不同彗差下波前像差引导个体化切削术后视觉质量的对比研究  

Comparative study of visual quality after wavefront guided LASIK in different coma

作　　者：张婉婷 穆红梅 高芬 张金嵩[2] 

机构地区：[1]开封市中心医院眼科,河南省开封市475000 [2]郑州大学第一附属医院眼科,河南省郑州市450052

出　　处：《眼科新进展》2015年第8期765-768,共4页Recent Advances in Ophthalmology

基　　金：开封市科技攻关项目(编号:110325)~~

摘　　要：目的比较不同彗差在准分子激光屈光矫正中的临床差异。方法拟在我院行准分子激光近视矫正的患者中,选取瞳孔直径6 mm时,全眼高阶像差均方根(root mean square,RMS)值>0.25μm的中低度近视患者198例(198眼),随机分为观察A组100例(100眼)和对照B组98例(98眼)。A、B两组中,彗差值≤0.37μm分别为A1组(56例)和B1组(53例);彗差值>0.37μm分别为A2组(44例)和B2组(45例)。A组均接受除彗差外的波前像差引导手术;B组均接受所有像差矫正。比较术前及术后1周、1个月、3个月的视力,6 mm瞳孔直径下全眼高阶像差RMS值,彗差Zernike多项式值,标准、暗及明亮环境下100%、25%、10%、5%不同对比度下的视力。结果术前A1组与B1组,A2组与B2组的彗差、总高阶像差(total higher order aberration,t HOA)对比差异均无统计学意义(均为P>0.05)。术后1周、1个月A2组与B2组t HOA比较差异有统计学意义(P<0.05),术后1周、1个月、3个月彗差比较差异均有统计学意义(均为P<0.05)。术后对比度视力比较:暗背景下对比,A2组与B2组25%对比度下术后1周、10%对比度下术后1个月两组间均有差异(均为P<0.05);5%对比度下术后1个月、3个月两组间差异均有统计学意义(均为P<0.05)。亮背景下对比,A1组与B1组术后1周5%对比度下两组间差异有统计学意义(P=0.037)。A2组与B2组,10%对比度视力在术后1个月25%对比度下术后1周时差异有统计学意义(均为P<0.05);5%LASIK更有意义。Objective To compare different clinical differences after excimer la- ser refractive correction in different coma. Methods According to the criteria that to- tal higher order aberration （tHOA） root mean square （RMS） was higher than 0. 25 μm when pupil diameter was 6 mm, 198 low or middle degree myopic patients （ 198 eyes） were randomly divided into two groups. Group A as experimental group （100 eyes） re- ceived LASIK guided by all wavefront aberrations but coma. Group B as the control group （98 eyes） were treated with LASIK by all wavefront guided. They each were divided into two groups based on the value of coma. The coma in group A1 （56 eyes） and group B1 （53 eyes） was less than or equal to 0.37 μm, group A2 （44 eyes） and group B2 （45 eyes） was higher than 0.37μm. A series of factors including uncorrected visual acuity （ UCVA）, RMS of ocular higher-order aberrations in 6 nun pupil diameter, answer of Zernike polynomials evaluations of coma, and normal, dark and bright environment 100% ,25%, 10% , 5% under different contrast visual acuity before operation and 1 week, 1 month,3 months after operation were compared. Results Before operation, no significant difference was found in coma and total higher order aberration （tHOA） not only between group A1 and group B1 ,but also between group A2 and group 132 （all P 〉 0.05 ）. tHOA of group A2 was significantly higher than group B2 at 1 week and 1 month after operation （ all P 〈 0.05 ）. Coma was significant different between group A1 and group B2 at all 3 postoperative points-in-time （ all P 〈 0.05 ）. Significant difference were found between scotopia of group A2 and group B2 at 1 week and 1 month after operation when the contrast ratio was 25% and 10% （ all P 〈 0.05 ）. When the contrast ratio was 5% ,scotopia of group A2 and group B2 at 1 month and 3 months after operation were significant different （ all P 〈 0.05 ）. When contrast visual acuity under the bright backgrounds and the contrast rati

关 键 词：波前像差 彗差 LASIK 对比度视力 

分 类 号：R779.63[医药卫生—眼科]