调节放松及调节状态人眼波前像差的研究

Investigation of wavefront aberrations in humans with and without accommodation

目的研究正视眼、低中度近视眼的调节作用对波前像差的影响。方法采用Hartmann-Shack原理的WASCA波前像差仪,分别测量64例正视眼和中低度近视眼(其中正视组9眼,低度近视组21眼,中度近视组34眼)在调节放松和调节状态的波前像差。结果调节放松状态各组间的总高阶像差、彗差、球差差异均无显著性,水平彗差和球差与总高阶像差存在线性相关(P值分别为0.0019和0.0008);左右眼别的高阶像差差异无显著性。调节状态各组间总高阶像差、彗差、球差差异均无显著性。调节前后进行配对t检验,结果示调节导致球镜度增加(P<0.01),球差减小(P<0.01),并有向负值方向改变的趋势,调节作用能够产生明显的彗差和总高阶像差的改变。结论近视屈光度的增加并不会引起高阶像差的改变,两者无相关性。水平彗差、球差与总高阶像差存在线性相关性,正常人眼高阶像差主要由彗差和球差决定。人眼调节时,高阶像差发生改变,尤其球差的改变有统计学意义,人眼可能通过球差的负向改变来完成视近。

Objective To investigate the effect of accommodation to the wavefront aberrations （WA） in emmetropic and myopic patients. Methods The WA of 64 emmetropes and myopes （including 9 emmetropes, 21 mild myopes and 34 moderate myopes） were measured with a Hartmann-Shack wavefront aberrometer under accommodation and non-accommodation. Results There were no significant differences in higher-order aberrations （HOA）, spherical aberrations （SA） and coma under non-accommodation. And horizontal coma and SA were correlated with HOA （r=0.3813,r=0.4090）. There was no significant difference in the WA between the left and right eyes. There was also no significant differences in HOA, SA, and coma under accommmodation. When data with and without accommodation were analyzed, the results showed a significant increase in spherical diopters （P〈0.01）, SA decreased significantly toward negative values （P〈0.01）, and there were no obvious changes in the coma and HOA under accommodation. Conclusion Increases in the severity of myopia do not increase HOA. Horizontal coma and SA have a linear correlation with HOA. HOA is mainly determined by coma and SA. Accommodation can induce changes in HOA, and a negative change in SA may improve near vision.