Q-LASIK手术前后波前像差与对比度视力的相关关系

Correlation between Ocular Wavefront Aberrations and Contrast Visual Acuity before and after Q-LASIK

目的探讨低中度近视眼接受Q值引导非球面切削LASIK手术前后在暗环境暗背景下眼波前像差与对比度视力的变化及其相关性。方法低中度近视患者36例取其右眼,用WaveLight Allegretto鹰视波前像差仪检测全眼波前像差,取瞳孔直径为6.5 mm时的全眼总像差、高阶像差、第3、4阶像差均方根,以及垂直和水平慧差、球差值进行分析;用多功能视力检查仪在暗环境暗背景下分别测量对比度为100%、25%、10%和5%4种对比度视力(MFVA)。观察分析术前术前和术后1,3个月各指标的变化,用多元线性回归分析不同对比度视力与高阶像差间相关关系。结果垂直慧差、总像差术后值比术前下降,差异有显著意义(P<0.05);术后球差、第4阶像差、总高阶像差值均比术前增加,差异有显著意义(P<0.05);术后1、3月对比度视力均优于术前视力,其差异均有显著意义(P<0.05);术前垂直慧差值、第3阶像差与高阶像差均方根分别与10%对比度视力的直线相关关系有显著意义(P<0.05);球差值与5%对比度视力的直线相关关系有非常显著意义(P<0.01);术后1月,球差值分别与25%、10%、5%对比度视力的直线相关关系有显著意义(P<0.05),第4阶像差与总像差均方根分别与100%、25%、10%、5%对比度视力的直线相关关系有非常显著意义(P<0.01);术后3个月,球差值分别与25%、10%和5%对比度视力的直线相关关系有显著意义(P<0.05),第4阶像差均方根分别与100%、25%、10%和5%对比度视力的直线相关关系有显著意义(P<0.05),总高阶像差均方根分别与10%、5%对比度视力的直线相关关系有显著意义(P<0.05),其余像差与对比度视力的直线相关关系无显著意义(P>0.05)。结论在暗环境下,慧差和球差均是术前影响视觉质量的重要因素,角膜屈光手术后球差变化的影响更为显著。

Objective To investigate the correlation between ocular high-order aberration and contrast visual acuity（CVA） in low and moderate myopice eyes before and after Q-LASIK. Methods Thirty-six low-moderate myopia patients（36 right eyes） were enrolled in this study.Some representative high-order aberration and CVA with 4 contrast concentrations（100%,25%,10%,5%） were measured by Allegro wavefront analyzer and multi-functional visual acuity tester（MFVA-1000）.Multiple linear regression was used to analyze the relationships between ocular high-order aberration and CVA with dark background in dark environment before and 1,3months after surgery. Results One and 3 months after surgery,the vertical coma and total aberration decreased,while the spherical aberration,4th order aberration and total high-order aberration increased obviously（P0.05）.The 4 contrast concentrations of visual acuity were higher than those of CVA before surgery（P0.05）.Before surgery,the vertical coma,spherical aberration and total high order aberration were significantly correlated with the visual acuity at the contrast concentration of 10%（P0.05）,the spherical aberration was significantly correlated with the visual acuity at the contrast concentration of 5%（P0.01）.One month after surgery,the spherical aberration was significantly correlated with the visual acuity at each low contrast concentration（P0.05）,the 4th order aberration and total high order aberration were significantly correlated with the 4 contrast concentrations of visual acuity（P0.05）.Three months after surgery,the spherical aberration was significantly correlated with the visual acuity at each low contrast concentration（P0.05）,4th order aberration was significantly correlated with four contrast levels of visual acuity（P0.05）.Beside,the total high-order aberration was significantly correlated with the visual acuity at the contrast concentrations of 10% and 5%（P0.05）.Others were not（P0.05）. Conclusions Coma and spherical aberration are the important factors for visual performance.However,the main aberration factor affecting postoperation visual performance is spherical aberration under dark environment in low and moderate myopic eyes.