目的：分析不同程度近视患者FS-LASIK术后满意度和夜间视觉症状及其相关因素。

方法：回顾性研究。纳入2018-06/2019-09在我院行FS-LASIK术后3mo以上的近视患者75例150眼，根据术前等效球镜度(SE)分为高度近视组(≥-6.00组，43例86眼)和中低度近视组(<-6.00D，32例64眼)。术后6mo，使用Sirius三维眼前节分析系统测量角膜地形图及7mm暗瞳孔直径角膜高阶像差(总高阶像差、球差、彗差、三叶草差)，并填写问卷评估术后满意度及夜间视觉症状。

结果：高度近视组和中低度近视组术前等效球镜度分别为-7.85±1.27、-4.57±1.01D。术后两组患者7mm暗瞳孔直径角膜总高阶像差、球差、彗差均有差异(P<0.001)，三叶草差无差异(P>0.05)。高度近视组和中低度近视组术后满意度分别为95.3%和100.0%； 两组中分别有18.8%、9.3%的患者认为夜间视力比术前差，51.2%、40.6%的患者出现光晕症状，41.9%、43.8%的患者出现星芒症状，18.6%、15.6%的患者出现重影症状。两组患者除夜间视力有差异(P=0.010)外，其它夜间视觉症状无差异(均P>0.05)。纳入患者术后满意度与术前散光、光学区直径大小呈正相关(均P<0.05)； 夜间视力与术前SE、术后角膜曲率呈正相关(均P<0.05)，与术中切削深度、术后角膜总高阶像差、球差、彗差呈负相关(均P<0.05)； 星芒症状与术前角膜总高阶像差、彗差及术后三叶草差呈正相关(均P<0.05)； 重影症状与术前散光呈正相关(P<0.05)。

结论：高度近视患者术后夜间视力较中低度近视患者差，主要与暗瞳孔环境下总高阶像差、球差、彗差增加有关； 高度近视术后可出现与低中度近视相似程度的光晕、星芒、重影症状，但不影响术后总体满意度。

METHODS:This was a retrospective study. Totally 75 patients(150 eyes)who underwent FS-LASIK in Xi'an No.1 Hospital from June 2018 to September 2019 were included. All subjects were divided into two groups based on spherical equivalent(SE): high myopia group(SE≥-6.00D)and low-to-moderate myopia group(<-6.00D). Six months after surgery, corneal topography and corneal higher-order aberrations(total HOAs, spherical aberrations, coma and trefoil)under 7mm pupil diameter was investigated by Sirius. Patients were required to complete a questionnaire to evaluate satisfaction and night vision symptoms.

RESULTS:For the high myopia group and low-to-moderate myopia group, preoperative SE was -7.85±1.27D and -4.57±1.01D respectively. There were significant differences in total HOAs, spherical aberrations and coma(all P<0.001)except for the trefoil(P>0.05)between the two groups. Overall satisfaction was 95.3% and 100.0% in high and low-to-moderate myopia group. 18.8% and 9.3% experienced worsen night vision, 51.2% and 40.6% experienced halo, 41.9% and 43.8% experienced starburst, and 18.6% and 15.6% experienced double vision, respectively. Except that there was significant differences in night vision between the two groups(P=0.010), the occurrence of other night vision symptoms were similar and there were no significant differences in any of them(all P>0.05). For all patients, the satisfaction was correlated with preoperative astigmatism and ablation zone(all P<0.05), night vision was correlated with preoperative SE, ablation depth, corneal curvature, total HOAs, spherical aberrations and coma postoperatively(all P<0.05), star burst was correlated with preoperative total HOAs, coma and postoperative trefoil(all P<0.05), double vision was correlated with preoperative astigmatism(P<0.05).

CONCLUSION: High myopic patient experienced worsen night vision mainly because of increased total HOAs, spherical aberration and coma. However, symptoms such as halo, starburst and double vision were similar in both groups and did not affect overall satisfaction.