准分子激光近视手术台高阶像差的临床分析

发布时间：2018-11-09 14:32

【摘要】：目的:观察角膜像差和全眼像差的分布规律,了解屈光度和手术方式对高阶像差的影响,明确角膜像差和全眼像差之间的联系,为角膜个体化切削技术提供参考依据,指导改善近视患者术后视觉质量。方法:选取2009年2月至2010年2月在重庆医科大学附属第一医院接受准分子激光近视矫正手术治疗的患者266例(532眼),近视屈光范围-1.5～-10.0D,散光范围-0.25～-5.0D,以近视、散光和手术方式分组比较。所有数据采用SPSS 16.0软件包进行处理和统计。结果: 1.角膜像差术前和术后1月角膜各项高阶像差、彗差、球差的增幅具有统计学差异;术后角膜彗差、球差与近视屈光度呈线性负相关;术后角膜各分阶高阶像差在不同近视度数组中具有明显差异,而在散光组中无差异;LASEK组比LASIK组高阶像差增幅小,以RMS3和RMSh有统计学意义。 2.全眼像差术前和术后1月全眼各项高阶像差、彗差、球差的增幅具有统计学差异;术前全眼总像差与近视屈光度呈线性负相关,术后全眼高阶像差、彗差、球差与近视屈光度呈线性负相关;术后全眼各分阶高阶像差在不同近视、散光中具有明显差异;LASEK组比LASIK组高阶像差增幅小,以RMS4有统计学意义。 3.角膜像差和全眼像差在高阶像差中均以3阶和4阶为主,术前角膜高阶像差主要集中在球差上,全眼高阶像差主要集中在彗差上,术后角膜高阶像差以彗差增加更显著,而全眼高阶像差以球差增加更显著。结论: 1.对于角膜和全眼像差,二者各项Zernike系数和各分阶RMS分布规律具有一致性,从3阶～6阶呈递减趋势,阶数越高,像差越小;术后高阶像差均有明显增加,但彗差和球差的增加不同步。 2.术前角膜和全眼的各项高阶像差与近视、散光无相关性,术后角膜和全眼的彗差、球差与近视屈光度均呈线性负相关,但角膜和全眼的各项高阶像差与散光无相关性。 3.术后1月,LASEK组高阶像差的增幅在角膜和全眼像差中均小于LASIK组高阶像差的增幅。
[Abstract]:Objective: to observe the distribution of corneal aberration and all-eye aberration, to understand the effect of refractive error and surgical method on high-order aberration, to clarify the relationship between corneal aberration and all-eye aberration, and to provide reference for individualized keratectomy. To guide the improvement of postoperative visual quality of myopia patients. Methods: from February 2009 to February 2010, 266 patients (532 eyes) received excimer laser myopia correction in the first affiliated Hospital of Chongqing Medical University. Astigmatism range-0.25-5.0 D, compared with myopia, astigmatism and surgical procedures. All the data were processed and counted by SPSS 16.0 software package. Results: 1. The increase of corneal aberration, coma and spherical aberration were statistically different before and 1 month after operation, the corneal coma, spherical aberration and myopic diopter were linearly negatively correlated with corneal aberration. There were significant differences in corneal high-order aberrations in different myopia groups, but no difference in astigmatism group. The increase of high-order aberration in LASEK group was smaller than that in LASIK group, RMS3 and RMSh had statistical significance. 2. There were significant differences in the increase of high-order aberration, coma and spherical aberration between all eyes before and one month after operation. There was a linear negative correlation between preoperative total aberration and myopic diopter, postoperative high order aberration, coma, spherical aberration and myopic diopter. The increase of higher order aberration in LASEK group was smaller than that in LASIK group, especially in RMS4 group. 3. Corneal aberrations and all-eye aberrations were mainly of order 3 and 4 in high order aberrations. Preoperative high order aberrations were mainly concentrated on spherical aberrations, all ocular high order aberrations were mainly concentrated on coma aberrations, and corneal high order aberrations increased more significantly after operation. The higher order aberration of the whole eye is more obvious than that of spherical aberration. Conclusion: 1. For corneal aberration and all eye aberration, the Zernike coefficients and the distribution of RMS were consistent. The aberration decreased from order 3 to order 6, and the higher the order was, the smaller the aberration was. The higher order aberration increased significantly after operation, but the increase of coma and spherical aberration was not synchronized. 2. There was no correlation between high order aberrations of cornea and all eyes before operation and myopia, astigmatism. There was a linear negative correlation between coma and spherical aberration of cornea and eyes after operation, but there was no correlation between high order aberrations of cornea and eyes and astigmatism. 3. One month after operation, the increase of higher order aberration in LASEK group was lower than that in LASIK group.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R779.63

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