高度近视患者飞秒 LASIK 术后高阶像差的变化。

High-order aberration changes after femtosecond LASIK surgery in patients with high myopia.

机构信息

Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-sen University, Guangzhou, China.

Department of Ophthalmology, Center of Optometry of the First Affiliated Hospital of Harbin Medical University, Harbin, China.

出版信息

Ann Palliat Med. 2021 Jul;10(7):7689-7696. doi: 10.21037/apm-21-1677.

DOI:10.21037/apm-21-1677

PMID:34353057

Abstract

BACKGROUND

To investigate the relationship between high-order aberration (HOA) changes and RCST/CT (residual corneal stroma thickness/corneal thickness) after femtosecond LASIK surgery.

METHODS

A total of 65 eyes from 39 patients with high myopia, who had femtosecond (FS) laser-assisted in situ keratomileusis (LASIK) surgery performed in our hospital, were included in this study. HOA and central corneal thickness were measured preoperatively and at 1 week, 1 month, and 3 months after FS-LASIK by Sirius Scheimpflug-Placido topography. Residual corneal stroma thickness (RCST) and ablation depth were measured during surgery.

RESULTS

Horizontal coma (Z31), spherical aberration (Z40), second horizontal coma (Z51), second horizontal trefoil (Z53), pentafoil (Z55), second spherical aberration (Z60), and total HOAs were significantly increased at 1 week, 1 month, and 3 months after surgery compared with the preoperative values (P<0.05), but no significant differences were found in horizontal trefoil (Z33; P>0.05). Furthermore, Z31, Z40, and HOAs were significantly increased at 3 months post-surgery compared with the values at 1 week post-operation (P<0.05). Positive correlations were found between ablation depth and Z60 at 1 week and 1 month after surgery (r=0.291 and 0.337, respectively; P<0.05). Ablation depth was positively correlated with Z40 and Z60 at 3 months after surgery (r=0.439 and 0.336, respectively; P<0.05). The RCST/CT was negatively correlated with Z40, Z60, and HOAs at 3 months after surgery (r=-0.322, -0.412, and -0.321, respectively; P<0.05). There were no significant correlations between Zernike coefficients in terms of high-order aberration, HOAs, and RCST/CT at 1 week and 1 month post-surgery.

CONCLUSIONS

Corneal HOAs in high myopia patients increased significantly after FS-LASIK surgery, and this was mainly observed as increases in coma and spherical aberration. The greater the ablation depth, the larger the influence on spherical aberrations. The greater the RCST/CT, the smaller the influence of HOAs on the cornea.

摘要

背景

研究飞秒 LASIK 手术后高阶像差（HOA）变化与 RCST/CT（剩余角膜基质层厚度/角膜厚度）的关系。

方法

本研究纳入 39 例（65 只眼）高度近视患者，均接受飞秒（FS）激光辅助原位角膜磨镶术（LASIK）。术前及 FS-LASIK 术后 1 周、1 个月和 3 个月，采用 Sirius Scheimpflug-Placido 地形图仪测量 HOA 和中央角膜厚度。术中测量剩余角膜基质层厚度（RCST）和消融深度。

结果

术后 1 周、1 个月和 3 个月，水平彗差（Z31）、球差（Z40）、第二水平彗差（Z51）、第二水平三叶草（Z53）、五叶草（Z55）、第二球差（Z60）和总 HOA 均较术前显著增加（P<0.05），但水平三叶草（Z33；P>0.05）差异无统计学意义。此外，术后 3 个月 Z31、Z40 和 HOA 较术后 1 周显著增加（P<0.05）。术后 1 周和 1 个月，消融深度与 Z60 呈正相关（r=0.291 和 0.337，均 P<0.05）。术后 3 个月，消融深度与 Z40 和 Z60 呈正相关（r=0.439 和 0.336，均 P<0.05）。术后 3 个月 RCST/CT 与 Z40、Z60 和 HOA 呈负相关（r=-0.322、-0.412 和-0.321，均 P<0.05）。术后 1 周和 1 个月，高阶像差 Zernike 系数、HOA 和 RCST/CT 之间无显著相关性。