目的:比较分析角膜表层与基质层屈光手术后高阶像差及其变化值。方法:行准分子激光治疗的近视眼患者100例200眼,其中接受LASIK手术50例100眼,接受新型表层手术(ASA)50例100眼。LASIK手术组术前等效球镜度(SE)为-1.25～-9.25(平均-5.75±1.74)D,ASA手术组术前SE为-2～-9.25(平均-5.42±1.81)D。术前及术后1,3,6mo检查裸眼视力(UCVA)、最佳矫正视力(BSCVA)、球镜及柱镜度数、SE以及波前像差等。结果:C7,C12,RMS3,RMS4,RMS5,RMS6和RMSh的变化值均和球镜度变化值、SE变化值的绝对值显著正相关。术后1mo,ASA组C7绝对值、RMSh,RMS3和RMS6均显著小于LASIK组;术后3mo时,ASA组C7和C14显著小于LASIK组,LASIK组C12显著小于ASA组;术后6mo时,ASA组仅C14显著优于LASIK组。术后1mo时,ASA组RMS3,RMS5,RMS6和RMSh的变化值均显著小于LASIK组,术后3mo时,ASA组RMS6变化值显著小于LASIK组,术后6mo时,ASA组RMS3,RMS6和RMSh的变化值显著小于LASIK组。结论:高阶像差增大程度与球镜度及SE的变化程度正相关。ASA组术后高阶像差及其增大程度均小于LASIK组,术后6mo时两组差异仍显著。

AIM:To compare higher order aberrations(HOA)and their changes after surface and stromal ablation surgeries.METHODS:This prospective study included 200 eyes of 100 patients who sought for refractive surgery;50 patients(100 eyes)received laser in situ keratomileusis(LASIK)and 50 patients(100 eyes)received advanced surface ablation(ASA).Spherical equivalent(SE)of LASIK group ranged from-1.25 to-9.25(-5.75±1.74)D,SE of ASA group-2~-9.25(-5.42±1.81)D.Uncorrected visual acuity(UCVA),best spectacle-corrected visual acuity(BSCVA),spherical and cylindrical diopter,SE,and wavefront aberrations were recorded pre-ablation,1 month,3 and 6 months post-ablation.RESULTS:Changes of C7,C12,RMS3-6 and RMSh positively correlated with changes of spherical,cylindrical diopter and SE.C7,RMS3,RMS6 and RMSh of ASA group were smaller compared with LASIK group at 1st month post-operation;C7 and C14 of ASA were also smaller at 3rd month post-operation,while C12 of LASIK was smaller;only C14 of ASA was smaller than LASIK at 6th month post-operation.Compared with LASIK group,changes of RMS3,RMS5,RMS6 and RMSh in ASA group were smaller at 1st month post-operation;changes of RMS6 in ASA was smaller at 3 months post-operation;changes of RMS3,RMS6 and RMSh in ASA were smaller at 6th month post-operation.CONCLUSION:Increase of HOA positively correlate with changes of SE and spherical diopter.Both HOA and its increase in ASA group are smaller when compare with LASIK group,which maintain until 6 months post-operation.

R779.63

中国国家自然科学基金资助项目（No.30600692）