虹膜定位波前像差引导的LASIK术像差的改变与视觉质量的关系

目的：通过Wavescan波前像差分析仪检查和分析虹膜定位波前像差引导的LASIK手术前后波前像差的改变与视觉质量的关系。方法：随机抽取66例（130眼）行虹膜定位波前像差手术的病人。分别于术后1d、1周和1、3、6个月检查裸眼视力（uncorrected visual acuity，UCVA）及满意度调查，术后3个月行波前像差检查。结果：术前平均最佳矫正视力（best corrected visual acuity，BCVA）为1．02±0．13，术后6个月平均UCVA为1．06±0．14，术后6个月平均UCVA较术前平均BCVA高（P〈0．05），视觉质量满意度为96．92％。术后总体像差均方根值（root of mean square of general aberration，RMSg）明显减小（P〈0．01），高阶像差均方根值（root of mean square of higher aberration，RMSh）增大（P〈0．01），高阶像差所占的百分比（Hiorder）增大（P〈0．01）。C4减小（P〈0．01），C7增大（P〈0．05），C12增大（P〈0．01），三叶草差Z33减小，C8增大。结论：虹膜定位波前像差引导的LASIK手术有助于提高患者的视觉质量，Zernike函数C7、C12增大与术后视觉质量有一定关系。

Relationship Between Changes of Aberration in Iris Positioning Wavefront-guided LASIK and Visual Quality

Objective： To analyze the relationship between changes of aberration in iris positioning wavefront -guided LASIK and visual quality. Methods： 130 eyes of 66 cases performed iris positioning wavefront-guided LASIK. The uncorrected visual acuity（UCVA） was detected and satisfaction degree were evaluated at 1 day, 1 week and 3 and 6 months after surgery. The wavefront aberration examination was performed at 3 months after surgery. Results： The preoperative best corrected visual acuity（BCVA） was 1.02 ± 0.13, the postoperative UCVA was 1.06 ± 0.14 at 6 months , the difference was significant（P〈 0.05）. The satisfaction degree of surgery was 96.92 96. The postoperative root of mean square of general aberration（RMSg） was markedly decreased（P 〈 0.01）. The postoperative root of mean square of higher aberration（RMSh） was markedly increased（P 〈 0.01）. The ratio of higherorder aberration（Hi order） was increased and the value of CA was decreased （P〈 0.01）, C7 and C12 increased（P〈 0.01, P〈0.05）, the value of trefoil aberration Z33 was reduced and the valuve of C8 was increased. Conclusion： Iris positioning wavefront- guided LASIK is helpful to improve visual quality. The zernike ruction including increasing C7 and C12 is related to postoperative visual quality.