Department of Ophthalmology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Medal Eye Institute, Chongqing, China.
PeerJ. 2024 Aug 21;12:e17940. doi: 10.7717/peerj.17940. eCollection 2024.
To compare the visual quality after wavefront-guided femtosecond LASIK (WFG FS-LASIK) in patients with different levels of preoperative total ocular higher-order aberrations to guide clinical decision-making regarding patient selection and treatment strategies.
This study included 112 right eyes of 112 patients who previously underwent WFG FS-LASIK for correcting myopia and myopic astigmatism. The patients were divided into two groups based on the mean values of preoperative total ocular HOAs (0.30 ± 0.09 µm): HOA ≤ 0.3 and > 0.3 groups. The visual acuity, manifest refraction, corneal Strehl ratio (SR), root mean square (RMS) of corneal and ocular aberrations, and area under the log contrast sensitivity function (AULCSF) of both groups were compared preoperatively and at 1, 3, 6, and 12 months postoperatively.
The induced ocular HOAs and coma (Δ = 1 mo - Preop) were significantly lower in the HOAs > 0.3 group than in the HOAs ≤ 0.3 group (ΔHOAs: 0.39 ± 0.19 . 0.29 ± 0.18 μm, = 2.797, = 0.006; Δ coma: 0.30 ± 0.19 . 0.20 ± 0.21 μm, = 2.542, = 0.012). In the HOAs > 0.3 group, ΔHOAs were negatively correlated with the preoperative ocular HOAs ( = -0.315, = 0.019). In the HOAs ≤ 0.3 group, the regression equation for Δ HOAs = 0.098 + 0.053 |SE| ( = 21.756, < 0.001). In the HOAs > 0.3 group, the regression equation for ΔHOAs = 0.534 - 1.081 HOAs + 0.038|Sphere| ( = 7.954, = 0.001). The postoperative uncorrected distance visual acuity, spherical equivalent, corneal aberrations, SR and AULCSF of both groups were similar (all > 0.05). Furthermore, the ocular aberrations were not significantly different between both groups at 3, 6, and 12 months postoperatively (all > 0.05). In addition, compared with the preoperative period, the AULCSF of both groups were significantly increased in the postoperative period (all < 0.05).
The induced ocular HOAs and coma in HOAs > 0.3 group were lower. However, both groups achieved equivalent and excellent visual quality after WFG FS-LASIK. WFG FS-LASIK may provide significant visual benefits for a wider range of patients.
比较不同术前总眼高阶像差（HOA）水平的患者行波前引导飞秒 LASIK（WFG FS-LASIK）后的视觉质量，以指导患者选择和治疗策略。
本研究纳入了 112 例（112 只眼）先前因近视和近视散光接受 WFG FS-LASIK 治疗的患者。根据术前总眼 HOA 的平均值将患者分为两组（0.30 ± 0.09 µm）：HOA≤0.3 和>0.3 组。比较两组患者术前和术后 1、3、6 和 12 个月的视力、角膜前表面的角膜波前像差、角膜和眼总像差的均方根（RMS）、角膜斯特尔勒比（SR）、对数对比度敏感函数下面积（AULCSF）。
HOA > 0.3 组的眼诱导高阶像差和彗差（Δ=1 mo - Preop）明显低于 HOA≤0.3 组（ΔHOAs：0.39 ± 0.19 比 0.29 ± 0.18 µm，=2.797，=0.006；Δ彗差：0.30 ± 0.19 比 0.20 ± 0.21 µm，=2.542，=0.012）。在 HOA > 0.3 组中，ΔHOAs 与术前眼 HOA 呈负相关（= -0.315，=0.019）。在 HOA≤0.3 组中，Δ HOAs 的回归方程为Δ HOAs=0.098+0.053|SE|（=21.756，<0.001）。在 HOA > 0.3 组中，Δ HOAs 的回归方程为Δ HOAs=0.534-1.081HOAs+0.038|Sphere|（=7.954，=0.001）。两组术后未矫正远视力、等效球镜、角膜像差、SR 和 AULCSF 均相似（均>0.05）。此外，两组患者术后 3、6 和 12 个月的眼像差无显著差异（均>0.05）。此外，与术前相比，两组术后 AULCSF 均显著提高（均<0.05）。
HOA > 0.3 组的眼诱导高阶像差和彗差较低。然而，两组患者在 WFG FS-LASIK 后均获得了等效和卓越的视觉质量。WFG FS-LASIK 可能为更广泛的患者提供显著的视觉益处。
