LASIK手术前后的像差变化与对比敏感度相关关系探讨

The research of correlations between the contrast sensitivity and wavefront aberrations before and after LASIK

目的探讨激光原位角膜磨镶术（LASIK）术前术后的像差变化对对比敏感度的影响。方法临床病例自身对照研究。对2008年3月至2010年1月在深圳市眼科医院应用波前像差仪进行LASIK手术的218只眼进行波前像差的术前，术后1天、1周、1月、3月、6月的检查，并同时用对比敏感度检查表进行对比敏感度的检查，并将术前术后的结果进行相关性分析。结果（1）术前高阶像差与中频区对比敏感度存在弱相关性。（2）各空间频率对比敏感度在LASIK术后普遍降低，术后1个月逐渐接近术前水平。（3）术后低阶像差降低，高阶像差显著增加。（4）术后各像差成分和对比敏感度的负相关关系增强，值得注意的是5阶像差和彗差和各频区对比敏感度均没有明显相关性。结论近视眼各种高阶像差成分对不同空间频率对比敏感度有不同影响，它们多数为负相关关系，LASIK术后，其相关关系更加明显，但值得注意的是，无论在术前还是在术后，慧差和第5阶像差对各个空间频率的对比敏感度影响均不明显，提示一定的彗差可能在某些特定条件下对视觉功能不一定有害。

Objective To investigate the changes in the ocular aberrations induced by myopic LASIK refractive surgery and its correlations between the contrast sensitivity. Methods The ocular aberrations of 115 patients （218 eyes） were measured before and after LASIK refractive surgery by Zywave （RMS） and contrast sensitivity （CSF）. The correlations between the CSF and RMS were re- searched. Results （1） The correlations between the components of wavefront and the CSF was weak negative before surgery; （2） There was obvious decrease in CSF after LASIK, and it increased to preoperative level about 1 month post-operation; （3） RMS of wavefront aberration of. low order （2nd） decreased significantly and he high order aberration （〉3rd） was increased after surgery; （4） The negative correlations between the components of wavefront aberration and the CSF became stron- ger in post-operation. But the 5th order and vertical coma aberration had no obviously correlations with any CSF. Conclusions The RMS of high order aberration and CSF are negative correlation be- fore LASIK, and the correlation is become stronger after LASIK. But coma aberration and the 5th aberration has no obvious correlation with CSF.