L.T. SHAMSETDINOVA, I.A. MUSHKOVA, E.Yu. MARKOVA, N.V. MAYCHUK

The S. Fyodorov Eye Microsurgery Federal State Institution, 59a Beskudnikovsky Blvd., Moscow, Russian Federation 127486

Shamsetdinova L.T. ― clinical postgraduate student of the Department of Refractive Laser Surgery, e-mail: leylaapa@gmail.com

Mushkova I.A. ― D. Med. Sc., Head of the Department of Refractive Laser Surgery, e-mail: i.a.muskova@mail.ru

Markova E.Yu. ― D. Med. Sc., Head of the Department of Children’s Eye Microsurgery and Functional Rehabilition, e-mail: markova-ej@mai.ru

Maychuk N.V. ― Cand. Med. Sc., Senior Researcher of Department of Refractive Laser Surgery, e-mail: drmaichuk@yandex.ru

This article describes the results of postoperative asthenopia risk factors in patients with moderate and high myopia. 122 patients (244 eyes) underwent standard examination before corneal refractive surgery (CRS), as well as special research of accommodation and binocular functions. Customized Femto-LASIK was performed in all cases. Uncorrected vision acuity postoperatively was equal to or exceeding the preoperative best corrected vision acuity in all eyes. According to the convergence insufficiency symptom survey (CISS) survey performed 1 week after the surgery, patients were divided into 2 groups: group 1 (with the symptoms of asthenopia) and group 2 (without asthenopia). The retrospective analysis of the results of preoperative studies showed that the combination of accommodation disorders, low fusion reserves and the absence of binocular vision could prevent the adaptation to the CRS results and may be the risk factors of postoperative asthenopia development. CRS in patients with moderate and high myopia accompanied by the binocular vision allows improving the subjective and objective parameters of the accommodative function, which were reduced in the preoperative period, and correlates with patients’ satisfaction with the results of the refractive errors correction.

Key words: refractive surgery, asthenopia after refractive surgery, accommodation disorders, low fusion reserves, asthenopia.

REFERENCES

1. Katargina L.A., ed. Akkomodatsiya. Rukovodstvo dlya vrachey [Accommodation. A guide for doctors]. Moscow: Aprel; 2012. Pp. 40-9.
2. Somov E.E. Metody oftalʹmoergonomiki [Methods of ophthalmoergonomics]. Leningrad: Nauka, 1989. 158 p.
3. Dashevskiy A.I. Zritelʹnoe utomlenie kak snizhenie zritelʹnoy rabotosposobnosti i metody ego izmereniya [Visual fatigue as a decrease in visual performance and methods for measuring it]. Rukovodstvo po glaznym boleznyam. Vol. 1; part 1. Moscow: Medgiz, 1962. Pp. 182-93.
4. Shapovalov S.L., Milyavskaya T.I., Ignatʹev S.A. Osnovnye formy astenopii [The main forms of asthenopia]. Moscow: Mik, 2012. 288 p.
5. Abdi S. Asthenopia in school children. Thesis for doctoral degree. Stockholm, 2007. 168 r.
6. Noorden G.K., Campos E.C. Binocular vision and ocular motility. Mosby, 2002. R. 153-154.
7. Proskurina O.V. et al. Current classification of asthenopia: clinical forms and stages. Rossiyskiy oftalʹmologicheskiy zhurnal, 2016, no. 4, pp. 69-73 (in Russ.).
8. Godts D., Tassignon M.J., & Gobin L. Binocular vision impairment after refractive surgery. Journal of cataract and refractive surgery, 2004, 30, pp. 101-109. doi:10.1016/S0886-3350(03)00412-7.
9. Jimenez J., Villa C., Gonzalez-Anera R., Gutierrez R. Binocular visual performance after LASIK. J. Refract. Surg, 2006, 22, pp. 679-88.
10. Kushner B.J., Kowal L. Diplopia after refractive surgery. Arch. Ophthalmol, 2003, 121, pp. 315-21.
11. Anera R., Jimenez J., Villa C., et al. Technical note: Pre-surgical anisometropia influences post-LASIK binocular mesopic contrast sensitivity function. Ophthalmic Physiol. Optics, 2007, 27, pp. 210-2.
12. Pisarevskaya O.V., Mikhalevich I.M. Patterns and mechanisms of changes of structural-functional status of the visual system in patients with high myopia after laser keratomileusis and binarimeter. Byulletenʹ VSNTS SO RAMN, 2009, 5-6, pp. 69-70 (in Russ.).
13. Scheiman M., Mitchell G.L., Cotter S. et al. A randomized clinical trial of vision therapy / orthoptics versus pencil push ups for the treatment of convergence in sufficiency in young adults. Optom Vis. Sci, 2005, 82, pp. 583-95.
14. Shchukin S.Yu. Increase in «quality of visual life» of patients after excimer laser correction of myopia. Vestnik meditsinskogo stomatologicheskogo instituta, 2012, 2, pp. 54-57 (in Russ.).