微型角膜刀法准分子激光角膜上皮瓣下磨镶术治疗高度近视后眼高阶像差的变化

Influence of Epi-LASIK on higher-order aberrations in high myopia

目的:探讨微型角膜刀法准分子激光角膜上皮瓣下磨镶术(epipolis laser in situkeratomileusis,Epi-LASIK)治疗高度近视对眼高阶像差的影响。方法:对接受Epi-LASIK或LASIK手术治疗的高度近视患者(各36眼),采用WASCA Analyer波阵面像差仪检测术前、术后1,2wk,1,3,6mo时眼的各高阶像差值,应用SPSS11.5软件对所得数据进行统计学分析。结果:Epi-LASIK术后不同时间眼的总高阶像差和球差均较术前明显增加(P<0.05),且术后1,2wk时增加最多,而后随术后时间推移总高阶像差和球差逐渐减少,至术后3mo时基本稳定,但仍高于术前水平。术后1mo开始,Epi-LASIK组的总高阶像差和球差明显小于LASIK组(P<0.05);两组术后眼的水平彗差和垂直彗差均较术前有所增加(P<0.05),但增加幅度没有球差增加的幅度大且两组之间无显著差异(P>0.05)。结论:Epi-LASIK治疗高度近视后眼的高阶像差比术前增加,球差增加较为明显;Epi-LASIK在避免术后高阶像差增加方面较LASIK具有明显的优势。

AIM：To evaluate the effects of epipolis laser in situ keratomileusis（Epi-LASIK）on higher-order aberrations among high myopia patients.METHODS：Thirty-six eyes treated with Epi-LASIK and 36 eyes treated with LASIK were selected randomly for evaluation of the wavefront aberrations.Before and at 1 week,2 weeks,1,3,6 months after surgery,monochromatic wave-front aberrations of each eye were objectively measured using WASCA Analyzer Aberrometer.SPSS 11.5 was used for statistical analysis.RESULTS：After Epi-LASIK,the root mean square（RMS）values of total higher order and spherical aberrations increased significantly and peaked during 2 weeks and then decreased with time,but did not return to preoperative values.From 1 month after surgery,total higher order and spherical aberrations in Epi-LASIK group were significantly lower than that in LASIK group（P〈0.05）.Horizontal primary coma and vertical primary aberration increased in all patients,and there was no difference between two groups at any time after Epi-LASIK and LASIK.CONCLUSION：Higher-order aberrations increase obviously after Epi-LASIK among high myopia patients,especially sphereical aberration.The higher-order aberrations induced by Epi-LASIK are lower than that by LASIK.