准分子激光角膜表层手术与基质层手术对眼波前像差的比较  

Comparison of wavefront aberrations between surface ablation and stromal ablation surgeries

作　　者：李俏[1] 李莹[1] 龙琴[1] 艾凤荣[1] 罗岩[1] 陈秉钧[1] 丁欣[1] 

机构地区：[1]中国医学科学院北京协和医院眼科,中国北京市100730

出　　处：《国际眼科杂志》2011年第1期51-55,共5页International Eye Science

基　　金：中国国家自然科学基金资助项目(No.30600692)~~

摘　　要：目的:比较分析角膜表层与基质层屈光手术后高阶像差及其变化值。方法:行准分子激光治疗的近视眼患者100例200眼,其中接受LASIK手术50例100眼,接受新型表层手术(ASA)50例100眼。LASIK手术组术前等效球镜度(SE)为-1.25～-9.25(平均-5.75±1.74)D,ASA手术组术前SE为-2～-9.25(平均-5.42±1.81)D。术前及术后1,3,6mo检查裸眼视力(UCVA)、最佳矫正视力(BSCVA)、球镜及柱镜度数、SE以及波前像差等。结果:C7,C12,RMS3,RMS4,RMS5,RMS6和RMSh的变化值均和球镜度变化值、SE变化值的绝对值显著正相关。术后1mo,ASA组C7绝对值、RMSh,RMS3和RMS6均显著小于LASIK组;术后3mo时,ASA组C7和C14显著小于LASIK组,LASIK组C12显著小于ASA组;术后6mo时,ASA组仅C14显著优于LASIK组。术后1mo时,ASA组RMS3,RMS5,RMS6和RMSh的变化值均显著小于LASIK组,术后3mo时,ASA组RMS6变化值显著小于LASIK组,术后6mo时,ASA组RMS3,RMS6和RMSh的变化值显著小于LASIK组。结论:高阶像差增大程度与球镜度及SE的变化程度正相关。ASA组术后高阶像差及其增大程度均小于LASIK组,术后6mo时两组差异仍显著。AIM： To compare higher order aberrations （HOA） and their changes after surface and stromal ablation surgeries. METHODS： This prospective study included 200 eyes of 100 patients who sought for refractive surgery; 50 patients （100 eyes） received laser in situ keratomileusis （LASIK） and 50 patients （100 eyes） received advanced surface ablation （ASA）. Spherical equivalent （SE） of LASIK group ranged from -1.25 to -9.25（-5.75±1.74）D, SE of ASA group -2^-9.25（-5.42±1.81）D. Uncorrected visual acuity （UCVA）, best spectacle-corrected visual acuity （BSCVA）, spherical and cylindrical diopter, SE, and wavefront aberrations were recorded pre-ablation, 1 month, 3 and 6 months post-ablation. RESULTS： Changes of C7, C12, RMS3-6 and RMSh positively correlated with changes of spherical, cylindrical diopter and SE. C7, RMS3, RMS6 and RMSh of ASA group were smaller compared with LASIK group at 1st month post-operation; C7 and C14 of ASA were also smaller at 3rd month post-operation, while C12 of LASIK was smaller; only C14 of ASA was smaller than LASIK at 6th month post-operation. Compared with LASIK group, changes of RMS3, RMS5, RMS6 and RMSh in ASA group were smaller at 1st month post-operation; changes of RMS6 in ASA was smaller at 3 months post-operation; changes of RMS3, RMS6 and RMSh in ASA were smaller at 6th month post-operation. CONCLUSION： Increase of HOA positively correlate with changes of SE and spherical diopter. Both HOA and its increase in ASA group are smaller when compare with LASIK group, which maintain until 6 months post-operation.

关 键 词：近视 准分子激光原位角膜磨镶术 准分子激光上皮下角膜磨镶术 微型角膜刀准分子激光原位角膜磨镶术 波前像差 

分 类 号：R779.63[医药卫生—眼科]