波阵面引导与常规准分子激光原位角膜磨镶术后对比敏感度和主观感觉的比较

The analysis of subjective evaluation and contrast sensitivity function after wavefront-guided laser in situ keratomileusis and traditional laser in situ keratomileusis

目的探讨波阵面引导的准分子激光原位角膜磨镶术（LASIK）和传统LASIK给患者带来的主观方面的疗效差别。方法98例患者（98只眼）随机分为两组，试验组51人（51只眼），对照组47人（47只眼），分别接受波阵面引导的LASIK和传统LASIK，观察手术前后试验组与对照组对比敏感度和主观评估以及像差的变化。结果术后在光晕、夜晚视力、眩光和夜驾不适较术前变化的评估上，试验组不同程度地优于对照组（P〈0．05）；术后两组对比敏感度在各频段有差别，但以暗视下中、低频段较明显；手术后像差在两组间的差异有统计学意义，其对主观评估和对比敏感度的影响集中在夜视下和暗视下低、中频段，其中离焦和球差的影响最为明显，垂直彗差对主观评估和对比敏感度的影响与离焦和球差的影响方向相反。结论在术后对比敏感度和主观评估上，波阵面引导的LASIK优于传统LASIK组，这种优势主要与前者大幅度地降低了术后离焦和球差有关，垂直彗差可部分中和它们对视觉质量的影响。

Objective To investigate subjective visual performance after wavefront-guided LASIK and traditional LASIK. Methods Ninety-eight eyes of 98 patients were divided into group Zoptix and group PlanoScan. Subjective evaluation, contrast sensitivity function （CSF） and aberration were observed preoperatively and postoperatively. Results On subjective evaluation about halo, night visual acuity and blur, Group Zoptix was better than Group PlanoScan. The difference between Group Zoptix and Group PlanoScan was shown at all spatial frequencies, especially at low and middle spatial frequencies under mesopic conditions. The difference of aberration between two groups was obvious. Both of low order and higher order aberration were correlated with subjective evaluation and CSF, especially defocns and spherical aberration, whose influence were in reverse with vertical coma and higher order aberration without spherical aberration. Conclusion The subjective evaluation and CSF after wavefront-guided LASIK were better than traditional LASIK, which correlated with aberration, especially in defocus and spherical aberration, while the join of vertical coma can partially counteract their influence on patients＇ subjective evaluation and CSF.