波前像差引导的飞秒制瓣LASIK术后角膜后表面形态和高阶像差的变化  

Changes in posterior corneal elevation and higher order aberration after wavefront guided femtosecond laser assisted LASIK

作　　者：朱冉[1] 程蕾[1] 龙克利[1] 顾明珠[1] 李全德[1] 

机构地区：[1]徐州市眼病防治研究所,徐州市第一人民医院眼科,江苏徐州221002

出　　处：《徐州医学院学报》2015年第1期49-52,共4页Acta Academiae Medicinae Xuzhou

基　　金：徐州市科技计划项目（6836）

摘　　要：目的对比分析波前像差引导的飞秒制瓣准分子激光角膜原位磨镶术（LASIK）对中低度屈光不正患者的角膜后表面高度和高阶像差的影响。方法采用波前像差引导的飞秒激光制瓣LASIK治疗中低度屈光不正患者78例（156眼），术前、术后3个月分别检查并记录裸眼视力、最佳矫正视力、屈光度、角膜曲率、后表面高度、总高阶像差、彗差、三叶草差、球差、四叶草形像差，并进行术前术后对比分析。结果波前像差引导的飞秒制瓣LASIK术后裸眼视力达到或超过术前最佳矫正视力，短期内（3个月）角膜后表面稳定，术后眼总高阶像差、球差（包括四叶草形像差）不同程度地增加，具有统计学意义（P〈0．05），彗差、三叶草差变化无统计学意义（P〉0．05）。结论波前像差引导的飞秒制瓣LASIK术后短期内角膜形态稳定，术后高阶像差增加较小，视觉质量更高。Objective To compare and evaluate changes in corneal posterior elevation and high - order abberration （HOA） after wavefront guided （WG） femtosecond laser assited laser in situ keratomileusis（ FS - LASIK） , especially for total HOA, coma, trefoil, and spherical aberrations for patients with mild and moderate refractive errors. Methods In a retrospective case study, 156 eyes of 78 patients underwent wavefront guided femtosecond laser assisted LASIK. Corneal posterior elevation and corneal HOA were obtained preoperatively and 3 months postoperatively respectively. The change in posterior corneal elevation was measured using Pentacam system before operation and 3 months after operation. The RMS values of total HOA, coma, trefoil, and spherical aberrations with 6.5 mm pupil diameter by VISX WaveScan WaveFrontTM System. Results During the follow - up period, change in posterior elevation of the thinnest point before and after operation at any time point was not significant within the three groups. After operation, in the 6.25 mm pupil di- ameter, the whole corneal HOA and spherical aberration were statistically significant increased （ P 〈 0.05 ） . There was no significant difference in postoperative refractions in coma aberration and trefoil aberration （ P 〉 0.05 ）. Conclusion Wavefront- guided FS - LASIK has advantage in improving uncorrected visual acuity. There is no change in posterior corneal elevation after femtosecond laser arid the posterior corneal surface is stable. WG FS - LASIK is more efficient to reduce the higher order aberration after operation.

关 键 词：屈光不正 飞秒激光 准分子激光角膜原位磨镶术 后表面高度 高阶像差 

分 类 号：R778[医药卫生—眼科]