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
2015年
11期
644-648
,共5页
近视%飞秒激光小切口基质透镜取出术%像差%散光%Kappa角
近視%飛秒激光小切口基質透鏡取齣術%像差%散光%Kappa角
근시%비초격광소절구기질투경취출술%상차%산광%Kappa각
Myopia%Small incision lenticule extraction%Aberrations%Astigmatism%kappa angle
目的 通过观察飞秒激光小切口基质透镜取出术(SMILE)治疗近视及近视散光眼术后全眼高阶像差的改变,探讨SMILE术后全眼高阶像差的变化特点及其相关因素.方法 回顾性研究.选择行SMILE手术治疗近视及近视散光患者共81例(162眼),随访时间3个月.术中眼球定位采用术前kappa角结合术中注视水印居中中心定位法.术前、术后3个月采用WASCA波前像差分析仪测量6 mm瞳孔直径下术眼的总高阶像差(HOA)及各单项HOA,同时采用Oculyzer眼前节分析系统测量kappa角及角膜Q值.手术前后数据比较应用配对t检验,运用Spearman秩相关分析法和Pearson相关分析总HOA及各项HOA的变化与术前等效球镜度(SE)、散光度及轴向、kappa角等参数的相关性.结果 手术前后总HOA(t=-12.24,P＜0.01)、球差(C40)(t=16.60,P＜0.01)、水平彗差(C31)(t=-11.06,P＜0.01)、垂直彗差(C3-1)(t=-3.14,P＜0.01)、垂直三叶草(C3-3)(t=-6.30,P＜0.01)、四阶水平散光(C42)(t=5.84,P＜0.01)的均方根(RMS)值差异均有统计学意义.手术前后Q值分别为-0.24±0.13和0.69±0.52,差异有统计学意义(t=-22.55,P＜0.01).术后3个月总HOA与SE相关(r=-0.23,P＜0.01),△总HOA主要与△C40、△C31相关(r=-0.40、0.26,P＜0.01),与术前Q值、Kappa角、散光度均无相关性;术后C40、△C40与术前SE相关(r=0.35、0.29,P＜0.01);C31与术前散光度和Q值相关(r=-0.24、-0.22,P＜0.05),△C31与术前散光度相关(r=-0.29,P＜0.01);术后C3-1和△C3-1与术前的SE、Q值、Kappa角、散光度均不相关.结论 近视及近视散光眼SMILE手术后总HOA增加,主要与术前SE有关,与散光度无关;手术前后C40变化量与术前SE有关,C31增加量与术前散光度有关.
目的 通過觀察飛秒激光小切口基質透鏡取齣術(SMILE)治療近視及近視散光眼術後全眼高階像差的改變,探討SMILE術後全眼高階像差的變化特點及其相關因素.方法 迴顧性研究.選擇行SMILE手術治療近視及近視散光患者共81例(162眼),隨訪時間3箇月.術中眼毬定位採用術前kappa角結閤術中註視水印居中中心定位法.術前、術後3箇月採用WASCA波前像差分析儀測量6 mm瞳孔直徑下術眼的總高階像差(HOA)及各單項HOA,同時採用Oculyzer眼前節分析繫統測量kappa角及角膜Q值.手術前後數據比較應用配對t檢驗,運用Spearman秩相關分析法和Pearson相關分析總HOA及各項HOA的變化與術前等效毬鏡度(SE)、散光度及軸嚮、kappa角等參數的相關性.結果 手術前後總HOA(t=-12.24,P＜0.01)、毬差(C40)(t=16.60,P＜0.01)、水平彗差(C31)(t=-11.06,P＜0.01)、垂直彗差(C3-1)(t=-3.14,P＜0.01)、垂直三葉草(C3-3)(t=-6.30,P＜0.01)、四階水平散光(C42)(t=5.84,P＜0.01)的均方根(RMS)值差異均有統計學意義.手術前後Q值分彆為-0.24±0.13和0.69±0.52,差異有統計學意義(t=-22.55,P＜0.01).術後3箇月總HOA與SE相關(r=-0.23,P＜0.01),△總HOA主要與△C40、△C31相關(r=-0.40、0.26,P＜0.01),與術前Q值、Kappa角、散光度均無相關性;術後C40、△C40與術前SE相關(r=0.35、0.29,P＜0.01);C31與術前散光度和Q值相關(r=-0.24、-0.22,P＜0.05),△C31與術前散光度相關(r=-0.29,P＜0.01);術後C3-1和△C3-1與術前的SE、Q值、Kappa角、散光度均不相關.結論 近視及近視散光眼SMILE手術後總HOA增加,主要與術前SE有關,與散光度無關;手術前後C40變化量與術前SE有關,C31增加量與術前散光度有關.
목적 통과관찰비초격광소절구기질투경취출술(SMILE)치료근시급근시산광안술후전안고계상차적개변,탐토SMILE술후전안고계상차적변화특점급기상관인소.방법 회고성연구.선택행SMILE수술치료근시급근시산광환자공81례(162안),수방시간3개월.술중안구정위채용술전kappa각결합술중주시수인거중중심정위법.술전、술후3개월채용WASCA파전상차분석의측량6 mm동공직경하술안적총고계상차(HOA)급각단항HOA,동시채용Oculyzer안전절분석계통측량kappa각급각막Q치.수술전후수거비교응용배대t검험,운용Spearman질상관분석법화Pearson상관분석총HOA급각항HOA적변화여술전등효구경도(SE)、산광도급축향、kappa각등삼수적상관성.결과 수술전후총HOA(t=-12.24,P＜0.01)、구차(C40)(t=16.60,P＜0.01)、수평혜차(C31)(t=-11.06,P＜0.01)、수직혜차(C3-1)(t=-3.14,P＜0.01)、수직삼협초(C3-3)(t=-6.30,P＜0.01)、사계수평산광(C42)(t=5.84,P＜0.01)적균방근(RMS)치차이균유통계학의의.수술전후Q치분별위-0.24±0.13화0.69±0.52,차이유통계학의의(t=-22.55,P＜0.01).술후3개월총HOA여SE상관(r=-0.23,P＜0.01),△총HOA주요여△C40、△C31상관(r=-0.40、0.26,P＜0.01),여술전Q치、Kappa각、산광도균무상관성;술후C40、△C40여술전SE상관(r=0.35、0.29,P＜0.01);C31여술전산광도화Q치상관(r=-0.24、-0.22,P＜0.05),△C31여술전산광도상관(r=-0.29,P＜0.01);술후C3-1화△C3-1여술전적SE、Q치、Kappa각、산광도균불상관.결론 근시급근시산광안SMILE수술후총HOA증가,주요여술전SE유관,여산광도무관;수술전후C40변화량여술전SE유관,C31증가량여술전산광도유관.
Objective To investigate the changes in higher-order aberrations (HOAs) after small incision lenticule extraction (SMILE) surgery for myopia and myopic astigmatism, and to evaluate the association between the postoperative changes in HOAs and related factors.Methods This was a retrospective study that included 81 patients (162 eyes) who had undergone SMILE for myopia or myopic astigmatism.The follow-up period was 3 months.Ocular HOAs with a 6 mm pupil diameter were measured by a WaveScan aberrometer preoperatively and 3 months postoperatively.The angle kappa and Q value were obtained with an ocular analyzer at same time.Paired t test was used to compare the ocular variables before and after surgery.Spearman rank and Pearson correlation coefficient analysis were used to assess the relationship between changes in total HOA and different HOAs with multiple factors that included pre-SE, astigmatism, angle kappa, etc.Results Statistically significant differences were found in the changes in total HOA (t=-12.24, P＜0.01), spherical aberration C40 (t=16.60, P＜0.01), C31 (t=-11.06, P＜0.01);C3-1 (t=-3.14, P＜0.01), Q value (t=-22.55, P＜0.01), Cf3 (t=-6.30, P＜0.01) and C42 (t=5.84, P＜0.01).There were significant correlations between total HOA at the three-month postoperative visit and preoperative SE (r=-0.23,P＜0.01).△total HOA was correlated with △C40 (r=-0.40, P＜0.01) and △C31 (r=0.26, P＜0.01) but was not related to pre-operative Q value, angle kappa or astigmatism (P＞0.05).The three-month postoperative C40 and △C40 were correlated with pre-SE (r=0.35, 0.29, P＜0.01);C31 was correlated with preoperative cylinder power and Q value (r=-0.24,-0.22, P＜0.05), and △C31 was correlated with preoperative cylinder power (r=-0.29, P＜0.01).There was no correlation between the postoperative C3-1 and /△C3-1 and preoperative SE, Q value, angle kappa, or cylinder power (P＞0.05).Conclusion A significant postoperative increase in total HOA after SMILE surgery is correlated with preoperative SE, but is not correlated with the degree of astigmatism.Postoperative C40 was only correlated with preoperative SE, while a postoperative increase in C31 was correlated with the preoperative degree of astigmatism.
