LASIK、SBK和LASEK对角膜高阶像差的影响

The effects of LASIK,sub-Bowman keratomileusis (SBK),and LASEK on corneal higher-order aberration

目的探讨于不同深度角膜基质面进行的近视矫正性激光角膜切削对人眼角膜高阶像差的影响。方法前瞻性队列研究。行准分子激光原位角膜磨镶术(LASIK)54例(106只眼),前弹力层下角膜磨镶术(SBK)80例(159只眼),准分子激光角膜上皮下磨镶术(LASEK)16例(32只眼),采用眼前节扫描仪(Allegretto Oculyzer)搜集这些患者手术前后的眼前节数据,转换得到角膜像差数据(以Zernike多项式形式表示高阶像差)。对数据采用方差分析;chisq:Kruskal-Wallis检验。结果术后所有眼裸眼视力>0.8。三组手术后测量角膜垂直彗差(Z3-1)、水平彗差(Z31)、彗差(Z33)、球差(Z40)值较术前的差异均存在统计学意义;三种手术后角膜垂直彗差(Z3-1)和球差(Z40)变化随时间变化有统计学差异。结论 LASIK和SBK及LASEK手术均会增加角膜高阶像差,但超薄瓣手术(SBK)和表面切削术(LASEK)对角膜高阶像差的影响低于标准的LASIK手术。

Objective To investigate the effects of different depth of corneal stroma ablation in laser in situ kerato-mileusis （LASIK）, sub-Bowman keratomileusis （SBK） and Laser-assisted subepithelial keratectomileusis （LASEK） on corneal higher-order aberrations.Methods This prospective study involved 54 subjects （106 eyes） treated with LASIK, 80 subjects （159 eyes） treated with SBK, and16 subjects （32 eyes） treated with LASEK.The data of anterior segment were obtained from ALLEGRO Oculyzer before and after the operations .Then we obtained the higher-order corneal aberra-tions which were analyzed with Zernike polynomials .The data were analyzed with variance and an independent chi-square Kruskal-Wallis test.Results The postoperative uncorrected visual acuity was better than 0.8 in all eyes.The preoperative and postoperative differences in vertical coma （ （ Z3-1 ） , horizontal coma （ （ Z3-1 ） , coma （ （ Z3-3 ） and spherical aberration （ （ Z4-0 ） between the three groups were significant .Changes in corneal vertical coma （ （ Z3-1 ） and spherical aberration （ （ Z4-0 ） over time were significantly different between the three groups as well .Conclusion Either LASIK or SBK or LASEK can increase postoperative corneal higher-order aberrations , but there is no significant difference in the changes in higher-order aberrations between the three types of operation .