近视散光患者眼球高阶像差的研究

Higher-order aberrations in myopic and astigmatism eyes

目的 了解国人近视散光患者眼球高阶像差的分布、瞳孔直径、近视、散光度数对高阶像差的影响。方法 使用依据Tscherning原理设计的AllegrettoWave波前像差仪 ,对 14 7只眼准分子激光原位角膜磨镶术 (LASIK)前的近视散光情况进行检查 ,分别提取当瞳孔直径为 4 0、4 5、5 0、5 0、5 5、6 0、6 5及 7 0mm时高阶像差的均方根 (RMS)值 ,根据近视和散光的度数高低分组对比研究分析。结果 同一只眼内从 3阶到 6阶像差的RMS值呈递减趋势 ;同阶像差内最大值与最小值相差6 1至 3 6 6倍 ;随着瞳孔的增大 ,高阶像差相应增加 ,尤其以 3阶的彗差和 4阶的球差增速快。当瞳孔小时近视度数只影响次级球差 (第 6级 ) ,随着瞳孔增大 ,近视度数既增加次级球差 ,也增加球差 (第4级 ) ,当瞳孔直径≥ 5 0mm时 ,次级彗差 (第五级 )也增加 ,但在任何瞳孔直径下 ,近视度数对彗差无明显影响。散光度数对高阶像差的影响 :当瞳孔直径≥ 6 5mm时 ,散光度数即使第 3级彗差增加 ,也使第 5阶的次级彗差增加 ,但在任何瞳孔直径下 ,散光度数对球差无明显影响。结论 高阶像差在个体中存在较大差异 ,瞳孔直径、近视和散光程度对高阶像差有明显的影响。 (中华眼科杂志 ,2 0 0 4,40 :13 16)

Objective To analyze the distribution of the higher order aberrations in the population of Chinese with myopia and astigmatism and determine whether the pupil size, degree of myopia and astigmatism affects the higher order aberrations. Methods Using a Tscherning method, 147 myopic and astigmatism eyes were evaluated before LASIK. The root mean square (RMS) values of higher order aberrations for each subject with pupil diameters of 4.5, 5.0, 5.5, 6.0, 6.5 and 7.0 mm were calculated. The subjects were divided into following groups: high myopia (>-6.00 D)and low myopia (≤-6.00 D); astigmatism groupⅠ(≥0.75 D) and astigmatism group Ⅱ(<0.75 D). Results The root mean square(RMS) values was decreased from 3rd order to sixth order aberrations in the same eye. The individual difference was from 6.1-fold to 36.6-fold in same type of aberration. All types of aberrations, in particular spherical and coma aberration, was increased significantly with increasing pupil size. Secondary spherical aberration, spherical and secondary coma aberration were affected by myopia, but coma aberration; astigmatism only affected the coma aberration , but spherical aberration. Conclusions The aberrations were increased with the increasing of refractive error such as myopia and astigmatism. Spherical aberration is more common in high myopia, Coma aberrations is related with astigmatism. (Chin J Ophthalmol, 2004,40:13-16)