青壮年近视患者高阶像差分析

Wavefront analysis of the ocular higher-order aberrations in the young prime myopic patients

目的 :探讨青壮年近视患者高阶像差的分布、影响因素及对视功能的影响。方法 :使用Allegretto波阵面像差仪对180例 (35 6只眼 ) (屈光度 - 0 5 0～ - 13 0 0D)拟行LASIK治疗的患者术前进行波阵面像差测量分析 ,并比较瞳孔大小、性别、屈光状态、最佳矫正视力 (BSCVA)等因素对高阶像差的影响。结果 :在 6 5mm和 4 0mm瞳孔直径时 ,95 %的近视患者高阶像差的均方根值 (RMSh)的分布范围分别为 0 0 9～ 0 30 μm和 0 0 3～ 0 14 μm ;RMSh、RMS3、RMS4值分别为 (0 19± 0 0 6 ) μm和 (0 0 9± 0 0 3) μm、(0 14± 0 0 6 ) μm和 (0 0 7± 0 0 3) μm、(0 0 9± 0 0 4 ) μm和 (0 0 4± 0 0 2 ) μm ;差异均有统计学意义 (P <0 0 5 ) ;高阶主导像差均以 3阶为著 ,分别占 80 %和 83% ,并以C7为最高。瞳孔增大后 ,球差、彗差比率增加。在 6 5mm瞳孔直径时 ,不同类型的高阶主导像差对BSCVA无影响 (P >0 0 5 )。高阶像差的RMS值与BSCVA呈负相关 (P <0 0 5 )。不同屈光度组高阶像差差异无统计学意义 (P >0 0 5 )。在 6 5mm瞳孔直径时 ,高度散光组的RMS4、RMS6高 ,而在 4 0mm瞳孔直径时 ,高度及低度散光组的RMS3、RMSh高于无散光组 (P <0 0 5 )。性别对高阶像差无影响 (P >0 0 5 )。?

Objective:To evaluate objectively the profile and variable factors of the ocular higher order aberrations (HOA) in the young prime myopic patients.Methods:The root mean square (RMS) values of the HOA (RMSh) of 356 myopic eyes (180 cases) ready for LASIK treatment were measured with Allegretto wave analyzer.The ages of these patients ranged from 17 to 44 years old and their refractive power ranged from -0 50D to -13 00D.The RMSh at 4 0mm and 6 5mm pupil diameters were calculated, and the variable factors were analyzed,such as pupil diameter,sex,refractive power,best spectacle corrected visual acuity (BSCVA).Results:It was found that RMSh ranged from 0 09μm to 0 30μm and from 0 03μm to 0 14μm in 95% myopic patients with 6 5mm and 4 0mm pupil diameter respectively.RMSh,RMS3 and RMS4 were (0 19±0 06)μm,(0 14±0 06)μm and (0 09±0 04)μm when pupil diameter was 6 5mm;(0 09±0 03)μm,(0 07±0 03)μm and (0 04±0 02)μm when pupil diameter was 4 0mm.There was significant difference between 6 5mm and 4 0mm pupil diameters (P<0 05).The third order aberration was the more frequent dominanting type of HOA and the ratio was 80% and 83% when pupil diameters were 6 5mm and 4 0mm respectively.C7 was the most frequent dominanting type in all the patients.The frequency of spherical aberration and coma increased as the pupil got larger.Various dominanting types of HOA had no significant effects on BSCVA (P>0 05),and there was a negative correlation between BSCVA and RMSh.The values of RMS4 and RMS6 in patients with high astigmatism were higher than those in patients with low astigmatism and without astigmatism when pupil diameter was 6 5mm.The values of RMS3 and RMSh in patients with high and low astigmatism were higher than those without astigmatism when pupil diameter was 4 0mm (P<0 05).Sex and myopia had no significant effects on RMSh (P> 05).Conclusions:The distribution of RMSh was ranged widely among the young prime myopic patients,and some patients had higher RMSh.As the pupil diameter got larger,RMS and RMSh increased significantly.Vertical coma was the more frequent dominanting type of HOA in myopic patients.Astigmatism dioptor affected coma,spherical aberration and HOA.BSCVA was affected significantly by the HOA.