水平斜视手术对眼波前像差的影响  

Effect of horizontal strabismus operation to wavefront aberration

作　　者：亢晓丽[1] 韦严[1] 杨积文[1] 赵平[1] 

机构地区：[1]中国医科大学附属第一医院眼科,沈阳110001

出　　处：《中国实用眼科杂志》2007年第1期47-49,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的观察并分析水平斜视矫正术前、后眼波前像差的动态变化。方法选择水平斜视患者26例30眼，年龄16～40岁（平均22岁），内斜10例，外斜16例。角膜无病变，均为首次手术患者，无弱视患者，均行单眼水平肌后徙加缩短术。术后随访观察60天。分别于手术前1天和手术后1，7，30，60天。用主观单色波前像差测量仪（苏州亮睛医疗器械有限公司WFA1000B波前像差仪）测量波前总像差及各分阶像差的改变。将所得数据进行统计学处理。结果1．二阶像差和二阶第5项X轴方向散光术后30天内均较术前增高，差别有统计学意义，术后60天恢复。二阶第3项Y轴散光和第4项离焦手术前后无差别。2．总的波前像差和高阶像差术后1天较术前明显增高，差别有统计学意义，但术后7天，即恢复至术前水平。结论1．水平肌退缩术会引起眼低阶像差的增加，术后增大的像差是二阶第五项像差（X轴方向的散光），说明水平斜视手术影响低阶像差中在水平方向的屈光力，而对垂直方向的屈光力和离焦（球镜）无影响。2．水平斜视手术可引起眼高阶像差的显著增加，但这种变化是一过性的，术后7天即可消失。3．斜视手术引起的眼高阶和低阶像差改变分别在术后7—60天内可逐渐恢复至术前水平，不会对视功能造成远期影响。Objective Investigate dynamic changes in wavefront aberration by comparing the preand postoperative aberration of patients with horizontal strabismus surgery. Methods 26 horizontal strabismus patients （30 eyes） were collected and excluded the corneal disease and amblyopia, whose age ranges from 16 to 44 （average age 22）, including 10 esophoria and 16 exotropia. The wavefront aberration was examined lday before surgery and 1,7,30 and 60 days after horizontal rectus recession and resection with wavefront aberrometer （Suzhou Brite Eye Aberrometer WFA1000B）. Results A significant change in RMS2 and z5 （astigmatism in 180 degree） was detected in 30 days after surgery, induced aberration returned to the initial value after 60 days. Changes of z3（astigmatism in 90 degree） and z4（defocus） were not statistically significant. The overall and high level wavefront aberration significantly changed ldays after surgery and returned to preoperative level 7days later. Conclusion 1.Horizontal strabismus surgery increased low level wavefront aberration, and the change took place in z5 （astigmatism in 180 degree）, which means that horizontal strabismus surgery affected diopter at X axis rather than diopter at Y axis and defocus. 2. High level aberration were significantly increased after horizontal strabismus surgery, but the change was transient and would disappear 7days later. 3. The change in high- and low- level aberration approximate preoperative status in 7-60days after surgery, therefore we concluded that it would not affect long term visual function.

关 键 词：水平斜视 直肌 波前像差 

分 类 号：R778[医药卫生—眼科]