准分子激光原位角膜磨镶术与准分子激光角膜上皮瓣下磨镶术对眼波阵面像差影响的对比

目的 探讨准分子激光原化角膜磨镶术（LASIK）和准分子激光角膜上皮瓣下磨镶术（LASEK）对眼波阵面像差的影响并作对比分析。方法 随机选取在我院屈光手术研究治疗中心就诊并行LASIK或LASEK治疗的近视患者各18例（18只眼）,使用WFA-1000型主观式波阵面像差仪分别于术前、术后10d、1和3个月行波阵面像差检查,应用Madab5．3软件计算1到35项各项的Zernik系数,计算出各高阶（3～7阶）和总高阶像差的均方根（RMS）。应用统计软件SPSS10．0对所得结果进行组间方差分析并做两两比较。结果 全部患者术后3个月时裸眼视力均达到或超过术前最佳矫正视力,无危害视力的并发症发生。LASIK术后10d时各高阶和总高阶像差较术前增加,1个月时明显减小,3个月时轻微增加。LASEK术后波阵面像差随时间推移逐渐减小,1个月时除3阶像差外均小于术前,3个月时所有高阶像均小于术前。LASIK手术前后分阶方差分析,3阶、4阶和总高阶像差差异有统计学意义。两两比较3阶像差术后10d和术前差异有统计学意义,而术后1个月及术后3个月时和术前差异无统计学意义,两者之间差异也无统计学意义;4阶和总高阶像差同样如此。LASEK手术前后各高阶和总高阶像差差异均有统计学意义,两两比较与LASIK相似。结论 LASIK和LASEK术后早期均会引起眼波阵面像差增加,但随时间推移逐渐减小,术后1、3个月时和术前比较已无统计学意义。与LASIK相比,LASEK术后眼波阵面像差增加的幅度较小。（

Comparison of wavefront aberration after LASIK and LASEK for treatment of myopia

Objective To evaluate the effects of laser in situ keratomileusis (LASIK) and laser-assisted subepithelial keratomileusis (LASEK) on wavefront aberration for treatment of myopia. Methods Eighteen right eyes with LASIK and 18 right eyes with LASEK were included in this study. The patients were selected randomly for evaluation of the wavefront aberration using a WFA1000 subjective aberrometer before and 10 days, 1 and 3 months after treatment. The coefficient of 35 terms of zenike was obtained by aberrometer, and root mean square (RMS) of each and total high order aberration was calculated by Matlab5.3. SPSS10.0 was used for statistical analysis. Results Uncorrected visual acuity in all eyes after operation achieved or exceeded preoperative best corrected visual acuity; no serious complication occurred to threaten visual acuity. RMS of each and total high order aberration was increased at 10 days after LASIK, and then decreased at 1 and 3 months, during which period the changes after LASEK were the same as those after LASIK, only smaller than that of the preoperative data except order 3. Statistical difference of order 3, 4 and total high order before and 10 days after LASIK was significant, while that 1 and 3 months was insignificant. There was statistically significant difference of each and total high order before and after LASEK, whereas, the results of LASEK showed no significant difference when compared with that of LASIK. Conclusions RMS of wavefront aberration increased rapidly at 10 days after LASIK and LASEK and decreased gradually at 1 and 3 months. There was no statistically significant difference in RMS at 1 and 3 months after treatment. The degree of crease after LASEK is smaller than that after LASIK.(Chin J Ophthalmol,2005,41:966-971)