干眼症患者合并高水平高阶像差对视觉质量的影响

【目的】探讨干眼症患者视觉质量下降的原因，寻找客观评估干眼症患者视觉质量的指标。【方法】选取2007年6月至2009年5月就诊的干眼症患者127例，裸眼视力≥0．8，平均年龄37．3（25～45）岁。根据有无视物模糊的主诉分为A、B组，通过角膜荧光素钠染色检查、BUT测定、Schirmer试验及波前像差检查，比较4项检查结果的差异。【结果】角膜荧光素钠染色检查、BUT测定、Schirmer试验两组比较差异均无显著性（P〉0．05）；波前像差检查6mm瞳孔直径下A组伴视物模糊干眼症患者的总高阶像差、彗差、三叶草像散均较B组不伴视物模糊干眼症患者明显升高，其中彗差有很明显升高（P〈0．01），三叶草有较明显升高（P〈20．05）。A组与B组比较球差差异无统计学意义（P〉0．05）。【结论】干眼症患者合并高水平高阶像差，可以导致视觉质量下降。提示波前像差检查可作为客观评估干眼症患者视觉质量的指标。

Effect of High Order Aberration on Visual Quality in Patients with Dry Eye

Objective] To investigate the factors that may decrease visual quality in patients with dry eye and to search the parameter that can evaluate the visual quality of dry eye patients. Methods] From June 2007 to May 2009, 127 patients were studied. All of their naked visual acuity was equal to or higher than 0. 8. Their age ranged from 25 to 45 years old and the average age was 37.3 years old. According to whether they complained of blurred vision, they were divided into group A and B. Fluorescein stain, breakup time of tear film （BUT）, Schirmer＇s test and wavefront aberration were tested. Results] The difference in fluorescein stain, BUT, Schirmer＇s test between two groups were of no statistical significance （ P 〉0.05）. Total high order aberration, coma aberration and clover aberration in group A were higher than those in group B. And the difference in coma aberration and clover aberration was of statistical significance, the P value was lower than 0.01 and 0.05, respectively. The difference in spherical aberration was of no statistical significance （ P 〉0.05）. Conclusion] In patients with dry eye, coma aberration and clover aberration can decrease their visual quality. And wavefront aberration test can be taken to evaluate the visual quality objectively.