Liu Hong-Ting, Zhou Zhou, Luo Wu-Qiang, He Wen-Jing, Agbedia Owhofasa, Wang Jiang-Xia, Huang Jian-Zhong, Gao Xin, Kong Min, Li Min, Li Li
Visual Science and Optometry Center, the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, Guangxi Zhuang Autonomous Region, China.
Ophthalmology Center, the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, Guangxi Zhuang Autonomous Region, China.
Int J Ophthalmol. 2018 Apr 18;11(4):656-661. doi: 10.18240/ijo.2018.04.20. eCollection 2018.
To compare the optical quality after implantation of implantable collamer lens (ICL) and wavefront-guided laser keratomileusis (WG-LASIK).
The study included 40 eyes of 22 patients with myopia who accepted ICL implantation and 40 eyes of 20 patients with myopia who received WG-LASIK. Before surgery and three months after surgery, the objective scattering index (OSI), the values of modulation transfer function (MTF) cutoff frequency, Strehl ratio, and the Optical Quality Analysis System (OQAS) values (OVs) were accessed. The higher order aberrations (HOAs) data including coma, trefoil, spherical, 2 astigmatism and tetrafoil were also obtained. For patients with pupil size <6 mm, HOAs data were analyzed for 4 mm-pupil diameter. For patients with pupil size ≥6 mm, HOAs data were calculated for 6 mm-pupil diameter. Visual acuity, refraction, pupil size and intraocular pressures were also recorded.
In both ICL and WG-LASIK group, significant improvements in visual acuities were found postoperatively, with a significant reduction in spherical equivalent (< 0.001). After the ICL implantation, the OSI decreased slightly from 2.34±1.92 to 2.24±1.18 with no statistical significance (=0.62). While in WG-LASIK group, the OSI significantly increased from 0.68±0.43 preoperatively to 0.91±0.53 postoperatively (Wilcoxon signed ranks test, =0.000). None of the mean MTF cutoff frequency, Strehl ratio, OVs showed statistically significant changes in both ICL and WG-LASIK groups. In the ICL group, there were no statistical differences in the total HOAs for either 4 mm-pupil or 6 mm-pupil. In the WG-LASIK group, the HOA parameters increased significantly at 4 mm-pupil. The total ocular HOAs, coma, spherical and 2 astigmatism were 0.12±0.06, 0.06±0.03, 0.00±0.03, 0.02±0.01, respectively. After the operation, these values were increased into 0.16±0.07, 0.08±0.05, -0.04±0.04, 0.03±0.01 respectively (Wilcoxon signed ranks test, all <0.05). At 6 mm-pupil, the induction of total HOAs was not statistically significant in the WG-LASIK group.
ICL implantation has a less disturbance to optical quality than WG-LASIK. The OQAS is a valuable complementary measurement to the wavefront aberrometers in evaluating the optical quality.
比较植入式隐形眼镜（ICL）植入术与波前引导准分子激光原位角膜磨镶术（WG-LASIK）术后的光学质量。
该研究纳入了22例接受ICL植入术的近视患者的40只眼以及20例接受WG-LASIK手术的近视患者的40只眼。在手术前及手术后三个月，测量客观散射指数（OSI）、调制传递函数（MTF）截止频率值、斯特列尔比以及光学质量分析系统（OQAS）值（OVs）。还获取了包括彗差、三叶草像差、球差、二级像散和四叶草像差在内的高阶像差（HOAs）数据。对于瞳孔直径<6mm的患者，分析4mm瞳孔直径下的HOAs数据。对于瞳孔直径≥6mm的患者，计算6mm瞳孔直径下的HOAs数据。同时记录视力、屈光、瞳孔大小和眼压。
ICL组和WG-LASIK组术后视力均有显著提高，等效球镜度显著降低（<0.001）。ICL植入术后，OSI从2.34±1.92略有下降至2.24±1.18，无统计学意义（=0.62）。而在WG-LASIK组，OSI术前为±0.43，术后显著增加至0.91±0.53（Wilcoxon符号秩检验，=0.000）。ICL组和WG-LASIK组的平均MTF截止频率、斯特列尔比、OVs均无统计学显著变化。在ICL组，4mm瞳孔或6mm瞳孔下的总高阶像差均无统计学差异。在WG-LASIK组，4mm瞳孔下的高阶像差参数显著增加。总眼高阶像差、彗差、球差和二级像散分别为0.12±0.06、0.06±0.03、0.00±0.03、0.02±0.01。术后，这些值分别增加至0.16±0.07、0.08±0.05、-0.04±0.04、0.03±0.01（Wilcoxon符号秩检验，均<0.05）。在6mm瞳孔下，WG-LASIK组总高阶像差的诱导无统计学意义。
ICL植入术对光学质量的干扰小于WG-LASIK。在评估光学质量方面，OQAS是波前像差仪的一项有价值的补充测量方法。
