方法：收集2014-06/2015-03就诊于我院屈光手术中心的近视及近视散光患者共125例245眼，其中行LASIK术38例74眼，飞秒激光制瓣的LASIK术42例83眼，全飞秒激光FLEx术45例88眼，分别于术前及术后1mo应用iTrace检查仪进行角膜高阶像差的测量。采用重复测量设计资料的方差分析对数据进行组内及组间的比较。

结果：三组受试对象手术前后角膜总高阶像差、垂直彗差、水平彗差及球差均有显著性差异(P分别为0.002、<0.01、<0.01、<0.01)即三种手术方式对角膜高阶像差均有显著性影响。不同手术方式间总高阶像差、水平彗差、球差均无统计学差异，仅垂直彗差的差异表现出显著性(F=3.943，P=0.021)，对垂直彗差进一步进行组间两两比较，结果发现FLEx组与其余两组的垂直彗差均存在统计学差异。

结论：三种手术方式术后1mo高阶像差均较术前明显增加，由于全飞秒激光 FLEx术进行透镜取出时的切口仍较大，对角膜高阶像差仍造成一定的影响，未表现出明显的优势。

METHODS: One hundred and twenty-five patients(245 eyes)from June 2014 to March 2015 in refractive surgery center of our hospital were recruited. There were 38 patients(74 eyes)underwent LASIK, 42 patients(83 eyes)underwent FS-LASIK, and 45 patients(88 eyes)underwent FLEx. The higher-order aberrations were measured preoperatively, at 1mo after surgeries with iTrace. The repeated measure of ANOVA was used to analyze the changes on higher-order aberrations among the groups.

RESULTS: Compared to the preoperative corneal higher-order aberrations, vertical coma aberration, horizontal coma aberration and spherical aberration, there were significantly differences in the three groups postoperatively(P=0.002, <0.01, <0.01, <0.01), which meant the three different surgeries effected the higher-order aberrations. Among these three different groups, we found that there were no significantly difference on total HOA, horizontal coma aberration and spherical aberrations(P>0.05). But it showed difference on vertical coma aberration(F=3.943,P=0.021). By multiple comparisons, there were statistical significance on vertical coma aberration between FLEx group and the other two.

CONCLUSION: The postoperative corneal higher-order aberrations all in creased in three groups. Due to the large incision in FLEx, the corneal aberration is still increased after surgeries. And the FLEx does not show a certain advantage yet.