目的:比较常规准分子激光原位角膜磨镶术(标准LASIK)和波前像差引导的个体化准分子激光原位角膜磨镶术(波前像差引导LASIK)矫正中高度近视后高阶像差的变化情况。方法:选取2008-10/2009-05在我院行准分子激光手术者共60例120眼。按手术方式不同分为两组:波前组,接受波前像差引导的个体化准分子激光原位角膜磨镶术30例60眼;标准组,接受常规准分子激光原位角膜磨镶术30例60眼。所有患者于术前与术后6mo行波前像差(WaveScan WaveFrontTM System,AMOCo.,USA)检查,观察两组术前术后高阶像差的变化,并比较两组的差别。结果:所有患者无手术并发症,矫正视力≥1.0。波前组和标准组高阶像差均呈增加趋势,以彗差和球差增加为主。波前组HOAROM,Z7,Z8,Z12分别显著增加了73.2%,64.1%,128.9%和139.5%(P<0.05),标准组HOAROM,Z7,Z8,Z12分别显著增加了98.3%,149.1%,193.2%和107.8%(P<0.05)。波前组在总高阶像差(HOAROM)、30°三叶草(Z6)、垂直彗差(Z7)和水平彗差(Z8)高阶像差的改变显著优于标准组(P<0.05)。结论:术后6mo的随访结果表明,波前像差引导的LASIK可更好的控制术后高阶像差的增加,有助于患者获得更好的视觉质量。

AIM:To evaluate clinical efficacy of wavefront-guided laser in situ keratomileusis(LASIK) compared to standard LASIK for moderate and high myopia correction in the aspects of higher-order aberrations.METHODS:One hundred and twenty eyes of 60 subjects were studied from December 2008 to May 2009 at Ophthalmic Refractive Surgery Center (department of Ophthalmology in Changhai Hospital).The subjects were divided into 2 groups:wavefront-guided LASIK group and standard LASIK group,60 eyes of 30 subjects were enrolled in each group respectively.Ocular higher-order aberrations were evaluated by WaveScan WaveFrontTM System (AMO Co.,USA) before and 6 months after operation.The change of the ocular higher-order aberrations was calculated.RESULTS:After operation,all subjects had uncorrected visual acuity of 20/20 or better 6 months postoperatively,and they had no complications.It had shown an increase in ocular higher-order aberrations both in two groups,especially in comalike aberration and spherical-like aberration.The increase of total higher-order aberration,vertical comalike aberration,horizontal comalike aberration and spherical-like aberration were increased by 73.2%,64.1%,128.9% and 139.5% (P<0.05) in wavefront-guided LASIK group,while they were increased by 98.3%,149.1%,193.2% and 107.8% (P<0.05) in standard LASIK group.The change of HOAROM,Z6,Z7 and Z8 in wavefront-guided LASIK group was superior to that in standard LASIK group.CONCLUSION:Wavefront-guided LASIK has better control of the increase in higher-order aberrations than standard LASIK group,and it can help patients get better visual quality than standard LASIK.

R779.63