中华眼视光学与视觉科学杂志
中華眼視光學與視覺科學雜誌
중화안시광학여시각과학잡지
CHINESE JOURNAL OF OPTOMETRY OPHTHALMOLOGY AND VISUAL SCIENCE
2014年
7期
416-420
,共5页
飞秒激光%飞秒激光小切口基质透镜取出术%视觉质量%Q值%高阶像差
飛秒激光%飛秒激光小切口基質透鏡取齣術%視覺質量%Q值%高階像差
비초격광%비초격광소절구기질투경취출술%시각질량%Q치%고계상차
Femtosecond laser%Small incision lenticule extraction%Visual quality%Q-value%Higher order aberration
目的 探讨SMILE术后角膜前表面非球面性与角膜高阶像差变化特点及其相关性.方法 前瞻性研究.随机选取自愿行SMILE手术的屈光不正患者41例,均选右眼为研究眼,于手术前及手术后3个月分别测量患者角膜前表面6、7、8、9 mm直径范围的非球面系数Q值,并测量角膜总高阶像差(HOA)、球差(Z40)、次级球差(Z60)、垂直彗差(Z3-1)、水平彗差(Z31)、水平三叶草(Z3-3)、倾斜三叶草(Z33)等高阶像差.采用配对t检验和Pearson相关进行数据分析.结果 SMILE手术后角膜前表面6、7、8、9 mm直径范围Q值均由负值转变为正值(t=-23.558、-26.661、-28.366、-28.788,P＜0.01).角膜HOA、Z40、Z06、Z3-1、Z31数值均增大(t=-11.815、-11.813、-16.209、6.470、4.835,P＜0.01),而Z3-3、Z33与术前比较差异无统计学意义(t=0.278、-1.064,P＞0.05).术前角膜HOA、Z40 、Z3-1与Q值有一定的相关性(P＜0.05),SMILE手术前后角膜HOA、Z40差值与角膜前表面各直径范围Q值差值均呈正相关关系(HOA:r =0.554、0.480、0.416、0.352,P＜0.05;Z40:r=0.671、0.577、0.495、0.395,P＜0.05);Z3-1差值与6、7 mm直径范围Q值差值呈正相关(r=0.377、0.342,P＜0.05);Z31差值与6、7、8 mm直径范围Q值差值呈正相关(r=0.436、0.385、0.316,P＜0.05);Z60、Z3-3、Z33差值与各直径范围Q值差值均无相关性.透镜直径与SMILE手术前后Q值差值无相关性;与角膜HOA、Z40差值呈负相关(r=-0.315,-0.393,P＜0.05);与角膜Z60、Z3-1、Z31、Z3-3、Z33差值均无相关性(P＞0.05).结论 SMILE手术后角膜前表面Q值由负值转变为正值;角膜高阶像差增大;透镜直径越大,角膜HOA、Z40变化越小.角膜前表面Q值与角膜HOA、Z40、Z3-1、Z31变化量均有正相关关系,其中与Z40相关程度最强.
目的 探討SMILE術後角膜前錶麵非毬麵性與角膜高階像差變化特點及其相關性.方法 前瞻性研究.隨機選取自願行SMILE手術的屈光不正患者41例,均選右眼為研究眼,于手術前及手術後3箇月分彆測量患者角膜前錶麵6、7、8、9 mm直徑範圍的非毬麵繫數Q值,併測量角膜總高階像差(HOA)、毬差(Z40)、次級毬差(Z60)、垂直彗差(Z3-1)、水平彗差(Z31)、水平三葉草(Z3-3)、傾斜三葉草(Z33)等高階像差.採用配對t檢驗和Pearson相關進行數據分析.結果 SMILE手術後角膜前錶麵6、7、8、9 mm直徑範圍Q值均由負值轉變為正值(t=-23.558、-26.661、-28.366、-28.788,P＜0.01).角膜HOA、Z40、Z06、Z3-1、Z31數值均增大(t=-11.815、-11.813、-16.209、6.470、4.835,P＜0.01),而Z3-3、Z33與術前比較差異無統計學意義(t=0.278、-1.064,P＞0.05).術前角膜HOA、Z40 、Z3-1與Q值有一定的相關性(P＜0.05),SMILE手術前後角膜HOA、Z40差值與角膜前錶麵各直徑範圍Q值差值均呈正相關關繫(HOA:r =0.554、0.480、0.416、0.352,P＜0.05;Z40:r=0.671、0.577、0.495、0.395,P＜0.05);Z3-1差值與6、7 mm直徑範圍Q值差值呈正相關(r=0.377、0.342,P＜0.05);Z31差值與6、7、8 mm直徑範圍Q值差值呈正相關(r=0.436、0.385、0.316,P＜0.05);Z60、Z3-3、Z33差值與各直徑範圍Q值差值均無相關性.透鏡直徑與SMILE手術前後Q值差值無相關性;與角膜HOA、Z40差值呈負相關(r=-0.315,-0.393,P＜0.05);與角膜Z60、Z3-1、Z31、Z3-3、Z33差值均無相關性(P＞0.05).結論 SMILE手術後角膜前錶麵Q值由負值轉變為正值;角膜高階像差增大;透鏡直徑越大,角膜HOA、Z40變化越小.角膜前錶麵Q值與角膜HOA、Z40、Z3-1、Z31變化量均有正相關關繫,其中與Z40相關程度最彊.
목적 탐토SMILE술후각막전표면비구면성여각막고계상차변화특점급기상관성.방법 전첨성연구.수궤선취자원행SMILE수술적굴광불정환자41례,균선우안위연구안,우수술전급수술후3개월분별측량환자각막전표면6、7、8、9 mm직경범위적비구면계수Q치,병측량각막총고계상차(HOA)、구차(Z40)、차급구차(Z60)、수직혜차(Z3-1)、수평혜차(Z31)、수평삼협초(Z3-3)、경사삼협초(Z33)등고계상차.채용배대t검험화Pearson상관진행수거분석.결과 SMILE수술후각막전표면6、7、8、9 mm직경범위Q치균유부치전변위정치(t=-23.558、-26.661、-28.366、-28.788,P＜0.01).각막HOA、Z40、Z06、Z3-1、Z31수치균증대(t=-11.815、-11.813、-16.209、6.470、4.835,P＜0.01),이Z3-3、Z33여술전비교차이무통계학의의(t=0.278、-1.064,P＞0.05).술전각막HOA、Z40 、Z3-1여Q치유일정적상관성(P＜0.05),SMILE수술전후각막HOA、Z40차치여각막전표면각직경범위Q치차치균정정상관관계(HOA:r =0.554、0.480、0.416、0.352,P＜0.05;Z40:r=0.671、0.577、0.495、0.395,P＜0.05);Z3-1차치여6、7 mm직경범위Q치차치정정상관(r=0.377、0.342,P＜0.05);Z31차치여6、7、8 mm직경범위Q치차치정정상관(r=0.436、0.385、0.316,P＜0.05);Z60、Z3-3、Z33차치여각직경범위Q치차치균무상관성.투경직경여SMILE수술전후Q치차치무상관성;여각막HOA、Z40차치정부상관(r=-0.315,-0.393,P＜0.05);여각막Z60、Z3-1、Z31、Z3-3、Z33차치균무상관성(P＞0.05).결론 SMILE수술후각막전표면Q치유부치전변위정치;각막고계상차증대;투경직경월대,각막HOA、Z40변화월소.각막전표면Q치여각막HOA、Z40、Z3-1、Z31변화량균유정상관관계,기중여Z40상관정도최강.
Objective To evaluate the characteristics of anterior corneal asphericity and higher order aberrations after SMILE surgery,and to analyze the correlation between them.Methods In this prospective study,41 subjects who underwent SMILE surgery were enrolled with right eyes selected for the study.The asphericity coefficient Q-value at diameters of 6,7,8 and 9 mm and total higher order aberrations (HOA),spherical aberrations (Z40),secondary spherical aberrations (Z60),vertical coma (Z3-1),horizontal coma (Z31),y-trefoil (Z3-3) and x-trefoil (Z33) of the cornea were measured before surgery and 3 months following the surgery.A paired-samples t test and Pearson correlation were used for analysis.Results All Q-values increased from negative to positive after SMILE surgery and the differences were statistically significant (t=-23.558,-26.661,-28.366,-28.788,P＜0.01).Corneal HOA,Z40,Z60,Z3-1 and Z31 increased and the differences were statistically significant as well (t=-11.815,-11.813,-16.209,6.470,4.835,P＜0.01).However,the change in Z3-3 or Z33 was not significant (t=0.278,-1.064,P＞0.05).Among corneal higher order aberrations,a linear correlation was found between the Q-value and corneal HOA,Z40 and Z3-t before surgery (P＜0.05).The change in corneal HOA and Z40 had a positive linear correlation with the Q-value at each diameter (HOA:r=0.554,0.480,0.416,0.352,P＜0.05; Z40:r=0.671,0.577,0.495,0.395,P＜0.05).The difference in Z3-1 had a positive linear correlation with the Q-values at diameters 6 and 7 mm (r=0.377,0.342,P＜0.05).The difference in Z31 had a positive linear correlation with the Q-values at diameters 6,7 and 8 mm (r=0.436,0.385,0.316,P＜0.05).No linear correlation was found between the changes in the Q-values at each diameter and those of Z3 3,Z33 or Z60 (P＞0.05).There was not a linear correlation between the change in the Q-values and lens diameter (P＞0.05).Lens diameter had a negative linear correlation with the changes in HOA and Z40 (r=-0.315,-0.393,P＜0.05).No linear correlation was found between the changes in Z60,Z3-1,Z31,Z3-3,Z33 (P＞0.05).Conclusion The anterior corneal asphericity changed from negative to positive and corneal higher order aberrations increased after surgery.The smaller the lens diameter,the larger the changes in HOA and Z40.There were positive linear correlations between the changes in anterior corneal asphericity and those of corneal HOA,Z40,Z3-1 and Z31 with the change in spherical aberrations having the closest correlation with the Q-value.
