波阵面像差分布规律对视网膜脱离诊断及确立手术方式的辅助价值

Adjunctive effect of wavefront aberration on diagnosis and defined operative method of retinal detachment

为评价波阵面像差在视网膜脱离诊断和手术中的应用价值,选择2004-07/2005-02在大连医科大学附属第一医院行巩膜外冷凝、硅胶外垫压及(或)玻璃体腔注气术的孔源性视网膜脱离患者17例(17眼),均为单眼视网膜脱离,其中10例为近视眼视网膜脱离,7例为非近视眼视网膜脱离。所有患眼于术前、术后1,3个月应用德国Wavelight Laser TechnologyAG公司生产的Allegretto Wavelight Analyzer波阵面像差仪进行波阵面像差测定,以对侧非视网膜脱离眼为对照。结果显示:①手术前视网膜脱离侧波阵面像差中第1,3,4,5,6阶均方根值及高阶均方根值均显著高于对照侧(P<0.05);手术后3个月视网膜脱离眼与对照侧眼的第1～6阶均方根值、总体均方根及高阶均方根值均无明显差异(P>0.05)。②术前近视视网膜脱离眼第1,3阶均方根值和高阶均方根值低于非近视视网膜脱离眼(P<0.05)。提示波阵面像差可辅助诊断视网膜脱离,并可用于指导手术方式,另外近视眼与非近视眼的波阵面像差具有不同之处,因此在一定程度上应区别对待。

To evaluate the application of wavefront aberration in diagnosis and operation of retinal detachment. Totally 17 rhegmatogenous retinal detachment patients （17 eyes）, who received outer scieral cryocoagulation, silicon cushion and （or） intravitreous injection of gas, were selected from July 2004 to February 2005 at First Hospital Affiliated to Dalian Medical University. These cases were all retinal detachment in one eye. Of the 17 patients, 10 were diagnosed as having myopic eye retinal detachment and 7 were non-myopic eye retinal detachment. The wavefront aberrations of these patients were checked with wavefront aberrometer produced by German Wavelight Laser Technology AG Company before operation, 1 and 3 months after operation, and compared with the other eyes. The results showed that ①Root mean square （RMS）1, RMS3-RMS6 and rent of mean square of higher aberration （RMSH） were significantly higher than those in the control group before operation （P 〈 0.05）. There was no significant difference in RMS1-RMS6, root of mean square of general aberration （RMSg） and RMSh between retinal detachment eyes and control eyes 3 months after operation （P 〉 0.05）. ②RMS1, RMS3 and RMSH in the myopic retinal detachment eyes were lower than those in the non-myopic retinal detachment eyes before operation （P 〈 0.05）. It indicated that wavefront aberration could diagnose retinal detachment and guide operative method. Wavefront aberration between myopic eye and non-myopic eye is different, so it should be considered differently.