CAJ | 학술논문

目的采用波前像差仪进行客观验光,比较分析显然验光与不同瞳孔直径下含有不同高阶成分的波前像差验光的关系.方法横断面研究.选取近视及近视散光患者31例(62眼),利用基于Hartmann-Shack原理的波前传感系统进行波前像差测量,根据所测数据计算出不同瞳孔直径下仅有离焦的屈光度,包含离焦及球差的屈光度和含有离焦、球差及二级球差的屈光度,并应用Friedman检验分析临床显然验光与这些波前像差验光屈光度的关系.结果 2、3、4、5、6 mm直径瞳孔下的波前客观屈光度分别与临床显然验光屈光度比较,仅含有离焦时的屈光度差异最小,球镜度差异的中位数分别为-0.540、-0.473、-0.422、-0.407 、-0.290 D,差异具有统计学意义(Z=99.29,P＜0.01)；柱镜度差异的中位数分别为0.193、0.142、0.119、0.078、0.065 D,差异具有统计学意义(Z=30.25,P＜0.01)；平均散光轴差异的中位数分别为-2.41、-2.89、-3.03、-1.94、-2.40°,差异无统计学意义(Z=4.42,P＞0.05).含有高阶成分的屈光度与临床显然验光差异较大.结论由波前像差计算得到的屈光度与瞳孔直径和高阶像差参与的多少有关.纳入较高阶球差后等效屈光度降低,较大瞳孔直径下无高阶像差参与的波前屈光度与临床显然验光较接近.波前验光散光轴向与主觉验光较接近.
목적 채용파전상차의진행객관험광,비교분석현연험광여불동동공직경하함유불동고계성분적파전상차험광적관계.방법 횡단면연구.선취근시급근시산광환자31례(62안),이용기우Hartmann-Shack원리적파전전감계통진행파전상차측량,근거소측수거계산출불동동공직경하부유리초적굴광도,포함리초급구차적굴광도화함유리초、구차급이급구차적굴광도,병응용Friedman검험분석림상현연험광여저사파전상차험광굴광도적관계.결과 2、3、4、5、6 mm직경동공하적파전객관굴광도분별여림상현연험광굴광도비교,부함유리초시적굴광도차이최소,구경도차이적중위수분별위-0.540、-0.473、-0.422、-0.407 、-0.290 D,차이구유통계학의의(Z=99.29,P＜0.01)；주경도차이적중위수분별위0.193、0.142、0.119、0.078、0.065 D,차이구유통계학의의(Z=30.25,P＜0.01)；평균산광축차이적중위수분별위-2.41、-2.89、-3.03、-1.94、-2.40°,차이무통계학의의(Z=4.42,P＞0.05).함유고계성분적굴광도여림상현연험광차이교대.결론 유파전상차계산득도적굴광도여동공직경화고계상차삼여적다소유관.납입교고계구차후등효굴광도강저,교대동공직경하무고계상차삼여적파전굴광도여림상현연험광교접근.파전험광산광축향여주각험광교접근.
Objective To study an objective refraction method that includes different models of higher order aberrations; to study the relationship between manifest and objective refractions from wavefront aberrations with different pupils sizes.Methods Sixty-two eyes were included in this crosssectional study.Wavefront aberrations were measured using a Shack- Hartmann aberrometcr (WaveScan wavefront system, VISX, Inc., Santa Clara, CA). Refractive errors were computed that included different models of higher order aberrations for different pupil sizes. These refractions were then compared to manifest refractions using the Friedman test.Results The mean differences in refractive errors from wavefront aberrations were smallest between manifest refraction and objective refraction when only lower order aberrations were included.For 2,3,4,5,and 6 mm pupil sizes,the refractions for the median sphere were -0.540,-0.473,-0.422,-0.407 and -0.290 D,respectively.The differences were statistically significant (Z=99.29,P＜0.01).The refractions for the median cylinder were 0.193,0.142,0.119,0.078 and 0.065 D,respectively.The differences were statistically significant (Z=30.25,P＜0.01).The parameters for the median axis were -2.41,-2.89,-3.03,-1.94 and -2.40°,respectively.The differences were not statistically significant for all pupil sizes (Z=4.42,P＞0.05).Refractive errors with higher order aberrations included were significantly different from manifest refractions.Conclusion Objective refraction from wavefront aberrations varies with pupil size when models for higher order aberrations are included.The equivalent sphere is smaller when the spherical aberration is included.The refractive errors for lower order aberration for larger pupil diameters is in better agreement with manifest refraction than smaller pupil sizes.The mean axis difference is small between the two methods.