近视性屈光参差患者FS-LASIK术前后视网膜周边离焦与角膜高阶像差的变化  

Change of Retinal Peripheral Defocus and Corneal Higher-Order Aberrations in Patients with Myopic Anisometropia before and after FS-LASIK

作　　者：童宇婷 周跃华 杜玉芹 李羽 Yuting Tong;Yuehua Zhou;Yuqin Du;Yu Li(Ineye Hospital of Chengdu University of Traditional Chinese Medicine(TCM),Chengdu 610036,China)

机构地区：[1]成都中医药大学附属银海眼科医院,成都610036

出　　处：《中华眼视光学与视觉科学杂志》2024年第11期831-837,共7页Chinese Journal Of Optometry Ophthalmology And Visual Science

摘　　要：目的:观察近视性屈光参差患者行飞秒激光制瓣准分子激光原位角膜磨镶术(FS-LASIK)前后视网膜周边离焦与角膜高阶像差的变化并探究两者的相关性。方法:前瞻性临床研究。连续纳入2023年9—12月于成都中医药大学附属银海眼科医院行FS-LASIK手术的近视性屈光参差患者60例(120眼),根据等效球镜度将患者双眼分为近视程度高组(高度组)60眼和近视程度低组(低度组)60眼。于FS-LASIK术前和术后3个月采用多光谱屈光地形图测量视网膜周边离焦,根据测量范围分为视网膜周边总离焦(TRDV)及视网膜周边0°~10°、10°~20°、20°~30°、30°~40°、40°~53°的平均离焦量(分别为RDV0-10、RDV10-20、RDV20-30、RDV30-40、RDV40-53);采用Itrace像差仪测量角膜高阶像差,包括总高阶像差(tHOA)、垂直三叶草像差、垂直彗差、水平三叶草像差、水平彗差、球差等。采用配对样本t检验分析组间视网膜周边离焦量的差异,Wilcoxon秩和检验分析组间角膜高阶像差的差异,并采用Spearman相关检验分析手术前后视网膜周边离焦的变化量与角膜高阶像差变化量的相关性。结果:术前高度组TRDV、RDV20-30、RDV30-40、RDV40-53明显高于低度组(t=2.82~5.41,均P<0.05),术后组间所有视网膜周边离焦参数差异均无统计学意义(均P>0.05)。在组内,低度组术后TRDV、RDV20-30、RDV30-40及RDV40-53均较术前明显降低(t=2.92~9.96,均P<0.05);高度组术后TRDV、RDV10-20、RDV20-30、RDV30-40及RDV40-53明显低于术前(t=2.66~16.48,均P<0.05)。术前组间所有角膜高阶像差参数差异均无统计学意义(均P>0.05);术后高度组垂直彗差、球差明显高于低度组(Z=-3.33,P=0.001;Z=-3.70,P<0.001)。术后高度组和低度组的tHOA、垂直三叶草像差、垂直彗差、水平彗差、水平三叶草像差及球差均较术前明显升高(Z=-5.86~-2.66,均P<0.05)。在相关性分析中,∆tHOA与∆RDV30-40、∆RDV40-53呈负相关(r=-0.18,P=0.005;r=-0.18Objective:To observe the changes in retinal peripheral defocus and corneal higher-order aberrations in patients with myopic anisometropia before and after femtosecond laser-assisted laser in situ keratomileusis(FS-LASIK),and to explore the correlations between retinal peripheral defocus and corneal higher-order aberrations.Methods:This was a prospective clinical study.Totally 60 patients(120 eyes)with myopic anisometropia who came to the Ineye Hospital of Chengdu University of TCM for FS-LASIK from September to December 2023 were included in this study.The eyes of the patients with myopic anisometropia were divided into two groups according to the equivalent spherical refraction:the high myopia group(60 eyes)and the low myopia group(60 eyes).Retinal peripheral defocus was measured by Multispectral refraction topography before and 3 months after FS-LASIK.According to the measurement range,the retinal peripheral defocus was divided into total peripheral retinal defocus(TRDV),the average peripheral retinal defocus of 0°to 10°,10°to 20°,20°to 30°,30°to 40°and 40°to 53°(RDV0-10,RDV10-20,RDV20-30,RDV30-40 and RDV40-53).Corneal higher-order aberrations were measured by Itrace analyzer including the total higher-order aberration(tHOA),the vertical trefoil,the vertical coma,the horizontal coma,the horizontal trefoil,and the spherical aberration(SA).The differences of retinal peripheral defocus between groups were analyzed by paired sample t-test and the differences of corneal higher-order aberrations between groups were analyzed by Wilcoxon rank sum test.Spearman's rank correlation test was used to analyze the correlation between the changes of retinal peripheral defocus and the changes of corneal higher-order aberration parameters before and after FS-LASIK.Results:The preoperative TRDV,RDV20-30,RDV30-40,and RDV40-53 in the high myopia group were significantly higher than those in the low myopia group(t=2.82-5.41,all P<0.05).However,all postoperative parameters between the high myopia group and the low myopia gr

关 键 词：近视 屈光参差 飞秒激光制瓣准分子激光原位角膜磨镶术 视网膜周边离焦 角膜高阶像差 

分 类 号：R779.63[医药卫生—眼科]