成人正视眼与近视眼角膜高阶像差分布的研究  

Clinical study on higher order aberrations of anterior cornea in eyes with emmetropia and myopia of adults

作　　者：李颖[1] 孙静波[1] 单丽[1] 赵耀[1] 于志红[1] 张丽华[1] 王淑荣[1] 

机构地区：[1]哈尔滨医科大学附属第二医院眼科,黑龙江省哈尔滨市150086

出　　处：《眼科新进展》2008年第7期520-524,共5页Recent Advances in Ophthalmology

基　　金：黑龙江省科技攻关基金资助(编号:GC05C410)~~

摘　　要：目的研究角膜前表面高阶像差在成人正视眼与单纯近视和复性近视散光眼的分布。方法选取年龄在18-50岁拟做LASIK手术的患者，单纯近视眼患者149例292眼。按球镜屈光度分成低度、中度、高度3组；复性近视散光患者351例（691眼），按柱镜屈光度分成低度、中度、高度3组。年龄在18～50岁成人正视眼60例108眼作为对照组，要求电脑验光球镜屈光度在±1．00D以内。柱镜在-1．00D以内，且裸眼视力在1．0以上。角膜波前像差分析采用OPTIKON 2000 Keratron Scout分析仪。角膜波前像差分析均为6mm瞳孔直径。结果无论成人正视眼还是近视眼均存在高阶像差，6mm瞳孔直径均以三阶和四阶为主，高阶像差RMs值呈递减趋势，阶数越高，像差越小。正视眼组存在较大的彗差，而单纯近视眼组彗差较小，2组比较差异有显著统计学意义（P〈0．001）；正视眼组球差较小，而单纯近视眼组球差较大，2组比较差异有统计学意义（P〈0．05）。正视眼和近视散光眼2组均存在较大彗差，但2组比较无统计学意义（P〉0．05），而在其他像差Z（3，±3）、Z（4，0）、Z（4，±2）、Z（4，±4）、Z（5，±1）、Z（5，±3）、Z（5，±5）、RMSg2组比较差异均有统计学意义（P〈0．05）。单纯近视眼和近视散光眼在各像差Z（3，±1）、Z（3，±3）、Z（4，0）、Z（4，±2）、Z（4，±4）、Z（5，±1）、Z（5，±3）、Z（5，±5）及RMSg比较差异均有统计学意义（P〈0．05）。球差和球镜度数呈正相关（r=-0．501，P〈0．001），其他高阶像差和球镜度数无关，但在-6．00D以上的近视眼中，彗差和球镜度数呈正相关（r=-0．409，P〈0．005）。球差和散光度无关（P〉0．5），其他像差均和散光度有关（P〈0．05），随着散光度的增加，各像差的RMS值均增加。结论无论正视眼还是近视眼都存在角膜高阶像差，均以三�Objective To describe the characteristics of higher order aberrations of anterior cornea in adult Chinese eyes with emmetropia, myopia and compound myopic astigmatism, Methods Patients with 18 to 50 age,who want to do LASIK were selected. One hundred and fourty nine cases （292 eyes） of myopia were enrolled and presented into three groups according to their diopters of spherical refractive error（low： ≤ -3.00 D;middle： 〉 -3.00 D, ≤ -6.00 D; high： 〉 -6.00 D）. Each group respectively included 41 cases（79 eyes） and 61 cases（ 120 eyes） and 47 cases（93 eyes）.351 cases（691 eyes） ofcompotmd myopic astigmatism were enrolled and presented into three groups according to their diopters of cylindrical refractive error（low： ≤ - 1.00 D;middle： 〉 - 1.00 D, ≤ - 2.00 D; high： 〉 - 2.00 D ）. Each group respectively included 126 cases（242 eyes） and 123 cases（240 eyes） and 102 eases（209 eyes）.60 cases（ 108 eyes） with emmetropia were enrolled as subjects. The OPTIKON 2000 Keratron Scout device was used for topographies and corneal wavefront measurements, Wavefront aberrations were analyzed for 6 mm pupil zone. Results There were higher order aberrations in emmetropia,myopia and compound myopic astigmatism. For 6 mm pupil, there were mainly the 3rd order and 4th order aberrations. The RMS of aberrations decreased gradually with the order increasing. The coma in emmetropic group is higher than that in myopic group. They had statistically significant relation（ P 〈0.001 ）. The spherical aberration in emmetropic group is lower than that in the myopic group. There was statistical significance in two groups （ P 〈 0.05 ）. Between emmetropic group and compound myopic astigmatism group, there was statistical significance in Z（3, ＋3）,Z（4, ＋2）,Z（4, ＋ 4）,Z（5, ＋ 1）,Z（5, ＋3）,Z（5, ＋5） and RMSg（P〈 0.05）,except Z（3, ＋ 1 ） （P 〉 0.05）. Between myopic group and compound myopic astignmtism group, there was statistical sign

关 键 词：正视眼 近视 散光 角膜波前像差 

分 类 号：R778[医药卫生—眼科]