配戴散光设计型角膜塑形镜对人眼像差的影响

目的：通过观察散光设计型角膜塑形镜配戴后人眼高阶像差的变化，评价该角膜塑形镜对人眼视觉质量的影响。方法：回顾性研究。选取石迎辉眼科诊所门诊2015 年2 月至2016 年8 月期间配戴散光设计型角膜塑形镜患者25例（50眼），测量配戴塑形镜前，戴镜后1个月、3个月、6个月、1年，在5、7 mm瞳孔直径下的高阶像差均方根（RMS）值。戴镜前后各像差值比较采用重复测量方差分析，各组间比较采用LSD检验，当校正系数Epsilon < 0.7 时，采用Bonferroni法进行两两比较。结果：戴镜后在5 mm和7 mm瞳孔直径时像散、彗差、球差、剩余像差及总高阶像差较戴镜前均增加，差异有统计学意义（5 mm：F =5.15、11.11、10.73、6.95、11.18，均P < 0.05； 7 mm：F =2.93、4.71、9.34、5.01、5.70，均P < 0.05）。随着戴镜时间的延长，各像差值逐渐增大，戴镜3 个月时达到最大值，随后逐渐降低。结论：角膜散光较大患者配戴散光设计型角膜塑形镜后高阶像差增加，人眼视觉质量下降。

ocular higher order aberration Changes after Wearing toric orthokeratology lenses

Objective: To evaluate vision quality by observing the changes of ocular higher order aberration after wearing toric orthokeratology lenses. Methods: In this retrospective case series, the higher order aberrations (HOA) of both eyes of 25 toric orthokeratology lenses users, who had no ocular diseases other than myopia,were quantified with the CSO-Modia Wave wavefront analyzer from February 2015 to August 2016. Zernike polynomials were used to describe the wavefront measurements. Root mean square values of the total HOAs, total coma, total spherical, total astigmatism, and residual aberrations were obtained in the same eyes before and at 1-, 3-, 6-, and 12-months after fitting the contact lenses. The general linear model for repeated measurements and Bonferroni tests were used to analyze the data. Results: After wearing the lenses, in5 mm and 7 mm pupil diameter astigmatism aberration, coma, spherical aberration, residual aberration and total higher order aberration were increased compare to before wearing, the difference was statistically significant (5 mm: F =5.15, 11.11, 10.73, 6.95, 11.18, respectively, all P < 0.05; 7 mm: F =2.93, 4.71, 9.34,5.01, 5.70, respectively, all P < 0.05). The aberration values increased gradually after lens wear. The values peaked at three months, and then gradually decreased. Conclusions: Wavefront analysis showed that the total HOAs, total coma, total spherical aberration, total astigmatism, and residual aberrations were increased after toric orthokeratology lenses wear. Toric orthokeratology lenses reduced the quality of vision in the subjects of this study.