vision correction in China (2023)
Expert Work group of Expert consensus on preoperative refraction and simulation of monocular vision for laser vision correction in China (2023)
Division of Refractive Surgery Branch of Ophthalmology, China National Health Association
Zhou Xingtao
Authors Info & Affiliations
Expert Work group of Expert consensus on preoperative refraction and simulation of monocular vision for laser vision correction in China (2023)
Division of Refractive Surgery Branch of Ophthalmology, China National Health Association
Zhou Xingtao
Department of Ophthalmology, Eye & ENT Hospital, Fudan University, NHC Key Laboratory of Myopia, Shanghai Research Center of Ophthalmology and Optometry, Shanghai 200031, China
·
DOI: 10.3760/cma.j.cn115989-20230809-00064
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摘要

近年来,激光在临床治疗中的应用日益广泛,激光角膜屈光手术已成为矫治近视及老视等屈光不正的重要方式之一,为我国成年人屈光不正的矫正提供了重要的技术支撑。目前,不断提高相关患者的视觉和生活质量仍是激光角膜屈光手术追求的最终目标,而精确的术前验光和单眼视耐受性模拟是保证手术有效性、实现患者最优视觉质量、同时达到患者术后舒适性的重要环节,但目前我国仍缺乏规范的验光流程、术前相关检查项目及结果判断的标准化,以及术前与患者进行有效沟通的要点。为规范从事屈光临床研究者及相关从业人员的术前检查流程和检查方法,中国民族卫生协会眼学科分会屈光学组组织我国相关领域专家,在复习和研究国内外循证医学研究文献的基础上,归纳我国临床存在的、亟待解决的相关问题,结合本专业领域专家的临床实践,充分讨论并制定《中国激光角膜屈光手术术前验光及单眼视模拟专家共识(2023)》,就激光角膜屈光手术前主觉验光、客观验光、主客观结合验光、主视眼判断、双眼视觉功能检查及单眼视耐受性试戴模拟等临床问题提出专家推荐意见,旨在提高从事屈光诊疗的专业人员及相关从业人员对激光角膜屈光手术术前验光和单眼视试戴模拟的精确度及合理评估患者的耐受程度,使我国激光角膜屈光手术验光诊疗工作更加规范化、个性化和人文化。

屈光不正/手术;近视;老视;验光;单眼视耐受性模拟;专家共识;激光角膜屈光手术
ABSTRACT

With the widespread application of laser vision correction in clinical treatment, it has become one of the important treatment methods for the correction of refractive errors, such as myopia and presbyopia, and provides important technical support for the treatment for refractive errors in Chinese adults.At present, continuously improving the visual acuity and quality of life is still the ultimate goal pursued by refractive surgeons.Accurate preoperative refraction and simulation of monocular vision are important procedures to ensure surgical effectiveness, achieve optimal visual quality, and achieve postoperative comfort for patients.However, up to now, there is no prefer practice pattern for refraction in China, standardized preoperative examination or effective consultations with patients before surgery.In order to standardize the preoperative examination for clinical researchers and practitioners engaged in laser vision correction, the Division of Refractive Surgery Branch of Ophthalmology, China National Health Association organized experts to review evidence-based literature nationally and internationally, summarize the clinical problems that need to be solved in clinical practice.After discussion, the experts develop the Expert consensus on preoperative refraction and simulation of monocular vision for laser vision correction in China (2023) and provide recommendations on clinical issues such as subjective refraction, objective refraction, subjective combined with objective refraction, dominant eye evaluation, binocular visual function examination, and monocular vision simulation before laser vision correction.The aim of this consensus is to improve the accuracy of preoperative refraction and monocular vision test for laser vision correction, and to make laser vision correction more standardized, personalized and humanistic in China.

Refractive error/surgery;Myopia;Presbyopia;Refraction;Simulation of monocular vision;Expert consensus;Laser vision correction
Zhou Xingtao, Department of Ophthalmology, Eye & ENT Hospital, Fudan University, NHC Key Laboratory of Myopia, Shanghai Research Center of Ophthalmology and Optometry, Shanghai 200031, China, Email: mocdef.3ab61oatgnixuohztcod
引用本文

《中国激光角膜屈光手术术前验光及单眼视模拟专家共识(2023)》专家组,中国民族卫生协会眼学科分会屈光学组. 中国激光角膜屈光手术术前验光及单眼视模拟专家共识(2023)[J]. 中华实验眼科杂志,2023,41(12):1145-1151.

DOI:10.3760/cma.j.cn115989-20230809-00064

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我国每年有百万屈光不正患者接受激光角膜屈光手术,传统的激光角膜屈光手术多涉及年轻患者近视的矫治,近年来越来越多的老视人群也开始选择激光角膜屈光手术进行老视矫治,激光角膜屈光手术量逐年上升。随着我国角膜屈光手术的广泛开展及相关专家共识的发布,手术质量及患者术后视觉质量均不断提升,影响术眼术后视力恢复的严重并发症已罕有发生 [ 1 ]。然而,随着眼科研究的快速进步以及角膜屈光手术设备和手术方式的不断更新,患者对术后视觉质量的要求不断提高,因此优化角膜屈光手术方法以提高手术预测性是临床医生的不懈追求,而精准的术前验光是保证手术质量的关键环节。术前验光检查受操作者经验和理解不同的影响而导致验光结果的差异,如何优化及规范受检眼的术前验光、单眼视耐受性模拟的流程和术前沟通要点,是进一步提高我国激光角膜屈光手术术后预测性和患者满意度的关键,但目前国内外尚无规范激光角膜屈光手术术前验光和单眼视模拟的指南和专家意见。中国民族卫生协会眼学科分会屈光学组于2022年5月组织成立《中国激光角膜屈光手术术前验光及单眼视模拟专家共识(2023)》(简称《共识》)撰写组,专家组成员包括屈光手术专业专家、中华医学会激光医学分会专家、中华医学会角膜病学组相关专家及相关辅助检查专业专家。专家组成员对全国具备开展激光角膜屈光手术资质的医疗单位手术负责人和相关检查人员进行调查,收集并整理术前验光及单眼视模拟检查时面临的亟待解决的临床问题。由于目前该领域尚未形成统一的可遵循指南,本专家组检索并复习PubMed数据库、《中华眼科杂志》、《中华实验眼科杂志》和《中华眼视光学与视觉科学杂志》等发表的相关文献,结合临床实践归纳并整理重要的临床问题,组织线上和线下会议,针对收集的问题进行充分讨论和论证。执笔成员依据专家组的讨论撰写《共识》初稿,通过电子邮件或微信方式提请各位专家独立审阅并提出修改意见,执笔成员收到反馈意见并整理,通过讨论确定是否接受修改意见并对《共识》稿件进行反复修改,于2023年8月通过专家组成员的线上沟通达成《共识》终稿,对中国激光角膜屈光手术术前验光及单眼视模拟的标准化操作提出专家推荐建议,供我国激光角膜屈光手术相关医技医护人员及相关从业者在临床工作实践中参照实施。
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参考文献
[1]
中华医学会眼科学分会眼视光学组中国医师协会眼科医师分会眼视光学组中国医师协会眼科医师分会屈光手术学组中国角膜屈光手术围手术期干眼诊疗专家共识(2021年)[J]中华眼科杂志 202157(9)∶644650. DOI: 10.3760/cma.j.cn112142-20210312-00124 .
返回引文位置Google Scholar
百度学术
万方数据
Chinese Optometric Association of Chinese Ophthalmological SocietyOptometry Group of Chinese Ophthalmologist AssociationRefractive Surgery Group of Chinese Ophthalmologist Association. Expert consensus on the diagnosis and treatment of dry eye during perioperative period of corneal refractive surgery in China (2021)[J]Chin J Ophthalmol 202157(9)∶644650. DOI: 10.3760/cma.j.cn112142-20210312-00124 .
Goto CitationGoogle Scholar
Baidu Scholar
Wanfang Data
[2]
计岩郑克李莹飞秒激光小切口角膜基质透镜取出术患者沟通专家指导意见[J]中国眼耳鼻喉科杂志 202222(6)∶661664. DOI: 10.14166/j.issn.1671-2420.2022.06.027 .
返回引文位置Google Scholar
百度学术
万方数据
Ji Y Zheng K Li Y et al. Expert guidance for communication with patients for femtosecond laser small incision lenticule extraction[J]Chin J Ophthalmol Otorhinol 202222(6)∶661664. DOI: 10.14166/j.issn.1671-2420.2022.06.027 .
Goto CitationGoogle Scholar
Baidu Scholar
Wanfang Data
[3]
中华医学会眼科学分会眼视光学组中国经上皮准分子激光角膜切削术专家共识(2019年)[J]中华眼科杂志 201955(3)∶169173. DOI: 10.3760/cma.j.issn.0412-4081.2019.03.003 .
返回引文位置Google Scholar
百度学术
万方数据
[4]
中华医学会眼科学分会眼视光学组我国飞秒激光小切口角膜基质透镜取出手术规范专家共识(2018年)[J]中华眼科杂志 201854(10)∶729736. DOI: 10.3760/cma.j.issn.0412-4081.2018.10.003 .
返回引文位置Google Scholar
百度学术
万方数据
[5]
中华医学会眼科学分会斜视与小儿眼科学组中国儿童睫状肌麻痹验光及安全用药专家共识(2019年)[J]中华眼科杂志 201955(1)∶712. DOI: 10.3760/cma.j.issn.0412-4081.2019.01.003 .
返回引文位置Google Scholar
百度学术
万方数据
[6]
瞿佳眼视光学理论和方法[M]. 3版北京人民卫生出版社 20181896.
[7]
Iizuka T Kawamorita T Handa T et al. Refractive and visual function changes in twilight conditions[J/OL]PLoS One 202217(4)∶e0267149[2023-07-20]https://pubmed.ncbi.nlm.nih.gov/35427398/. DOI: 10.1371/journal.pone.0267149 .
返回引文位置Google Scholar
百度学术
万方数据
[8]
Chirre E Prieto PM Schwarz C et al. Night myopia is reduced in binocular vision[J/OL]J Vis 201616(8)∶16[2023-07-20]https://pubmed.ncbi.nlm.nih.gov/27333457/. DOI: 10.1167/16.8.16 .
返回引文位置Google Scholar
百度学术
万方数据
[9]
Reinstein DZ Yap TE Carp GI et al. Reproducibility of manifest refraction between surgeons and optometrists in a clinical refractive surgery practice[J]J Cataract Refract Surg 201440(3)∶450459. DOI: 10.1016/j.jcrs.2013.08.053 .
返回引文位置Google Scholar
百度学术
万方数据
[10]
Taneri S Arba-Mosquera S Rost A et al. Repeatability and reproducibility of manifest refraction[J]J Cataract Refract Surg 202046(12)∶16591666. DOI: 10.1097/j.jcrs.0000000000000343 .
返回引文位置Google Scholar
百度学术
万方数据
[11]
Jacobs DS Afshari NA Bishop RJ et al. Refractive errors preferred practice pattern ® [J]Ophthalmology 2023130(3)∶160. DOI: 10.1016/j.ophtha.2022.10.031 .
返回引文位置Google Scholar
百度学术
万方数据
[12]
瞿佳眼视光学理论和方法[M]. 3版北京人民卫生出版社 2018129140.
[13]
李珊珊吴昌凡赵海峰主导眼与眼部疾病的相关性研究进展[J]中华眼视光学与视觉科学杂志 202224(7)∶551555. DOI: 10.3760/cma.j.cn115909-20210218-00064 .
返回引文位置Google Scholar
百度学术
万方数据
Li SS Wu CF Zhao HF . Current research on correlation between dominant eye and ocular diseases[J]Chin J Optom Ophthalmol Vis Sci 202224(7)∶551555. DOI: 10.3760/cma.j.cn115909-20210218-00064 .
Goto CitationGoogle Scholar
Baidu Scholar
Wanfang Data
[14]
WALLS GL . A theory of ocular dominance[J]AMA Arch Ophthalmol 195145(4)∶387412. DOI: 10.1001/archopht.1951.01700010395005 .
返回引文位置Google Scholar
百度学术
万方数据
[15]
Russo A Reinstein DZ Filini O et al. Visual and refractive outcomes following laser blended vision with non-linear aspheric micro-anisometropia (PRESBYOND) in myopic and hyperopic patients[J]J Refract Surg 202238(5)∶288297. DOI: 10.3928/1081597X-20220323-01 .
返回引文位置Google Scholar
百度学术
万方数据
[16]
中国医师协会眼科医师分会屈光手术学组中国伴年龄相关性调节不足屈光不正患者激光角膜屈光手术专家共识(2021年)[J]中华眼科杂志 202157(9)∶651657. DOI: 10.3760/cma.j.cn112142-20210523-00246 .
返回引文位置Google Scholar
百度学术
万方数据
Refractive Surgery Group of Chinese Ophthalmologist Association. Chinese expert consensus on laser corneal refractive surgery for correction of refractive errors with age-related accommodation deficiency (2021)[J]Chin J Ophthalmol 202157(9)∶651657. DOI: 10.3760/cma.j.cn112142-20210523-00246 .
Goto CitationGoogle Scholar
Baidu Scholar
Wanfang Data
[17]
张悦王雁徐路路近视人群主导眼与非主导眼全眼、角膜前表面及眼内散光的差异[J]中华实验眼科杂志 202341(3)∶271275. DOI: 10.3760/cma.j.cn115989-20190522-00227 .
返回引文位置Google Scholar
百度学术
万方数据
Zhang Y Wang Y Xu LL et al. Differences in refractive astigmatism,anterior corneal surface astigmatism and ocular residual astigmatism between dominant and non-dominant eyes in myopia[J]Chin J Exp Ophthalmol 202341(3)∶271275. DOI: 10.3760/cma.j.cn115989-20190522-00227 .
Goto CitationGoogle Scholar
Baidu Scholar
Wanfang Data
[18]
邹昊翰王雁崔彤飞秒激光小切口角膜透镜取出术前后主导眼变化及其影响因素[J]中华实验眼科杂志 202240(11)∶10851089. DOI: 10.3760/cma.j.cn115989-20190306-00101 .
返回引文位置Google Scholar
百度学术
万方数据
Zou HH Wang Y Cui T et al. Ocular dominance switches after small incision lenticule extraction and its influencing factors[J]Chin J Exp Ophthalmol 202240(11)∶10851089. DOI: 10.3760/cma.j.cn115989-20190306-00101 .
Goto CitationGoogle Scholar
Baidu Scholar
Wanfang Data
[19]
王光霁双眼视觉学[M]. 3版北京人民卫生出版社 20185575.
[20]
Muthu S Jethani J Annavajjhala S et al. Integrating binocular vision assessment in refractive surgery work-up:proposition and protocol[J]Indian J Ophthalmol 202068(12)∶28352846. DOI: 10.4103/ijo.IJO_2724_20 .
返回引文位置Google Scholar
百度学术
万方数据
[21]
兰长骏谭青青廖萱重视屈光手术相关的双眼视觉异常问题及其风险筛查[J]中华实验眼科杂志 202038(2)∶8184. DOI: 10.3760/cma.j.issn.2095-0160.2020.02.001 .
返回引文位置Google Scholar
百度学术
万方数据
Lan CJ Tan QQ Liao X Binocular vision problems associated with refractive surgery and the use of risk screening[J]Chin J Exp Ophthalmol 202038(2)∶8184. DOI: 10.3760/cma.j.issn.2095-0160.2020.02.001 .
Goto CitationGoogle Scholar
Baidu Scholar
Wanfang Data
[22]
陈茹茹吕帆王瑞珺单眼深度知觉对调节反应的影响[J]中华实验眼科杂志 201533(6)∶519524. DOI: 10.3760/cma.j.issn.2095-0160.2015.06.009 .
返回引文位置Google Scholar
百度学术
万方数据
Chen RR Lyu F Wang RJ et al. Effect of monocular depth perception on accommodative response[J]Chin J Exp Ophthalmol 201533(6)∶519524. DOI: 10.3760/cma.j.issn.2095-0160.2015.06.009 .
Goto CitationGoogle Scholar
Baidu Scholar
Wanfang Data
[23]
Gupta N Naroo SA Wolffsohn JS . Is randomisation necessary for measuring defocus curves in pre-presbyopes?[J]Cont Lens Anterior Eye 200730(2)∶119124. DOI: 10.1016/j.clae.2007.02.005 .
返回引文位置Google Scholar
百度学术
万方数据
备注信息
A
周行涛,复旦大学附属眼耳鼻喉科医院 国家卫生健康委近视眼重点实验室 上海市眼视光学研究中心,上海 200031,Email: mocdef.3ab61oatgnixuohztcod
B
http://www.guidelines-registry.cn/,PREPARE-2023CN479
C
http://www.guidelines-redistry.cn/,PREPARE-2023CN479
D
所有作者均声明不存在利益冲突。本共识制定过程中的资金来源于国家自然科学基金资助,未接受任何企业的赞助
E
本共识专家组声明坚持客观立场,以专业知识、研究数据和临床经验为依据,由中国民族卫生协会眼学科分会屈光学组部分专家起草,经过学组专家背对背修订和充分讨论,最终形成本共识
F
本共识的内容仅代表参与制定的专家对本共识的指导意见,供屈光手术专科医师、检查医师和技师参考。尽管专家们进行了广泛的意见征询和讨论,但仍有不全面之处。本共识所提供的建议并非强制性意见,与本共识不一致的做法并不意味着错误或不当。随着临床经验的积累和治疗手段的涌现,以及临床研究的更新,未来需要对本共识定期修订、更新,为患者带来更多临床获益
G
本《共识》将在《中华实验眼科杂志》期刊正式发表,利用杂志自媒体平台免费推送并在屈光手术大会进行宣讲,为从事角膜屈光手术诊疗工作的眼科医师和技师解读本共识内容并进行相关培训。建议临床屈光手术医师和研究者关注本《共识》的发布情况,充分了解相关规范和建议,更好地造福广大患者
H
国家自然科学基金面上项目 (82271119)
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