目的 观察波阵面像差引导的非球面LASIK术后高阶像差的变化.方法 前瞻性研究.选取符合条件的患者120例(240只眼)分为3个组:波阵面像差引导的非球面LASIK组(A组);波阵面像差引导的LASIK组(B组);Q值引导的非球面LASIK组(C组),对手术前后A组的高阶像差进行研究,随访时间为术后1周及1、3、6个月.对3个组患者术后高阶像差进行比较,随访时间为术后6个月.手术前后数据的比较采用独立样本t检验;3个组之间的数据比较采用单因素方差分析,组间的多重比较进行Dunnet t检验.结果 A组总高阶像差术前及术后1周、1、3、6个月分别为(0.43±0.12)、(0.39±0.12)、(0.47±0.14)、(0.40±0.12)、(0.38±0.11) μm,术后各时间点与术前比较差异均无统计学意义(t=0.874,-1.145,0.652,0.496;P＞0.05),但随着时间的延长,有变小的趋势;球差分别为(0.14±0.08)、(0.17±0.11)、(0.26±0.10)、(0.25±0.12)、(0.18±0.09) μm,术后1周和术前比较差异无统计学意义(t=-1.815,P=0.077),术后1、3、6个月时均大于术前(t=-4.410,-2.375,-1.870,P＜0.05).术后6个月,术后A组、B组、C组总高阶像差分别为(0.38±0.11)、(0.61±0.13)、(0.46±0.15) μm,球差分别为(0.18±0.09)、(0.46±0.12)、(0.19±0.13) μm,高阶像差和球差3个组之间的比较,A组和C组明显低于B组,差异均有统计学意义(P＜0.05),A组和C组差异无统计学意义(P =0.866),但A组术后较术前变化小于C组;A组、B组、C组垂直彗差分别为(0.16±0.11)、(0.17±0.13)、(0.13±0.12) μm,水平彗差分别为(0.16±0.13)、(0.23±0.15) μm、(0.14±0.10)μm,3个组患者在垂直彗差和水平彗差方面比较差异均无统计学意义(F =0.367,0.254;P＞0.05).结论 波阵面像差引导的非球面个体化LASIK与波阵面像差引导的LASIK相比能更好地减少术后高阶像差和球差的增加,且术后较术前变化小于Q值引导的非球面LASIK.%Objective To compare the higher order aberration of wavefront-guided aspherical versus wavefront-guided and Q-value guided aspheric personalized LASIK surgery in the treatment of myopia.Methods Prospective study.120 patients with myopia and/or astigmatism(240 eyes) were involved in our hospital from August 2010 to December 2010.There was a prospective study,divided into three groups:Wavefront-guided aspherical personalized LASIK in group A; Wavefront-guided LASIK in group B; Q-value guided aspheric LASIK in group C.The follow-up time was 6 months.The comparison of data before and after operation was two independent samples t test.The comparison among three groups was one-way analysis of variance,and multiple comparison between groups was Dunnet t test.Results A group:The differences between before and after surgery were not statistically significant in higher order aberration(t1 week =0.874,P1 week =0.387;t1 mouth =-1.145,P1 mouth =0.259;t3 mouth =0.652,P3 mouth =0.518; t6 mouth =0.496,P6 mouth =0.439),but as the extension of time,The values have a tendency to become smaller; the difference was notstatistically significant in spherical aberration between before and after surgery 1 week (t =-1.815,P =0.077),and was statistically significant between before and after surgery 1 month,3 months and 6 months after surgery (t1 month =-4.410,P1 mouth =0.000 ; t3 mouth =-2.375,P3 mouth =0.022 ; t6 mouth =-1.870,P6 month =0.000),the values after surgery were higher.The differences between before and after surgery were not statistically significant in coma aberration (t1 week =1.028,P1 week =0.310; t1 mouth =0.847,P1 mouth =0.402;t3 mouth =0.210,P3 mouth =0.984; t6 mouth =0.533,P6 mouth =0.597).At 6 months,the higher order aberration and spherical aberration in A group and C group were significantly lower than the B group,and the differences were statistically significant(PA&B =0.000; PC&B =0.000),the differences between A group and C group were not statistically significant in higher order aberration and spherical aberration (P =0.866),but A group is less than the C group in changes before and after surgery.The differences among three groups were not statistically significant in the vertical and horizontal coma(Frertical coma =0.367,Pvertical come =0.683;Fhorizontal coma =0.254,Phorizontal coma =0.797).Conclusion Wavefront-guided aspherical personalized LASIK compared with wavefront-guided personalized LASIK can better reduce the increases of the higher order aberration and spherical aberration,and the changes between preoperative and postoperative is less than Qvalue guided aspheric personalized LASIK.
展开▼
