不同类型近视眼高阶像差的临床研究

Study on higher order aberrations in different types of myopic eyes

目的针对不同类型近视眼高阶像差的分析,探讨曲率性近视眼与轴性近视眼在人眼高阶像差中的差异。方法采用前瞻性研究,选取单纯性近视眼患者77例116眼,将其分为两组,分别为曲率性近视眼组(24例37眼)和轴性近视眼组(53例79眼),组内再分为低度曲率性近视眼组(14例22眼)、中度曲率性近视眼组(10例15眼)以及低度轴性近视眼组(16例25眼)、中度轴性近视眼组(25例36眼)和高度轴性近视眼组(12例18眼)。利用波前像差仪获取入选患眼瞳孔直径分别为4mm、5mm、6mm时高阶像差值,进行分组比较。结果曲率性近视眼组不同瞳孔直径(4mm、5mm、6mm)下彗差(0.066±0.031、0.094±0.046和0.133±0.059)、球差(0.038±0.123、0.061±0.026和0.098±0.042)和总高阶像差(0.078±0.029、0.119±0.046和0.179±0.062)均高于轴性近视眼组不同瞳孔直径(4mm、5mm、6mm)下彗差(0.053±0.018、0.073±0.026和0.097±0.042)、球差(0.029±0.110、0.041±0.016和0.063±0.025)和总高阶像差(0.062±0.018、0.090±0.023和0.131±0.036),差异均有统计学意义(均为P<0.05)。进一步比较发现,低度曲率性近视眼组与低度轴性近视眼组不同瞳孔直径下眼各高阶像差相比,差异均无统计学意义(均为P>0.05);中度曲率性近视眼组不同瞳孔直径下彗差、球差、总高阶像差以及6mm瞳孔直径下的次级球差均高于中度轴性近视眼组,差异均有统计学意义(均为P<0.05)。结论中度近视时,在不同瞳孔直径下曲率性近视眼的彗差、球差及总高阶像差均较轴性近视眼大,而在低度近视眼中,二者各高阶像差则没有差异。

Objective To explore the difference of ocular higher order aberra- tions between curvature myopia and axial myopia, according to the analysis of higher order aberrations in different types of myopic eyes. Methods It was a prospective study. Seventy-seven simple myopic patients （116 eyes） participated in this study and were divided into two groups：curvature myopia group （24 patients, 37 eyes） and axial myopia group （53 patients, 79 eyes）. Then the two groups were subdivided into those subgroups：low curvature myopia group（ 14 patients,22 eyes） ,moderate curvature myopia group （ 10 patients, 15 eyes）, low axial myopia group （ 15 patients, 25 eyes）, moderate axial myopia group（25 patients,36 eyes） and high axial myopia group（ 12 patients, 18 eyes） according to the refraction. The values of higher order aberrations were analyzed at different pupil diameters（4 ram,5 nun,5 mm） between the two groups and the corre- sponding subgroups, respectively. Results The values of higher order aberrations： co- ma（0. 056 ± 0. 031,0. 094 ± 0. 045 and 0. 133 ± 0. 059） ,spherical aberration（0. 038 ± 0. 123,0.061 ± 0. 025 and 0. 098 ± 0. 042 ） and total higher order aberrations （ 0. 078 ± 0. 029,0. 119 ±0. 045 and 0. 179 ± 0.052） in curvature myopia group were higher than those,which were the same kind of values： coma（0. 053 ± 0. 018,0. 073 ± 0. 025 and 0. 097 ±0. 042） ,spherical aberration（0. 029 ±0. 110,0. 041 ±0. 016 and 0. 053 ±0. 025）, total higher order aberrations （ 0. 052 ± 0. 018 , 0. 090 ± 0.023 and 0. 131 ± 0. 035 ）, in axial myopia group at different pupil diameters （ 4 mm, 5 mm, 5 mm ）, there were statistical differences （ all P 〈 0.05 ）. Further comparisons revealed that there was no statistical difference in values of all high order aberrations between low curvature myopia group and low axial myopia group with different diameter pupil（ all P 〉0.05 ） ,while the values of coma, spherical aberration, total higher order aberrations at different diameter pupils and secondary spherical aberration at 5 nun diameter pupil were higher than those of moderate axial myopia group ,and there were statistical differences（ all P 〈 0.05 ）. Conclusion Curvature myopia has much more coma, spherical aberration and total higher order aberrations at different pupil diameters than axial myopia in moderate myopic eyes, while the comparisons between two groups with low myopia has no significant difference, respectively.