高度近视和高度远视的准分子激光原位角膜磨镶术的波前像差结果

Wavefront aberration outcomes of LASIK for high myopia and high hyperopia.

作者信息

Pesudovs Konrad

机构信息

Department of Ophthalmology, Flinders Medical Center and Flinders University of South Australia, Bedford Park, South Australia, Australia.

出版信息

J Refract Surg. 2005 Sep-Oct;21(5):S508-12. doi: 10.3928/1081-597X-20050901-18.

DOI:10.3928/1081-597X-20050901-18

PMID:16209452

Abstract

PURPOSE

To determine the higher order aberrations at the corneal first surface after conventional LASIK for high myopia and high hyperopia.

METHODS

This was a retrospective study using a convenience sample with subjects divided into five groups by level of refractive correction. Group 1 were normals, having no eye disease or previous surgery, but may have had refractive error. Group 2 had low myopia (-1.00 to -5.87 D), group 3 high myopia (> 6.00 D), group 4 low hyperopia (+1.00 to +3.87 D), and group 5 high hyperopia (> 4.00 D). LASIK was performed using a Technolas 217 laser. Corneal topography was taken with Orbscan II, and Placido data exported to VOLPro software v6.71. Wavefront aberrations were determined for a 6.0-mm pupil.

RESULTS

The study included 264 subjects-group 1 (normal), n=204; group 2 (low myopia), n=20; group 3 (high myopia), n=20; group 4 (low hyperopia), n=10; and group 5 (high hyperopia), n=10. The spherical equivalent refractive error corrected (mean +/-SD) was 0.00 +/- 0.00 D in group 1, -3.92 +/- 1.47 D in group 2, -9.53 +/- 2.06 D in group 3, +2.49 +/- 0.51 D in group 4, and +5.54 +/- 1.22 D in group 5. The total higher order root-mean-square (RMS) wavefront aberration was 0.38 +/- 0.07 microm in group 1, 0.69 +/- 0.22 microm in group 2, 1.36 +/- 1.79 microm in group 3, 0.64 +/- 0.34 microm in group 4, and 1.76 +/- 0.54 microm in group 5. Spherical aberration was 0.25 +/- 0.06 mcirom in group 1, 0.45 +/- 0.11 microm in group 2, 0.64 +/- 0.29 microm in group 3, -0.11 +/- 0.15 microm in group 4, and -0.56 +/- 0.22 microm in group 5. The refractive correction (Rx) was highly correlated to total higher order RMS for myopic correction higher order RMS = 0.38 - 0.07 Rx, R2=0.52, and for hyperopic correction higher order RMS = 0.18 + 0.28 Rx, R2 = 0.75.

CONCLUSIONS

Conventional LASIK increases all corneal higher order aberrations with induced aberrations increasing with the magnitude of refractive correction. High refractive corrections, both myopic (>6.00 D) and hyperopic (>5.00 D), can lead to very high levels of corneal higher order aberrations.

摘要

目的

确定高度近视和高度远视患者接受传统准分子激光原位角膜磨镶术（LASIK）后角膜前表面的高阶像差。

方法

这是一项回顾性研究，采用便利抽样，根据屈光矫正程度将受试者分为五组。第1组为正常人，无眼部疾病或既往手术史，但可能有屈光不正。第2组为低度近视（-1.00至-5.87 D），第3组为高度近视（> 6.00 D），第4组为低度远视（+1.00至+3.87 D），第5组为高度远视（> 4.00 D）。使用Technolas 217激光进行LASIK手术。采用Orbscan II进行角膜地形图检查，并将Placido数据导出到VOLPro软件v6.71。测量6.0毫米瞳孔的波前像差。

结果

该研究纳入264名受试者——第1组（正常），n = 204；第2组（低度近视），n = 20；第3组（高度近视），n = 20；第4组（低度远视），n = 10；第5组（高度远视），n = 10。第1组矫正后的等效球镜屈光不正（均值±标准差）为0.00±0.00 D，第2组为-3.92±1.47 D，第3组为-9.53±2.06 D，第4组为+2.49±0.51 D，第5组为+5.54±1.22 D。第1组总的高阶均方根（RMS）波前像差为0.38±0.07微米，第2组为0.69±0.22微米，第3组为1.36±1.79微米，第4组为0.64±0.34微米，第5组为1.76±0.54微米。第1组的球差为0.25±0.06微米，第2组为0.45±0.11微米，第3组为0.64±0.29微米，第4组为-0.11±0.15微米，第5组为-0.56±0.22微米。近视矫正时，屈光矫正（Rx）与总的高阶RMS高度相关（高阶RMS = 0.38 - 0.07 Rx，R2 = 0.52）；远视矫正时，高阶RMS = 0.18 + 0.28 Rx，R2 = 0.75。