目的：评价自适应光学视觉模拟器(VAO)测量全眼高阶像差的重复性及与OPD-Scan Ⅲ测量全眼高阶像差的一致性。

方法：采用横断面研究方法。纳入2023-08/09在成都东区爱尔眼科医院屈光科就诊的近视患者204例204眼(均取右眼数据)。由同一位操作熟练的检查者分别使用两种设备进行检查，使用VAO测量4.5 mm瞳孔直径下3-6阶的高阶像差，VAO和OPD-Scan Ⅲ测量3-6 mm瞳孔直径下全眼总高阶像差(tHOA)、球差(SA)、彗差(Coma)和三叶草像差(Trefoil)，评估VAO测量全眼像差的重复性及两种设备的一致性。

结果：VAO测量全眼的高阶像差均显示较高的重复性(0.767≤ICC≤0.941、S_w<0.01 μm、TRT<0.1 μm)。4-6 mm瞳孔直径下VAO与OPD-Scan Ⅲ的Coma测量值无差异(P>0.05)，其余瞳孔直径下全眼总高阶像差的测量值均有差异(均P<0.05)。VAO与OPD-Scan Ⅲ的3 mm瞳孔直径下各阶像差以及4、5 mm瞳孔直径下的SA、4 mm瞳孔直径下的Coma测量值的95%LoA<0.1，显示一致性较好，其余瞳孔直径下的像差测量值的95%LoA>0.1，显示一致性较差，两种设备3 mm(r=0.218-0.317，P<0.01)、4 mm(r=0.406-0.672，P<0.01)、5 mm(r=0.538-0.839，P<0.01； r=0.030-0.109，P>0.01)以及6 mm(r=0.369-0.766，P<0.01)瞳孔直径下高阶像差测量值差异较大。

结论：VAO测量3-6 mm瞳孔直径下全眼高阶像差结果时具有良好的重复性，但VAO与OPD-Scan Ⅲ的3-6 mm瞳孔直径下的全眼高阶像差测量值存在差异性，一致性较差，临床应用不可互换。

METHODS: A cross-sectional study was conducted from August to September 2023, including a total of 204 patients(204 eyes)with myopia whose right eyes were measured. The examinations were performed by the same skilled examiner using both devices separately. The VAO device was used to measure higher order aberrations of orders 3 to 6 at a pupil diameter of 4.5 mm, while both the VAO and OPD-Scan Ⅲ devices were utilized to measure total higher-order aberration(tHOA), spherical aberration(SA), coma aberration(Coma), and trefoil aberration(Trefoil)of the entire eye at pupil diameters ranging from 3 to 6 mm. Furthermore, the repeatability of whole eye aberration measurements obtained with the VAO device was evaluated and the agreement of the two devices was assessed.

RESULTS: The whole-eye higher-order aberrations measured by VAO demonstrated excellent repeatability(0.767≤ICC≤0.941, S_w<0.01 μm, TRT<0.1 μm). There was no statistically significant difference in Coma measured by VAO or OPD-Scan Ⅲ for pupil diameters ranging from 4 to 6 mm(P>0.05), while a statistically significant difference was observed in whole-eye tHOA of other pupil diameters(all P<0.05). The agreement of aberration measurements for each order between VAO and OPD-Scan Ⅲ for 3 mm pupil diameters, SA at 4 and 5 mm pupil diameter and Coma at 4 mm pupil diameter showed a 95% limit of agreement(LoA)<0.1, indicating good agreement; however, poor agreement was found for the remaining aberration measurements at different pupil diameters, with a 95%LoA>0.1, and there were significant differences in higher-order aberrations measured by two devices under a pupil diameter of 3 mm(r=0.218-0.317, P<0.01), 4 mm(r=0.406-0.672, P<0.01), 5 mm(r=0.538-0.839, P<0.01 and r=0.030-0.109, P>0.01)and 6 mm(r=0.369-0.766, P<0.01).

CONCLUSION: The VAO demonstrates favorable repeatability when assessing whole-eye higher order aberration under pupil diameters of 3-6 mm. However, there is inadequate agreement and interchangeability in whole-eye higher order aberration at 3-6 mm pupil diameter between VAO and OPD-Scan Ⅲ for clinical purposes.