Epi-LASIK对近视眼高阶像差的影响

目的:探讨微型角膜刀准分子激光上皮瓣下角膜磨镶术(Epi-LASIK)对近视眼波前像差,尤其是高阶像差的影响。方法:应用Custom VueTM波前像差仪采集31例(62眼)行Epi-LASIK手术的近视患者的术前及术后1,6mo的波前像差,对所得的数据进行统计学分析。结果:Epi-LASIK术前的波前像差的分布以低阶像差占优势,为(90.12±1.02)%,高阶像差占(9.88±2.03)%。术后1mo高阶像差显著增加,整体高阶像差及各级高阶像差与术前比差异有显著性(P<0.01),高阶像差占(59.24±2.14)%,低阶像差占(40.76±3.06)%,高阶像差整体平均增加2.52倍,以二次彗差增加最多,达3.03倍,以二次球差增加其次,达2.84倍。术后6mo高阶像差占(51.74±3.08)%,低阶像差占(48.26±4.21)%。与术前相比,整体高阶像差差异仍有显著性(P<0.01),二次彗差和二次球差比术前仍有显著增加(P<0.01),但优势高阶像差彗差和球差逐渐恢复到术前水平,差异无显著性(P>0.05)。与术后1mo相比,高阶像差均有所减小,差异有显著性(P<0.01)。术前近视度数与术后各时期的整体高阶像差呈正相关,差异有显著性(P<0.01)。结论:常规Epi-LASIK术后高阶像差比术前明显增大,以二次彗差和二次球差为最显著,随着时间的推移有所减小,但不能恢复术前水平。术前近视度数越高,术后高阶像差越大。

Influence of Epi-LASIK on high-order aberrations of myopic eyes

AIM:To observe and evaluate the influence of epipolis laser in situ keratomileusis(Epi-LASIK)on high-order aberrations in myopic eyes.· METHODS:Sixty-two myopic eyes(31cases)were evaluated by the Custom VueTM wave analyzer at pre-Epi-LASIK,1 month,and 6 months after Epi-LASIK.The root mean square(RMS)values of aberrations were analyzed by SPSS10.0 statistics software.· RESULTS:Before Epi-LASIK,the constituent ratio of low order aberrations was(90.12±1.02)%,and high-order aberrations accounted for(9.88±2.03)%.One month after surgery,high-order aberrations had increased significantly(P<0.01).The constituent ratios of low order aberrations and high-order aberrations were(40.76±3.06)% and(59.24±2.14)% respectively.The total number of high-order aberrations increased 2.52 times over that preoperatively,especially second coma increased 3.03 times,spherical aberration increased 2.84 times.Six months after Epi-LASIK,the constituent ratios of low order aberrations and high-order aberrations were(48.26±4.21)% and(51.74±3.08)%.The total number of high-order aberrations,second coma and spherical aberration were larger than that preoperatively(P<0.01).Advantageous high-order aberrations had decreased with time.There was a significant positive correlation between severity of myopia and the total number of high-order aberrations after surgery(P<0.01).· CONCLUSION:Conventional Epi-LASIK increases high-order aberrations,especially second coma and spherical aberration.high-order aberrations after surgery tend to decrease with time,but can not return to preoperative values.The higher the myopia was,the greater the number of high-order aberrations were after surgery.