目的

探讨近视眼屈光手术患者手术期望值、依从性及其影响因素的占比。

方法

2022年4月至2022年5月采用整群抽样和线上问卷调查法在北京、上海、山东、新疆及浙江五省市发放问卷1139份纳入未行屈光手术的近视眼患者500例。其中，男性231例，女性269例；年龄19～49岁，平均年龄（25.0±5.0）岁。按等效球镜屈光度将患者分为低度近视眼、中度近视眼及高度近视眼。采用问卷调查的方式调查并记录患者的入选筛查、人口统计数据、近视眼病史及配戴框架眼镜的相关情况；对经上皮-准分子激光角膜切削术、准分子激光原位角膜磨镶术、飞秒激光小切口基质微透镜取出术、屈光性晶状体置换术及有晶状体眼人工晶状体植入术等5种手术方式的手术期望值和依从性。全部数据采用例数和百分比进行描述。连续型变量组间比较采用Kruskal-Wallis秩和检验，分类资料组间比较采用卡方检验。

结果

全部1139例患者中纳入应答者500例，问卷应答率为43.9%。患者主要由政府事业单位人员、在校学生和专业技术人员构成。全部纳入的患者500例中，对手术的期望能满足基本生活需要、高强度运动需求及高精度工作需求者分别为432例、386例及270例，分别占86.4%、77.2%及52.4%。年龄大、女性及月收入高的患者更倾向于术后视力要求能够满足高精度工作需要，其关联性具有统计学意义（OR＝1.04，0.62，0.42；P＜0.05）。患者的术后依从性倾向于术后使用2种药物、愿意每月随访1次及愿意坚持用药1个月者分别为274例、167例及223例，分别占58.3%、37.11%及47.5%。女性术后预期执行医嘱的依从性相比男性更高，其差异具有统计学意义（OR＝0.69，95%CI：0.42～0.91，P＜0.05）。

结论

不同职业和性别的近视眼患者对屈光矫正手术的预期存在差异，女性术后依从性更高，临床医师需要注重个性化治疗策略的选择。

Objective

To explore the surgical expectations，compliance，and the proportion of influencing factors among patients undergoing refractive surgery for myopia.

Methods

From April 2022 to May 2022，a cluster samplingmethod combined with an online questionnaire survey was employed to distribute 1139 questionnaires across five provinces and municipalities：Beijing，Shanghai，Shandong，Xinjiang，and Zhejiang.A total of500 cases of unoperated myopia patientswere enrolled.Among them，231 weremale and 269 were female，with an average age of（25.0±5.0）years（ranging from 19 to 49 years）.Patients were categorized into three groups based on equivalent spherical refractive power：mild myopia，moderatemyopia，and severe myopia.The study investigated and recorded patients′eligibility screening，demographic data，myopia history，and spectacle-wearing habits through questionnaire surveys.Additionally，the surgical expectations and compliance among patients who underwent five types of refractive surgeries were assessed：epithelial laser in situ keratomileusis（LASEK），laser-assisted in situ keratomileusis（LASIK），small incision lenticule extraction（SMILE），refractive lens exchange（RLE），and phakic intraocular lens（IOL）implantation.All data were described using counts and percentages.Continuous variables were compared between groups using the Kruskal-Wallis rank-sum test，while categorical data were analyzed using the chisquare test.

Results

Among the total1139 patients，500 responded to the questionnaire，resulting in a response rate of 43.9%.The patients primarily consisted of government employees，students，and technical professionals.Among the 500 included patients，432 patients，386 patients，and 270 patients respectively expected the surgery tomeet their basic living needs，high-intensity sports requirements，and high-precision work demands，accounting for 86.4%，77.2%，and 52.4% respectively.Older age，female gender，and highermonthly income were significantly associated with a higher expectation for the surgery to satisfy highprecision work needs（OR＝1.04，0.62，0.42；P＜0.05）.Post-surgery compliance was observed in 274 patients，167 patients，and 223 patients who used twomedications，attended follow-ups once amonth，and adhered tomedication for onemonth，respectively，accounting for 58.3%，37.11%，and 47.5%.Female patients demonstrated significantly higher compliance with post-surgery medical instructions compared to males（OR＝0.69，95%CI：0.42 to 0.91）.

Conclusions

There are differences in expectations for refractive correction surgery among patients of differentoccupations and genders，with females showing higher post-surgery compliance.Clinicians should focus on personalized treatment strategies.