飞秒激光辅助原位角膜磨镶术后术前瞳孔中心偏移对角膜高阶像差的影响。
Effect of preoperative pupil offset on corneal higher-order aberrations after femtosecond laser-assisted in situ keratomileusis.
机构信息
Tianjin Medical University Eye Hospital, Eye Institute and School of Optometry, Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Tianjin, 300384, China.
Aier Eye Hospital, Shanxi, 030006, China.
出版信息
BMC Ophthalmol. 2023 Jun 1;23(1):247. doi: 10.1186/s12886-023-02960-y.
BACKGROUND
This study aimed to investigate the relationship between multiple higher-order aberrations (HOAs) subgroups and pupil offset, as well as to analyze the factors affecting postoperative corneal HOAs in patients with different degrees of refractive errors.
METHODS
We enrolled 160 patients (316 eyes) aged ≥ 18 years who had undergone femtosecond laser-assisted in situ keratomileusis (FS-LASIK) treatment. Based on the relationship between the preoperative pupil offset and the postoperative ΔHOAs, all patients were divided into two groups: group I (pupil offset ≤ 0.20 mm) and group II (pupil offset > 0.20 mm). All of the eyes had low to high myopia with or without astigmatism (manifest refraction spherical equivalent (MRSE) < -10.00 D). Uncorrected distance visual acuity, corrected distance visual acuity, MRSE, pupil offset, central corneal thickness, corneal HOAs, vertical coma (Z), horizontal coma (Z), spherical aberration (Z), trefoil 0° (Z), and trefoil 30° (Z) over a 6 mm diameter central corneal zone diameter were evaluated preoperatively and at 1 and 3 months postoperatively.
RESULTS
Our result revealed significant differences in postoperative corneal total root mean square (RMS) HOAs, RMS vertical coma, RMS horizontal coma, RMS spherical aberration, and RMS trefoil 30° between group I and group II. ΔMRSE was found to be an effective factor for ΔRMS HOAs (R = 0.383), ΔRMS horizontal coma (R = 0.205), and ΔRMS spherical aberration (R = 0.397). In group II, multiple linear regression analysis revealed a significant correlation between preoperative pupillary offset and Δtotal RMS HOAs (R = 0.461), ΔRMS horizontal coma (R = 0.040), and ΔRMS trefoil 30°(R = 0.089). The ΔRMS vertical coma effect factor is the Y-component, and the factor influencing ΔRMS spherical aberration was ΔMRSE (R = 0.256).
CONCLUSION
A small pupil offset was associated with a lower induction of postoperative corneal HOAs. Efforts to optimize centration are critical for improving surgical outcomes in patients with FS-LASIK.
背景
本研究旨在探讨多个高阶像差（HOAs）亚组与瞳孔偏移之间的关系，并分析不同程度屈光不正患者术后角膜 HOAs 的影响因素。
方法
我们纳入了 160 名年龄≥18 岁的患者（316 只眼），这些患者均接受了飞秒激光辅助原位角膜磨镶术（FS-LASIK）治疗。根据术前瞳孔偏移与术后 ΔHOAs 的关系，将所有患者分为两组：I 组（瞳孔偏移≤0.20mm）和 II 组（瞳孔偏移>0.20mm）。所有患者均为低至高近视合并或不合并散光（矫正远视力球镜等效值（MRSE）<−10.00D）。分别于术前及术后 1 个月和 3 个月评估患者的裸眼远视力、最佳矫正远视力、MRSE、瞳孔偏移、中央角膜厚度、角膜 HOAs、垂直彗差（Z）、水平彗差（Z）、球差（Z）、6mm 中央角膜直径区的三叶 0°（Z）和三叶 30°（Z）。
结果
研究结果显示，I 组与 II 组患者术后角膜总均方根（RMS）HOAs、RMS 垂直彗差、RMS 水平彗差、RMS 球差和 RMS 三叶 30°差异有统计学意义。ΔMRSE 是 ΔRMS HOAs（R=0.383）、ΔRMS 水平彗差（R=0.205）和 ΔRMS 球差（R=0.397）的有效影响因素。在 II 组中，多元线性回归分析显示术前瞳孔偏移与 Δ总 RMS HOAs（R=0.461）、ΔRMS 水平彗差（R=0.040）和 ΔRMS 三叶 30°（R=0.089）呈显著相关。影响 ΔRMS 垂直彗差的效应因子是 Y 分量，影响 ΔRMS 球差的因子是 ΔMRSE（R=0.256）。
结论
小瞳孔偏移与术后角膜 HOAs 的诱导较低相关。在 FS-LASIK 中，优化定位对于改善手术结果至关重要。
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