LASIK术后早期角膜前表面高阶像差变化的临床分析

Clinical analysis of changes in higher-order aberrations on anterior corneal surface in the early stages after LASIK

目的：分析准分子激光原位角膜磨镶术（ LASIK ）术后早期（1d内）角膜前表面高阶像差的变化情况。 方法：前瞻性病例研究。应用3D SIRIUS角膜地形图仪采集并分析LASIK手术后100例200眼患者不同时间点（术前、术后5，30，60min及1d）的角膜前表面4mm光学区的各高阶像差的 RMS 值，并对检查结果进行方差分析。 结果：LASIK术后5～60 min角膜前表面顶点区各高阶像差均明显增大，但均于术后1d恢复至术前水平，差异无统计学意义（P＞0．05）；在各像差中Z17的RMS值增大幅度最大达1126．98％（ P＜0．01）， Z12增加幅度最小为147.92％（ P＝0．03）；各高阶像差增大的峰值不同，根据其特点可分为单峰值期、双峰值和平台型三类；平均角膜中央厚度在术后30，60min较术后5min时明显增加，并在术后1d明显降低。 结论：LASIK术后角膜前表面顶点区高阶像差会出现明显增大并于1d内恢复至术前水平。

AIM： To analyze the changes in higher -order aberrations on anterior corneal surface in the early stages （within 1d） after laser in situ keratomileusis （LASIK）. METHODS： A prospective study was designed for 200 eyes of 100 patients who had underwent LASIK.A 3D sirius corneal topography system （ SIRIUS） was used to collect and measure the root mean square （ RMS ） of corneal aberrations at the 4mm optical zones of cornea in different time （ preoperation and postoperation of 5, 30, 60min; 1d ）. Data were analyzed using analysis of variance （ ANOVA） . RESULTS： From 5min to 60min after surgery, the higher-order aberrations （ HOA ） on the peak area of corneal surface were significantly increased, but all in the second day returned to the preoperative level and the difference was not statistically significant （ P〉0.05 ） .In each aberrations＆#39;the root mean square （ RMS） of Z17 was markedly increased to maximum 1126.98% （ P〈0.01）, and the minimal increase of Z12 was 147.92% （P=0.03）. Their peaks of higher-order aberrations were different. According to their characteristics, they can be divided into single-peak period, double peak, and platform-type.Compared with postoperative 5min, the average central corneal thickness in the postoperative 30 and 60min increased significantly and recovered until the next day. CONCLUSION： Higher-order aberrations on anterior corneal surface in the early stages after LASIK increase significantly, and return to the preoperative levels within 1d.