近视眼高阶像差特征和影响因素分析

A Study on the Profile and Factors of the Higher Order in Myopia

目的了解我国近视散光患者眼高阶像差的分布，瞳孔直径、近视、散光度数对高阶像差的影响。方法像差数据由哈特曼-夏克Hartmann-Shack原理设计的Zywave波前像差仪对不同瞳孔直径的近视眼进行测量，共对103眼准分子激光手术前的近视散光情况进行检查，提取当瞳孔直径为5．0mm、6．0mm时高阶像差的均方根（RMS）值，根据近视和散光的度数高低分组对比研究分析。结果随着瞳孔的增大。高阶像差相应增加。6．0mm瞳孔下，同一眼内3～5阶像差的RMS值呈递减趋势。在低度和中度近视患者中，各高阶像差和屈光度无明显相关性；在高度近视患者中，高阶像差随着近视度数的增加而增加。彗差和球差均与屈光度有明显的相关性。高阶像差随着散光度数的增加而增加。彗差和散光度有明显的相关性，但球差和散光度无明显的相关性。结论高阶像差在个体中存在较大差异．瞳孔增大时球差和慧差比率增加，散光影响球差和慧差，瞳孔直径、近视和散光程度对高阶像差有明显的影响。

Objective To analyze the distribution of the higher-order aberrations in the population of China with myopia and astigmatism, and to determine whether the pupil size, degree of myopia and astigmatism of higher-order aberrations. Methods One hundred and three myopic astigmatism eyes were evaluated before refractive surgery by using a Hartmann-Shack method. The root mean square（RMS）values of higher-order aberrations for each subject with pupil diameters of 5.0 mm and 6.0 mm were calculated. The subjects were divided into following groups： high myopia（〉-6.00 D） ,medium myopia（-3.00～-6.00 D）and low myopia（≤-3.00 D） ,high astigmatism（≥0.75 D）and low astigmatism（〈0.75 D）. Results Higher-order aberrations were increased significantly with increasing pupil size. The RMS values were decreased from 3rd to 5th order aberrations with pupil diameters of 6.0 mm in the same eye. Spherical aberration and coma aberration were affected by high myopia;low and moderate myopia did not effect higher order aberrations. Astigmatism only affected the coma aberration, but not spherical aberration. Conclusion The aberrations increase with the pupil diameters, the increasing of refractive error such as myopia and astigmatism.