Abstract：Objective: To investigate the effect and clinical significance of corneal refractive surgery on binocular
visual function in myopia patients. Methods: This retrospective study was conducted with 82 patients (164
eyes) who underwent corneal refractive surgery at Changchun Aier Eye Refractive Surgery Center from
January 2018 to April 2020. The patients were aged 18 to 32 years (23.5±4.2). The preoperative spherical
equivalent (SE) ranged from -8.38 to -0.88 D (-4.75±1.69 D), and the enrolled patients were divided into
two groups on the basis of the SE values: 21 cases (42 eyes) in the anisometropia group, with a binocular
SE difference of ≥1.00 D; and 61 cases in the non-anisometropia group (122 eyes), with a binocular
SE difference of <1.00 D. Routine ophthalmic examination, accommodative function (amplitude of
accommodation, positive and negative relative accommodation, monocular and binocular accommodative
facility, binocular cross-cylinder), and vergence function (distance and near level phoria, positive and
negative fusion vergence, and accommodative convergence/accommodative ratio) were examined in all
patients before the operation and 1 week, 1 month, 3 months, and 6 months after the operation. Repeated
measurement analysis of variance was used to compare visual function between the two groups before
and after the operation. A two-factor repeated measurement analysis of variance and independent sample
t test were used to compare the groups. Spearman correlation analysis were used to study the relationship.
Results: In the anisometropia group, with respect to accommodative function, the accommodative
facility of the left eye decreased at 1 week after the operation compared to that before the operation,
and increased at 1, 3, and 6 months after the operation compared to accommodative facility before the
operation (F=2.552, P=0.045). With respect to vergence function, the near positive fusion vergence break
points and recovery points were all smaller than those before the operation (F=4.245, P=0.016; F=3.686,
P=0.009). In the non-anisometropia group, with respect to accommodative function, the positive relative
accommodation and amplitude of accommodation at each time point after the operation were higher
than those before the operation (F=16.118, P<0.001; F=14.839, P<0.001); with respect to the vergence
function, the distance level phoria was reduced at all time points after the operation in comparison with
those before the operation (F=2.898, P=0.029). The far negative fusion vergence break points and recovery
points, far positive fusion vergence recovery points, and near positive fusion vergence break points at all
time points after the operation were lower than those before the operation (F=7.310, P<0.001; F=5.131,
P=0.001; F=8.184, P<0.001; F=10.919, P<0.001). The far positive fusion vergence break points and near
positive fusion vergence recovery points gradually decreased after the operation, and were smaller at 1 to
6 months after the operation in comparison with the values before surgery, with the differences being
statistically significant (F=6.814, P<0.001; F=6.942, P<0.001). The far negative fusion vergence recovery
point increased significantly at 1 month after surgery in comparison with that before surgery, and gradually
decreased at 3 to 6 months after surgery, with no significant difference from the values before surgery
(F=2.811, P=0.037). There were statistically significant differences between the monocular accommodative
facility of the left eye and the binocular accommodative facility at different times in both the anisometropia
and non-anisometropia groups (right eye: FTime=0.555, P=0.655, FGroup=4.639, P=0.034, FInteraction=0.555,
P=0.655; left eye: FTime=2.611, P=0.048, FGroup=5.709, P=0.019, FInteraction=1.287, P=0.279; both eyes:
FTime=2.256, P=0.086, FGroup=4.314, P=0.041, FInteraction=0.847, P=0.465). Conclusions: The visual function
of myopia patients improves to varying degrees or is maintained at the preoperative level after corneal
refractive surgery, proving that corneal refractive surgery has a positive effect on visual function.
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