Gobbe Marine, Reinstein Dan Z, Archer Timothy J
*MST(Optom), PhD †MD, MA ‡MA London Vision Clinic, London, United Kingdom (all authors); Department of Ophthalmology, Columbia University Medical Center, New York, New York (DZR); and Centre Hospitalier National d'Ophtalmologie, Paris, France (DZR).
Optom Vis Sci. 2015 Apr;92(4):447-55. doi: 10.1097/OPX.0000000000000557.
To compare the change in aberrations produced by laser-assisted in situ keratomileusis (LASIK) measured by either front surface corneal aberrometry or Hartmann-Shack whole-eye aberrometry.
This was a retrospective case series from consecutive patients treated with LASIK at the London Vision Clinic, London, UK. Corneal and ocular wavefront data were collected before and after LASIK for myopia and hyperopia. To control for centration of corneal and whole-eye aberration measurements, only patients with pupil offset (measured as the distance between the corneal vertex and the entrance pupil center) of 0.25 mm or less were recruited. Corneal front surface wavefront was obtained from a Placido-based corneal topography system (Atlas), and whole-eye wavefront was measured by Hartmann-Shack aberrometry (WASCA) before and at least 3 months after surgery. All aberrations were calculated up to the fourth order for the 6-mm pupil diameter. Change in HORMS (higher-order root mean square [RMS]) and all individual Zernike coefficients from the second to the fourth order were compared.
One hundred myopic eyes and 50 hyperopic eyes were included for analysis. For myopic LASIK, the change measured by corneal aberrometry or whole-eye aberrometry differed on average by 0.077 μm for HORMS, by 0.024 μm for secondary astigmatism, and by 0.065 μm for spherical aberration (p ≤ 0.003). For hyperopic LASIK, there was no statistically significant difference between the change measured by corneal aberrometry and whole-eye aberrometry for third- and fourth-order individual Zernike coefficients (p ≥ 0.034). However, the change in HORMS measured by whole-eye aberrometry was 0.095 μm greater than that measured by corneal aberrometry (p < 0.001).
This study demonstrated that when measuring the change in higher-order aberrations induced by LASIK, corneal front surface aberrometry measurement was not interchangeable with whole-eye ocular aberrometry.
比较通过角膜前表面像差仪或哈特曼-夏克全眼像差仪测量的准分子原位角膜磨镶术（LASIK）所产生的像差变化。
这是一项对英国伦敦视觉诊所接受LASIK治疗的连续患者的回顾性病例系列研究。收集近视和远视患者LASIK手术前后的角膜和眼波前数据。为控制角膜和全眼像差测量的中心定位，仅纳入瞳孔偏移（测量为角膜顶点与入瞳中心之间的距离）为0.25mm或更小的患者。角膜前表面波前由基于普拉西多的角膜地形图系统（Atlas）获得，全眼波前在手术前及术后至少3个月通过哈特曼-夏克像差仪（WASCA）测量。所有像差针对6mm瞳孔直径计算至四阶。比较高阶均方根（RMS）的变化以及从二阶到四阶的所有单个泽尼克系数的变化。
纳入100只近视眼睛和50只远视眼睛进行分析。对于近视LASIK，通过角膜像差仪或全眼像差仪测量的变化在高阶均方根方面平均相差0.077μm，在继发性散光方面相差0.024μm，在球差方面相差0.065μm（p≤0.003）。对于远视LASIK，角膜像差仪和全眼像差仪测量的三阶和四阶单个泽尼克系数的变化之间无统计学显著差异（p≥0.034）。然而，全眼像差仪测量的高阶均方根变化比角膜像差仪测量的大0.095μm（p<0.001）。
本研究表明，在测量LASIK引起的高阶像差变化时，角膜前表面像差测量与全眼像差测量不可互换。
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