·论著·作者单位:221002徐州市眼病防治研究所(金红颖、王丹梅、孟觉天);温州医学院附属眼视光医院(王勤美)通讯作者:金红颖,Email:hongyingj@21cn.com角膜屈光手术对眼波前像差的影响金红颖王勤美王丹梅孟觉天【摘要】目的探讨大光斑式切削屈光手术对眼波前像差的影响,观察不同瞳孔区眼波前像差的改变。方法检查45例准分子激光原位角膜磨镶术(laserinsitukeratomileusis,LASIK)患者术前、术后10d和术后1个月的裸眼视力(uncorrectedvisualacuity,UCVA)、最佳矫正视力(bestcorrectedvisualacuity,BCVA)、等效球镜度(sphericalequivalent,SE)及波前像差,根据术前SE将患者分为高度、中度和低度3个不同的屈光度数组。使用Allegretto客观式波前像差分析仪检查眼部的波前像差,将所得数据进行统计学处理。结果术前平均BCVA为4198±0107;术后10d平均UCVA为4192±0110,BCVA为4195±0109;术后1个月时平均UCVA为4196±0109,BCVA为4199±0109。视力在术后随时间延长而好转,术后1个月时26只眼(3016%)BCVA好于术前。术后10d各组的SE为轻度远视或正视状态,随时间延长向近视方向漂移。各屈光度数组内,术后10d与1个月时,高阶像差为术前的2倍以上,以5阶二次彗差为最(P<0105);术后1个月,高阶像差比术后10d有减小(P>0105),但未恢复至术前水平。总像差术后较术前减小。各组内,无论术前术后,瞳孔直径为615mm时的像差显著大于瞳孔直径为4mm时的像差(P<0101)。在不同屈光度数组间,术前的高阶像差差异无显著意义(P>0105),而在术后10d及1个月,高阶像差的差异有显著意义(P<0105)。结论LASIK术后的高阶像差比术前明显增大,但随着时间的推移,像差减小,但未恢复到术前水平;屈光度数愈高,像差愈大;不同屈光度数的患者,术前的像差比较,差异无显著意义,术后差异出现显著意义。手术前后615mm瞳孔区的像差大于4mm瞳孔区的像差,并以球差最为显著。Allegretto系统适用于检测中低度近视患者的波前像差。【关键词】屈光,眼;角膜磨镶术,激光原位;近视InfluenceofcornealrefractivesurgeryonwavefrontaberrationsofhumaneyeJINHong2ying3,WANGQin2mei,WANGDan2mei,MENGJue2Tian13EyeInstituteofXuzhou,Xuzhou221002,ChinaCorrespondingauthor:JINHong2ying,Email:hongyingj@21cn1com【Abstract】ObjectiveToanalyzetheaberrationofhumaneyesafterLASIKbyusingwavefrontanalyzer,toevaluatetheeyeaberrationsbyusingthelargespotinrefractivesurgery,andtocomparetheaberrationsindifferentpupilzones1MethodsThisisaprospectiveclinicalstudy1Preoperativelyandpostoperatively,uncorrectedvisualacuity(UCVA),bestcorrectedvisualacuity(BCVA),sphericalequivalent(SE)andaberrationswereevaluatedoneachpatient1ThepatientsweredividedintothreedifferentgroupsaccordingtotheSEdiopterbeforethesurgery1WeusedtheSASandSPSS1010statisticsoftwaretoanalyzethedata1ResultsPreoperatively,BCVAwas4198±01071Tendaysaftersurgery,UCVAandBCVAwere4192±0110and4195±0109,respectively1Onemonthaftersurgery,UCVAandBCVAwere4196±0109and4199±0109,respectively1Overtime,visualacuityimprovedwithPostoperatively,partsoftheeye′sBCVAwerebetterthanpreoperatively1TendaysafterLASIK,theSEofthreegroupswerehyperopic1Butwithtime,SEchangestomyopia1IntheAllegrettoexam,highorderaberrationsincreasedimmediatelyaftersurgeryineachgroup(P<0105),butdecreasedwithtime(P>0105)anddidnotreturntopreoperativevaluesatonemonth1Preoperatively,thetotalaberrations(RMSg)werelargerthanpostoperatively1Theaberrationsespeciallysphericalarelargerinthe615mmpupilzonethaninthe4mmpupilzone1Preoperatively,therewerenosignificantdifferencesofhighorderaberrationsbetweenthethreegroups(P>0105)1Butaftersurgery,thereweresignificantdifferences(P<0105)1ConclusionsInitially,highorderaberrationsincreasedafterLASIK,butdecreasedovertime1Preoperatively,therewerenosignificantdifferencesofaberrationsbetw...
