翼状胬肉术后角膜前表面波前像差的改变

Wavefront aberration changes of the cornea anterior surface after pterygium surgery

目的 通过对比观察翼状胬肉手术前后角膜前表面波前像差的改变,评价翼状胬肉对角膜光学质量的影响.方法 选取翼状胬肉患者32例（42眼）作为试验组,同期另择正常人40例（40只眼）作为对照组.试验组患者均行翼状胬肉切除联合自体角膜缘干细胞移植手术,分别检查对照组和试验组术前及术后1、3、7d及1个月的角膜前表面波前像差,对比分析其变化.结果 与对照组比较,试验组各时点角膜散光度、总像差、总高阶像差均明显增大（均P〈0.05）,术后1、3、7d球差明显增大（均P〈0.05）,术前及术后1、3、7d慧差、三叶草像差均明显增大（均P〈0.05）;与术前比较,术后3d角膜散光度明显下降、球差明显增大（均P〈0.05）,术后7d及1个月膜散光度、总像差、总高阶像差、慧差、三叶草像差均明显降低、球差明显增大（均P〈0.05）;与术后1d比较,术后7d角膜散光度、总像差、总高阶像差、三叶草像差均明显降低（均P〈0.05）,术后1个月角膜散光度、总像差、总高阶像差、慧差、三叶草像差均明显降低（均P〈0.05）.结论 翼状胬肉侵及角膜2.0～4.0mm即可引起角膜散光度、总像差、总高阶像差、彗差及三叶草像差明显增大,手术可以降低角膜散光度、角膜前表面总像差、总高阶像差、彗差及三叶草像差,手术后1个月角膜前表面波前像差趋于稳定.

Objective To compare the wavefront aberration changes of the cornea anterior surface before and after pterygium surgery. Methods Thirty two patients （42 eyes） underwent pterygium surgery （test group） and 40 healthy adult subjects （40eyes） served as control group. Examination of corneal topography was performed before operation and ld, 3d, 7d and lm after operation. Results The corneal astigmatism, the RMS value of total aberrations, total high order aberrations in test group was significantly enlarged compared to control group （ P 〈 0.05）.The spherical aberrations in test group ld, 3d and lw after operation was significantly larger than that in control group（ P〈 0.05 ）.The coma and trefoil in test group before operation, 1d, 3d and lw after operation was significantly larger than those in control group （ P 〈 0.05）. In test group the corneal astigmatism 3d after operation was significantly smaller than that before operation （ P 〈 0.05）, the spherical aberrations was significantly larger than that before operation （ P 〈 0.05）. In test group the corneal astigmatism ,the RMS value of total aberrations, total high order aberrations, coma and trefoil 7d and lm after operation was significantly smaller than those before operation（ P 〈 0.05 ）, the spherical aberrations was significantly larger than that before operation （ P 〈 0.05）. In test group the corneal astigmatism ,the RMS value of total aberrations, total high order aberrations and trefoil 7d after operation was significantly smaller than those ld after operation （P 〈 0.05）,the corneal astigmatism ,the RMS value of total aberrations, total high order aberrations ,coma and trefoil 1month postoperatively were significantly smaller than those ld after operation （ P 〈 0.05）. Conclusion The results indicate that pterygium increases the corneal astigmatism, total aberrations, total high order aberrations, coma and trefoil, which can be significantly reduced by pterygium surgery.