角膜和全眼高阶波前像差的特点及年龄相关性变化的研究

Distribution and age-related changes in corneal and ocular higher-order aberrations in Chinese

目的研究人眼角膜和全眼单色高阶波前像差特点及年龄相关性变化。方法使用Tracey—iTrace视觉功能分析仪测量113只正常国人眼计59人，年龄5～73岁，平均（33．81±20．50）岁，角膜和全眼的球差（Zg）、总高阶像差（HOAs）、总彗差（TC）、总球差（TS）、总三叶草像差（TT）。并对角膜和全眼高阶波前像差进行年龄相关性分析。结果角膜Z4^0的均方根系数值平均为（0．27±0．07）μm（0．130～0．451）μm，虽然角膜Z4^0随年龄略呈增加趋势，但无统计学意义（r=0．172，p=0．069）。全眼的Z4^0随年龄增加而增加（r=0．545，p=0．000）。角膜的HOAs（r=0．499，p=0．000）、TC（r=0．149，p=0．021）、TT（r=0．344，p=0．000）和全眼的HOAs（r=0．427，p=0．000）、TC（r=0．253，p=0．007）、TT（r=0．185，p=0．050）均随年龄的增加而增加。角膜HOAs、TC、TF与全眼相对应像差呈正相关（r=0．327，p=0．000；r=0．233，p=0．013；r=0．481，p=0．000）。角膜TS不随年龄而变化（r=0．180，p=0．057），但全眼的TS随年龄的增加而增加（r=0．560，p=0．000）。结论国人角膜的HOAs、TC、TT随年龄的增加而增加，并导致了全眼的上述波前像差随年龄的增加而增高。角膜的TS和Z4^0不随年龄发生明显变化，全眼的TS和Z4^0随年龄增加是由于晶状体总球差和球差随年龄增加的结果。国人角膜球差具有较大个体差异性，手术前角膜球差的测量是非球面IOL选择的必要步骤。

Objective To investigate age-related changes in corneal and ocular monochromatic high-er-order aberrations and elucidate the distribution of corneal primary spherical in Chinese. Methods Using Tracey-iTrace visual function analyzer （EyeSys corneal topography combined with a ray-tracing aberrometer）, 113 normal eyes of 59 Chinese,mean age of 33.81±20.50 years （range,5-73 years）,were evaluated for corneal and ocular monochromatic total higher-order aberrations （HOAs）, primary spherical aberration （Z40）, total spherical （TS）,total coma （TC）,and total trefoil aberration （TT） in the central 6mm diameter. Correlation analysis was also performed to assess the association between age and both corneal and ocular higher-order aberrations. Results The mean Zemike coefficient of Z40 was （0.27±0.07）μm （range,0.130-0.451）. Although corneal Z40 increased slightly with age,the correlation was small and insignificant （r =0.172,p =0. 069）. However, ocular Z40 had a positive correlation with age （r =0.545 ,p=0.000）. Analyzer showed positive correlations with age for both corneal （r =0.499,p =0.000） and ocular （r =0.427,p =0.000） HOAs. Positive correlations were also observed between age and both corneal （r=0.149,p =0.021 ） and ocular （r=0.253 ,p =0.007） TC. Corneal and ocular TT （r =0.344 ,p =0.000 ; r =0.185 ,p =0.050, respectively） were increased with age. No significant correlation was found between corneal TS and age （r =0.180 ,p =0.057 ）, but TS of the whole eye increased with age （r =0.560,p =0.000）. There was a positive correlation between corneal and ocular HOAs （r=0.327,p =0.000）,TC （r=0.233,p=0.013）,and TT （r=0.481,p=0.000） aberration. Conclusions These resuits also suggest that the ocular HOAs,TC,and TT increase with age,mainly because of the increase in corneal HOAs, TC, and TT; and the Z40 aberration increases with age, mainly because of the increase in Z40 in the internal optics. Individual variability in corneal primary spherical aberration was observed in Chinese. Therefore, preoperative measurement of corneal Z40 is crucial to the selection of aspheric IOL.