LASEK对人眼波前像差的影响

Influences of LASEK on wavefront aberrations to human eyes

目的 探讨准分子激光上皮瓣下角膜磨镶术 (laserepithelialkeratomileusis,LASEK)对人眼波前像差的影响。 方法 观察 5 2例 (98眼 )LASEK患者术前及术后的裸眼视力(uncorrectedvisualacuity ,UCVA)、屈光等效球镜度 (spericalequivalent,SE)、最佳矫正视力 (bestcorrectedvisualacuity ,BC VA) ,并采集 6 .5mm瞳孔直径时术前及术后眼部的波前像差 ,将所得数据进行统计学处理。结果 术前平均BVAC为5 .0 7± 0 .4 2 ;术后 10dUCVA为 4 .93± 0 .15 ,BCVA为 5 .0 2±0 .0 9;术后 1个月平均UCVA为 4 .95± 0 .11,BCVA为5 0 4± 0 .0 4 ;视力在术后有逐渐好转趋势 ,术后 10dSE为轻度远视或正视状态 ,随时间延长向近视方向漂移。术后高阶像差增大为术前 1.5倍以上 ,术后 10d时为术前的 2倍 ,高度近视组以 5阶二次彗差为最 (P <0 .0 5 ) ,中低度近视组以 6阶二次球差为最 (P <0 0 1)。术后 1个月时高阶像差比术后10d减小 (P <0 .0 5 ) ,但不能恢复术前水平。总像差术后较术前减小。 2组患者 ,术前像差比较除 5阶二次彗差外差异均无显著性意义 ,术后高阶像差的差异均出现显著性意义 (P<0 .0 5 )。结论 LASEK术后高阶像差比术前明显增大 ,以5阶二次彗差和 6阶二次球差为最 ;随时间的推移像差有所减小 。

Objective To observe the changes in the eye aberrations by laser epithelial keratomileusis(LASEK)and to evaluate the influences of LASEK on wavefront aberrations to human eyes. Methods The included patients (52 cases) were divided int o two groups according to the preoperative spherical equivalent (SE) dioptre.The uncorrected visual acuity (UCVA),best corrected visual acuity (BCVA),SE and aberrations were evaluated preoperatively,postoperatively 10 days and 1 month fo r each case.We analyzed the aberration of human eyes by using wavefront analyzer .We used the SPSS11.0 statistics software to analyze the datas. Results Preoperative BCVA mean was 5.07±0.42;In ten days after surgery UCVA was 4.93±0.15,BCVA was 5.02±0.09 respectively;In one month after surgery UCVA and BCVA were 4.95±0.11 and 5.04±0.04;Visual acuity improved wi th time postoperatively,part of the eyes'BCVA were better than that preoperative ly.Ten days after surgery,all the SE of two groups were hyperopic.But with time, SE changed into to myopia.In the Allegretto exam,high order aberrations increase d 1.5 times over that preoperatively immediately after surgery in two groups(P <0.05),but decreased with time(P>05)and did not return to preoperative v alues at 1 month.Post operatively,the total aberrations(RMSg)were less than that preoperatively.The aberrations especially coma fifth order(P<0.05) in middle myopia group and spherical larger sixth order(P<0.01)in high myopi a group were larger than that preoperatively.Preoperatively there were no signif icant differences in high order aberrations except the fifth order(P<0.05)be tween the groups(P>05).But after surgery, there were significant differences(P<0.05). Conclusion High order aberrations increased after LASEK,especially coma the fifth ord er in middle myopia group and spherical sixth order in high myopia group are lar ger than preoperatively,but the aberrations decreased with time,and did not retu rn to preoperative values.Preoperatively there were no significant differences i n high order aberrations except the fifth order between different refractive deg ree groups.But after surgery,there were significant differences.