目的：对比分析波前像差与角膜地形图引导个体化准分子激光原位角膜磨镶术(LASIK)对近视患者术后视觉质量的影响。

方法：选取2016-01/2017-01期间我院眼科行LASIK近视患者100例200眼，随机分为A组、B组，各50例100眼，本研究全部选右眼作为研究对象。术前完善眼部检查，行LASIK术，术中A组根据波前像差仪检查资料进行个体化切削角膜基质，B组根据角膜地形图仪检查数据完成个体化切削。比较两组患者术后视力及视觉质量。

结果：两组患者术前视力情况比较差异无统计学意义(P>0.05)，术后6mo UCVA、BCVA及屈光度均较术前显著改善，差异有统计学意义(P<0.05)，且A组术后6mo屈光度显著低于B组，差异有统计学意义(P<0.05)。两组患者术前对比敏感度(CS)比较差异无统计学意义(P>0.05)，术后3mo两组各视标CS均优于术前，差异有统计学意义(P<0.05)，两组术后3mo除了明亮无眩光状态下CS差异无统计学意义(P>0.05)以外，A组在明亮眩光、昏暗有和无眩光状态下CS均显著优于B组，差异有统计学意义(P<0.05)。两组术前波前像差检测结果比较差异无统计学意义(P>0.05)，术后3mo两组总像差、总高阶像差、彗差及球差均呈明显增加趋势，差异有统计学意义(P<0.05)，但A组增加幅度显著低于B组，差异有统计学意义(P<0.05)。

结论：波前像差与角膜地形图引导个体化准分子手术均可显著改善近视患者视力，但前者在改善视觉质量方面优势更突出。

METHODS: During the period of January 2016 to January 2017, 100 patients(a total of 200 affected eyes)with myopia in our hospital were selected as the subjects, and they were randomly divided into Group A and Group B with 50 cases in each group. Before surgery, the eyes were examined and LASIK was performed. During surgery, the corneal stroma of eyes in Group A was cut individually according to the results of wavefront aberration examination while the individual cutting in Group B was performed according to the data of corneal topography. The visual acuity and visual quality were compared between the two groups after surgery.

RESULTS: There was no significant difference of the visual acuity between the two groups before surgery(P>0.05). The Log MAR uncorrected visual acuity(UCVA), Log MAR BCVA and diopter were significantly improved at 6mo after surgery(P<0.05), and the diopter of Group A at 6mo after surgery was lower than that of Group B(P<0.05). There was no significant difference of contrast sensitivity(CS)between the two groups before surgery(P>0.05). But CS of different optotypes in two groups at 3mo after surgery were all better than those before surgery(P<0.05). There was no significant difference between the two groups in CS under the bright and non-glare condition at 3mo after surgery(P>0.05). However, CS of Group A under bright glare, dark with glare and dark without glare states were significantly better than those of Group B(P<0.05). There was no significant difference of detection results of wavefront aberrations between the two groups before surgery(P>0.05). At 3mo after surgery, the total aberrations, total higher-order aberrations, comatic aberrations and spherical aberrations significantly increased in two groups(P<0.05), and the increase in Group A was obviously lower than that in Group B(P<0.05).

CONCLUSION: Both of wavefront aberration and corneal topography guided individualized excimer surgery can significantly improve the visual acuity of patients with myopia, but the former has more advantages in improving the visual quality.