Ma Luxin, Atchison David A, Albietz Julie M, Lenton Lee M, McLennan Suzanne G
Shandong University, Jinan, China.
J Refract Surg. 2004 Jul-Aug;20(4):307-16. doi: 10.3928/1081-597X-20040701-02.
To compare the magnitude of aberrations in eyes after elective hypermetropic laser in situ keratomileusis (LASIK) and refractive lens exchange (clear lens replacement).
Forty-nine patients (92 eyes) had hypermetropic LASIK and 28 (48 eyes) had refractive lens exchange; 23 hypermetropic subjects (41 eyes) were the control group. LASIK was performed with the Nidek EC-5000 excimer laser; ablation zones 5.5 to 6.0-mm in diameter with transition zones 7.5 to 8-mm in diameter. For refractive lens exchange, all but four IOLs were made of foldable acrylic. Aberrations and corneal topography were measured with the Nidek OPD-Scan model ARK-10000 more than 12 months after surgery. The higher-order root-mean-square (HORMS) wave aberrations for combined third to sixth Zernike aberration orders and the Zernike spherical aberration coefficient C(0)(4) at both 4.2-mm and 6.0-mm pupil sizes were calculated.
For the LASIK group, surgical refractive change correlated significantly with total, corneal, and internal HORMS and spherical aberrations (except with internal spherical aberration for a 4.2-mm diameter pupil). For the refractive lens exchange group, there were no significant correlations of surgical refractive change with any of these factors. Similarly, there were no significant correlations of refraction with any of these factors for the control group. For a 3-diopter change in refraction with 6-mm pupils, LASIK doubled the total HORMS aberrations. LASIK changed the sign of spherical aberration from positive to negative by increasing the negative asphericity of the anterior cornea. Taking age differences between groups into account, refractive lens exchange increased the total HORMS aberrations by 40% compared with that of the control group, but this was not statistically significant. However, refractive lens exchange significantly increased total spherical aberration.
Refractive lens exchange was a better refractive procedure than LASIK for minimizing total higher order optical aberrations that accompany hypermetropic refractive surgery.
比较选择性远视性准分子原位角膜磨镶术（LASIK）和屈光性晶状体置换术（透明晶状体置换术）后眼睛像差的大小。
49例患者（92只眼）接受了远视性LASIK手术，28例（48只眼）接受了屈光性晶状体置换术；23例远视受试者（41只眼）为对照组。使用Nidek EC - 5000准分子激光进行LASIK手术；消融区直径为5.5至6.0毫米，过渡区直径为7.5至8毫米。对于屈光性晶状体置换术，除4个人工晶状体外，其余均由可折叠丙烯酸制成。术后12个月以上，使用Nidek OPD - Scan模型ARK - 10000测量像差和角膜地形图。计算了4.2毫米和6.0毫米瞳孔大小下第三至第六阶泽尼克像差组合的高阶均方根（HORMS）波像差以及泽尼克球差系数C(0)(4)。
对于LASIK组，手术屈光变化与总、角膜和内部HORMS以及球差显著相关（4.2毫米直径瞳孔的内部球差除外）。对于屈光性晶状体置换术组，手术屈光变化与这些因素中的任何一个均无显著相关性。同样，对照组的屈光与这些因素中的任何一个也无显著相关性。对于6毫米瞳孔下3屈光度的屈光变化，LASIK使总HORMS像差增加了一倍。LASIK通过增加前角膜的负非球面性将球差的符号从正变为负。考虑到各组之间的年龄差异，屈光性晶状体置换术使总HORMS像差比对照组增加了40%，但这在统计学上无显著意义。然而，屈光性晶状体置换术显著增加了总球差。
在使远视性屈光手术伴随的总高阶光学像差最小化方面，屈光性晶状体置换术是比LASIK更好的屈光手术。
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