FS-LASIK术后视网膜周边离焦及视觉质量变化  

Changes in periretinal defocus and visual quality after femtosecond laser-assisted in situ keratomileusis

作　　者：李羽 郭玉 娟汪思瑶 张美美 周跃华 LI Yu;GUO Yujuan;WANG Siyao;ZHANG Meimei;ZHOU Yuehua(Eye School of Chengdu University of Traditional Chinese Medicine,Chengdu 510100,Sichuan Province,China;Ineye Hospital of Chengdu University of TCM,Chengdu 610084,Sichuan Province,China;Ophthalmology Beijing Ming Vision,Beijing 110000,China;Key Laboratory of Sichuan Province Ophthalmopathy Prevention&Cure and Visual Function Protection with TCM Laboratory,Chengdu 510100,Sichuan Province,China)

机构地区：[1]成都中医药大学眼科学院,四川省成都市510100 [2]成都中医大银海眼科医院,四川省成都市610084 [3]北京茗视光眼科,北京市110000 [4]中医药眼病防治与视功能保护四川省重点实验室,四川省成都市510100

出　　处：《眼科新进展》2024年第7期558-563,共6页Recent Advances in Ophthalmology

摘　　要：目的探讨飞秒激光辅助的准分子激光原位角膜磨镶术(FS-LASIK)术后视网膜周边离焦及视觉质量的变化。方法选取2023年3月至5月在成都中医大银海眼科医院行FS-LASIK的近视患者51例(102眼)纳入研究,其中女27例(54眼),男24例(48眼)。使用多光谱屈光地形图仪测量视网膜周边离焦。记录视网膜周边总屈光差异值(TRDV);四个象限的RDV:上方RDV(RDV-S)、下方RDV(RDV-I)、鼻侧RDV(RDV-N)及颞侧RDV(RDV-T);距黄斑中心凹10°、20°、30°、40°及53°相应同心圆环区域的RDV(分别表示为RDV 0°-10°、RDV 10°-20°、RDV 20°-30°、RDV 30°-40°、RDV 40°-53°)。采用视觉质量分析系统测量并记录客观散射指数(OSI)、斯特列尔比(SR),10 c·d^(-1)、20 c·d^(-1)、30 c·d^(-1)空间频率下的调制传递函数(MTF)值(分别表示为10 c·d^(-1) MTF、20 c·d^(-1) MTF、30 c·d^(-1) MTF)以及截止频率(MTF cutoff)。采用iTrace像差仪测量并记录角膜垂直三叶草(Z_(3)^(-3))、垂直彗差(Z_(3)^(-1))、水平彗差(Z_(3)^(1))、水平三叶草(Z_(3)^(3))、垂直四叶草(Z_(4)^(-4))、垂直二次散光(Z_(4)^(-2))、球差(Z_(4)^(0))、水平二次散光(Z_(4)^(2))、水平四叶草(Z_(4)^(4))及总高阶像差(HOA)的数据。对患者术前、术后1个月及术后3个月的测量数据进行比较及相关性分析。结果术前、术后1个月及术后3个月患者视网膜周边TRDV、RDV-S、RDV-N、RDV 20°-30°、RDV 30°-40°、RDV 40°-53°比较,术后1个月及3个月的值均较术前降低,差异均有统计学意义(均为P<0.001)。术前、术后1个月及术后3个月患者OSI、MTF cutoff及10 c·d^(-1) MTF比较,差异均有统计学意义(均为P<0.05)。术前、术后1个月及术后3个月患者角膜Z_(3)^(-3)、Z_(3)^(-1)、Z_(3)^(1)、Z_(3)^(3)、Z_(4)^(-4)、Z_(4)^(-2)、Z_(4)^(0)、Z_(4)^(2)、Z_(4)^(4)及HOA比较,差异均有统计学意义(均P<0.001)。Pearson相关分析结果显示,ΔRDV 0°-10°与ΔZ_(3)^(-3)、ΔZ_(3)^(1)、ΔZ_(4)^(-2)、ΔZObjective To explore the changes in periretinal defocus and visual quality after femtosecond laser-assisted in situ keratomileusis(FS-LASIK).Methods Fifty-one myopic patients(102 eyes)who underwent FS-LASIK at the Ineye Hospital of Chengdu University of Traditional Chinese Medicine from March to May 2023 were selected for the study,including 27 females(54 eyes)and 24 males(48 eyes).The defocus around the retina was measured using a multispectral refraction topography,and the total refraction difference value(TRDV)was recorded.The refraction difference value(RDV)in four quadrants:superior RDV(RDV-S),inferior RDV(RDV-I),nasal RDV(RDV-N),and temporal RDV(RDV-T),as well as the RDV in the concentric ring areas corresponding to 10°,20°,30°,40°,and 53°from the fovea of the macula(represented as RDV 0°-10°,RDV 10°-20°,RDV 20°-30°,RDV 30°-40°,and RDV 40°-53°,respectively)were also recorded.The objective scattering index(OSI),Strehl's ratio(SR),modulation transfer function(MTF)values(represented as 10 c·d^(-1) MTF,20 c·d^(-1) MTF,and 30 c·d^(-1) MTF,respectively)and cutoff frequencies(MTF cutoff)at the spatial frequencies of 10 c·d^(-1),20 c·d^(-1) and 30 c·d^(-1) were measured and recorded using a visual quality analysis system.The data of corneal vertical trefoil(Z_(3)^(-3)),vertical coma(Z_(3)^(-1)),horizontal coma(Z_(3)^(1)),horizontal trefoil(Z_(3)^(3)),vertical tetrafoil(Z_(4)^(-4)),vertical secondary astigmatism(Z_(4)^(-2)),spherical aberration(Z_(4)^(0)),horizontal secondary astigmatism(Z_(4)^(2)),horizontal tetrafoil(Z_(4)^(4)),and total higher-order aberration(HOA)were measured and recorded using the iTrace aberration meter.The measurement data of patients before surgery,one month after surgery,and three months after surgery were compared,and their correlations were analyzed.Results TRDV,RDV-S,RDV-N,RDV 20°-30°,RDV 30°-40°,and RDV 40°-53°around the retina of patients decreased one month and three months after surgery compared with those before surgery,and the differences were statistica

关 键 词：飞秒激光 准分子激光角膜原位磨镶术 周边离焦 视觉质量 高阶像差 

分 类 号：R779.63[医药卫生—眼科]