准分子激光原位角膜磨镶术和准分子激光角膜上皮瓣下磨镶术对近视患者高阶像差的影响

目的:探讨波阵面像差引导的准分子激光原位角膜磨镶术(laser in situ keratomileusis,LASIK)和准分子激光角膜上皮瓣下磨镶术(laser epithel ialkeratomileusis,LASEK)对近视眼高阶像差的影响,并作对比分析。方法:波阵面像差引导的LASIK手术(IK组)共18例36眼和波阵面像差引导的LASEK手术(EK组)共10例20眼,分别于术前和术后10d;1,3mo测量高阶像差,用t检验分析手术前后高阶像差的变化和不同手术方式对高阶像差影响。结果:两组术后总高阶像差RMS值均较术前增加,以三、四阶像差增加为主,五、六阶像差和水平彗差无明显变化;两组的球差均较术前增加,两组间无差异;术后EK组的总高阶像差、三阶、四阶像差和垂直彗差均小于IK组。结论:波阵面像差引导的LASIK和LASEK都会使眼高阶像差不同程度的增加,LASEK的增加幅度小于LASIK。

Effect of LASIK or LASEK on the higher order of wavefront aberration in patients with myopia

AIM:To explore the effects of wavefront-guided laser in situ keratomileusis(W-G-LASIK) and wavefront-guided laser epithelial keratomilersis(W-G-LASEK) on the higher order aberrations(HOAs) in patients with myopia.·METHODS:Twenty-eight patients(56 eyes) underwent W-G-LASIK or W-G-LASEK surgery for myopia,including 18 patients(36 eyes) for W-G-LASIK(IK group) and 10 patients(20 eyes) for W-G-LASEK(EK group).An examination on HOAs was performed on each eye preoperatively and 10 days,1 month and 3 months postoperatively.The data of different operation methods and the HOAs before and after operation was analyzed with Student’s t-test between the two groups.·RESULTS:Total HOA root mean square(RMS) showed an increase in both groups compared with that of preoperation,and the 3rd and 4th order aberration were dominant among theses.While,the 5th,6th and horizontal coma(C8) were similar with that of preoperation.Spherical aberration(C12) increased at any time postoperatively in both of the groups compared with that of preoperation.There was no significant difference between the two groups.Postoperatively,it was lower in EK group than in IK group in total,3rd,4th order aberration and vertical coma(C7).·CONCLUSION:Both procedures could increase the HOAs,but the HOAs improvement after W-G-LASEK was lower than that after W-G-LASIK.