波前像差引导飞秒激光制瓣LASIK术后不同范围角膜高阶像差的变化

发布时间：2018-05-16 23:04

本文选题：飞秒激光 + 角膜前表面　；参考：《眼科新进展》2014年07期

【摘要】：目的比较波前像差引导飞秒激光制瓣LASIK手术前后不同直径范围角膜前、后表面总高阶像差、球差、彗差、三叶草像差变化情况。方法应用Pentacam眼前节测量分析系统对术前及术后3~6个月行波前像差引导飞秒激光制瓣LASIK的患者24例(48眼)进行检查测量,分别获得角膜中央直径为4 mm、6 mm范围角膜前表面、角膜后表面、全角膜总高阶像差、球差(Z40和Z60)、彗差(Z3-1、Z3+1、Z5+1和Z5-1)以及三叶草像差(Z3+3、Z3-3、Z5+3和Z5-3)的RMS值。应用SPSS 13.0统计学软件进行数据分析。结果手术前随着测量范围的增大,除角膜前表面彗差外,角膜前、后表面其余各类像差分布均是增加的,且差异均有统计学意义(均为P0.05)。手术后角膜中央直径4 mm范围前表面彗差、三叶草增加相对明显,与术前相比均有统计学差异(均为P0.05);后表面各类像差改变均不明显,差异均无统计学意义(均为P0.05);全角膜各类像差均增加,与术前相比差异均有统计学意义(均为P0.05)。手术后角膜中央直径6 mm范围前表面球差、彗差、三叶草、总高阶像差均增加,与术前相比差异均有统计学意义(均为P0.05),其中彗差增加量与其他类像差增加量相比相对较小;后表面与全角膜各类像差均增加,与术前相比差异均有统计学意义(均为P0.05)。手术后角膜中央6 mm范围前后表面除慧差外,各类像差增加量均明显较4 mm范围大,差异均有统计学意义(均为P0.05)。手术后角膜前表面各类像差变化量均较角膜后表面各类像差变化量大。结论波前像差引导飞秒激光制瓣LASIK手术前后、不同直径范围均以角膜前表面高阶像差变化为主,角膜后表面变化较小。手术后不同直径范围角膜前后表面各类高阶像差变化特点也不同。
[Abstract]:Objective to compare the changes of total high order aberrations, spherical aberrations, coma and clover aberrations in the front and posterior surfaces of the cornea before and after LASIK with wavefront aberration guided by femtosecond laser flap. Methods 24 patients (48 eyes) with wavefront guided femtosecond laser flap LASIK were examined by Pentacam anterior segment analysis system before and 3 ~ 6 months after operation. The corneal anterior surface was obtained in the range of 4 mm to 6 mm in the central diameter of cornea. The RMS values of total high order aberration, spherical aberration Z40 and Z60, coma Z3-1Z31OZ51 and Z5-1) and clover aberration Z3C3Z3-3Z53 and Z5-3) on the posterior surface of the cornea. The data were analyzed by SPSS 13.0 statistical software. Results with the increase of the measurement range before operation, the distribution of aberrations in the anterior surface of cornea and in the posterior surface of the cornea were all increased except for the coma on the anterior surface of the cornea, and the differences were statistically significant (all P 0.05). After operation, the coma of anterior surface in the range of 4 mm in central diameter of cornea, the increase of clover was relatively obvious, and there was significant difference compared with pre-operation (all P 0.05), the change of all kinds of aberrations on the posterior surface was not obvious. There was no significant difference (all P 0.05), and all kinds of aberration of the cornea increased, and there was significant difference compared with pre-operation (all P 0.05). The spherical aberration of the anterior surface, coma, clover, and total high order aberration of the cornea in the range of 6 mm central diameter after operation increased significantly compared with those before operation (P 0.05), and the increase of coma was relatively small compared with that of other kinds of aberrations. All kinds of aberrations of the posterior surface and the whole cornea increased significantly compared with those before operation (P 0.05). After operation, the increase of all kinds of aberrations was significantly larger than that of 4 mm in the central 6 mm area of the cornea (all P 0.05). The changes of all kinds of aberrations on the anterior surface of the cornea after operation were larger than those on the posterior surface of the cornea. Conclusion before and after wavefront aberration guided femtosecond laser flap LASIK, the changes of high order aberrations on the anterior surface of cornea are dominant, and the change of the posterior surface of cornea is small. The changes of high-order aberrations of corneal surface in different diameter range after operation are also different.
【作者单位】：西安市第四医院眼科激光视力矫正中心;
【基金】：陕西省社会发展攻关项目(编号:2013K14-02-18) 西安市社会发展引导项目[编号:SF1315(3)、SF1207(3)]~~
【分类号】：R779.63

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