常规LASIK术后早期近视患者波前像差变化研究

目的探讨常规LASIK术后早期近视患者波前像差变化规律。方法抽取2008-03～07在广西视光中心接受常规LASIK手术的35例近视患者，其中男18例，女17例，年龄16—36岁；屈光度-0．50--10．50DS（等效球镜）。采用美国VISX公司生产的WaveScan波前像差仪对所有患者进行波前像差检测，收集每位患者术前、术后1天、1周、1个月、3个月和6个月共六个时间点的波前像差数据。将波前像差数据按检测时间分组后，使用SPSS13．0统计软件采用One．wayANOVA单因素方差分析，Game．Howell方法（方差不齐）或LSD法（方差齐性）比较六组间波前像差成份的差异。结果总像差：（1）术前与术后各时间点均不相同（P=0．000）；（2）术后各时间点两两比较均无统计学差异（P〉0．05）。彗差：（1）术前与术后1d无差异；术后1周、1个月、3个月、6个月间两两比较均无差异；（2）术前及术后1d分别与术后其他时间点两两比较差异均有统计学显著意义（P〈0．05）。球差：（1）术前与术后1天、1周、6个月无差异；术后1周、1个月、3个月，6个月两两间比较均无差异；（2）术前与术后1个月、3个月比较差异均有统计学显著意义（P〈0．05），术后1d与术后其他时间点比较差异均有统计学显著意义（P〈0．05）。总高阶像差、三叶草像差在术前、术后各时间点均无统计学差异（P〉0．05）。结论常规LASIK可明显减少总像差，但术后早期近视患者的总像差维持相对稳定，仅球差和彗差有所波动。

Study on the variation of myopic wavefront aberrations after conventional LASIK

Objective To investigate the variation of myopic wavefront aberrations after conventional LASIK. Methods Thirty five myopic out-patients （male 18, female 17） underwent conventional LASIK between March and July 2008 in Guangxi vision science and optometry center, aged from sixteen to thirty six, and refractive power ranged from -0. 50 to - 10. 50 diopters（ spherical equivalent） were enrolled retrospectively. WaveScan system（ Visx corp. made in USA） was used to capture each myopic wavefront aberration images at pre- and post- 1 day, 1 week, 1 month, 3 month and 6 month after conventional LASIK, respectively. Root mean square of wavefront error was used as a parameter of myopic optical quality in this study. One-way ANOVA and Game-Howell and LSD were analyzed to compare to each type of wavefront aberrations among the six time points by SPSS 13.0 version software. Results Total aberration： （ 1 ） Significant differences were showed between pre- and post-LASIK（ all P = 0. 000） ; （2） but there were no differences among the different time points after LASIK （ P 〉 0. 05 ）. Coma： （ 1 ） There were no differences neither between pre- and post-LASIK at day one, nor among the five time points after LASIK except at day one; （2） but there were statistic differences either compared pre-LASIK or compared post- 1 day with other time points after LASIK（P 〈 0. 05 ）. Spherical aberration ： （ 1 ） There were no differences when compared pre-LASIK with post- 1 day, 1 week or six month after LASIK. And there were no differences among the different time points after LASIK except post- 1 day（P〉0. 05） ; （2）There were significant differences when compared pre-LASIK with post- 1 month or 3 month, and compared post- 1 day with any other time points, too （ P 〈 0. 05 ）. No statistic differences were showed both total high order aberrations and trefoil aberration among the six different time points （P 〉 0. 05 ）. Conclusion Myopic total aberration maitained relatively stable, but spheric aberration and coma varied at early period after conventional LASIK.