瞳孔自然散大下近视眼高阶像差的临床分析

目的:探讨在瞳孔自然散大状态下近视眼高阶像差的分布以及屈光度、年龄等对高阶像差的影响。方法:采用美国VISX公司WaveScan波前像差仪对LASIK术前的140例(280眼)进行检查,在暗室内瞳孔自然散大6mm时的高阶像差RMS值(均方根)及Zernike系数,根据年龄、屈光度进行分组比较研究。结果:在暗室瞳孔自然散大的状态下,总高阶像差RMS均值为(0.251±0.089)μm,从三阶像差到六阶像差RMS值呈递减趋势,三阶彗差、三级散光及四阶球差的RMS值最为显著。高阶像差随近视程度的加深而增加,总高阶像差RMS值(RMSh)、三阶到六阶各阶的RMS值、三阶彗差的RMS值、三级散光RMS值、四阶球差RMS值与近视程度有显著差异(P<0.05)。三阶彗差与三级散光RMS值随年龄增长而增加。结论:高阶像差的个体差异较大,其中RMS值从三阶到六阶呈递减趋势,以三阶彗差、三级散光、四阶球差的RMS值最显著,高阶像差随近视程度的增加而增大,三阶彗差、三级散光RMS值随年龄增长而增大。

Observation on higher order aberrations of myopia in scotopic environment

Objective: To explore the distribution of ocular high-order aberrations of myopic eyes in scotopic environment,and to indentify the influences of age on the aberrations.Methods:In a scotopic environment,WaveScan(visx.inc.) were applied to examine 140 patients(280 myopic eyes) before they undergoing LASIK surgery,root-mean-square(RMS) values and Zernike coefficients were analyzed when pupil size were dilated to be 6.0 mm.The patients were divided into different groups according to refractive power and age.Results: In a scotopic environment,mean RMS value was(0.251±0.089) μm showing a decreasing tendency from 3rd to 6th order aberrations.Among the aberrations,3rd-order coma,trefoil and 4th-order spherical aberration were the most significant ones.High order aberrations increased with the refractive power.Significant differences were found among myopia,total ocular high order RMS and coma(P all <0.05).RMS of 3rd coma and trefoil increased with age.Conclusions: High-order aberrations varied widely among individuals.The RMS values decreased from 3rd to 6th order.Among the aberrations,the most significant ones were 3rd coma,trefiol and 4th spherical aberration.High-order aberrations increased with refractive power,while 3rd coma and trefoil increased with age.