[1]李羽,郭玉娟,汪思瑶,等.FS-LASIK术后视网膜周边离焦及视觉质量变化[J].眼科新进展,2024,44(7):558-563.[doi:10.13389/j.cnki.rao.2024.0108]
 LI Yu,GUO Yujuan,WANG Siyao,et al.Changes in periretinal defocus and visual quality after femtosecond laser-assisted in situ keratomileusis[J].Recent Advances in Ophthalmology,2024,44(7):558-563.[doi:10.13389/j.cnki.rao.2024.0108]
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FS-LASIK术后视网膜周边离焦及视觉质量变化/HTML
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
44卷
期数:
2024年7期
页码:
558-563
栏目:
应用研究
出版日期:
2024-07-01

文章信息/Info

Title:
Changes in periretinal defocus and visual quality after femtosecond laser-assisted in situ keratomileusis
作者:
李羽郭玉娟汪思瑶张美美周跃华
510100 四川省成都市,成都中医药大学眼科学院(李羽,郭玉娟,汪思瑶,周跃华);610084 四川省成都市,成都中医大银海眼科医院(李羽,周跃华);110000 北京市,北京茗视光眼科(张美美,周跃华);510100 四川省成都市,中医药眼病防治与视功能保护四川省重点实验室(周跃华)
Author(s):
LI Yu12GUO Yujuan1WANG Siyao1ZHANG Meimei3ZHOU Yuehua1234
1.Eye School of Chengdu University of Traditional Chinese Medicine,Chengdu 510100,Sichuan Province,China
2.Ineye Hospital of Chengdu University of TCM,Chengdu 610084,Sichuan Province,China
3.Ophthalmology Beijing Ming Vision,Beijing 110000,China
4.Key Laboratory of Sichuan Province Ophthalmopathy Prevention & Cure and Visual Function Protection with TCM Laboratory,Chengdu 510100,Sichuan Province,China
关键词:
飞秒激光准分子激光角膜原位磨镶术周边离焦视觉质量高阶像差
Keywords:
femtosecond laser excimer laser in situ keratomileusis periretinal defocus visual quality higher-order aberration
分类号:
R779.63
DOI:
10.13389/j.cnki.rao.2024.0108
文献标志码:
A
摘要:
目的 探讨飞秒激光辅助的准分子激光原位角膜磨镶术(FS-LASIK)术后视网膜周边离焦及视觉质量的变化。
方法 选取2023年3月至5月在成都中医大银海眼科医院行FS-LASIK的近视患者51例(102眼)纳入研究,其中女27例(54眼),男24例(48眼)。使用多光谱屈光地形图仪测量视网膜周边离焦。记录视网膜周边总屈光差异值(TRDV);四个象限的RDV:上方RDV(RDV-S)、下方RDV(RDV-I)、鼻侧RDV(RDV-N)及颞侧RDV(RDV-T);距黄斑中心凹10°、20°、30°、40°及53°相应同心圆环区域的RDV(分别表示为RDV 0°-10°、RDV 10°-20°、RDV 20°-30°、RDV 30°-40°、RDV 40°-53°)。采用视觉质量分析系统测量并记录客观散射指数(OSI)、斯特列尔比(SR),10 c·d-1、20 c·d-1、30 c·d-1空间频率下的调制传递函数(MTF)值(分别表示为10 c·d-1 MTF、20 c·d-1 MTF、30 c·d-1 MTF)以及截止频率(MTF cutoff)。采用iTrace像差仪测量并记录角膜垂直三叶草(Z3-3)、垂直彗差(Z3-1)、水平彗差(Z31)、水平三叶草(Z33)、垂直四叶草(Z4-4)、垂直二次散光(Z4-2)、球差(Z40)、水平二次散光(Z42)、水平四叶草(Z44)及总高阶像差(HOA)的数据。对患者术前、术后1个月及术后3个月的测量数据进行比较及相关性分析。
结果 术前、术后1个月及术后3个月患者视网膜周边TRDV、RDV-S、RDV-N、RDV 20°-30°、RDV 30°-40°、RDV 40°-53°比较,术后1个月及3个月的值均较术前降低,差异均有统计学意义(均为P<0.001)。术前、术后1个月及术后3个月患者OSI、MTF cutoff及10 c·d-1 MTF比较,差异均有统计学意义(均为P<0.05)。术前、术后1个月及术后3个月患者角膜Z3-3、Z3-1、Z31、Z33、Z4-4、Z4-2、Z40、Z42、Z44及HOA比较,差异均有统计学意义(均P<0.001)。Pearson相关分析结果显示,ΔRDV 0°-10°与ΔZ3-3、ΔZ31、ΔZ4-2、ΔZ40及ΔZ42均呈正相关(均为P<0.05);ΔRDV 10°-20°与ΔZ4-4及ΔZ4-2呈正相关(均为P<0.05);ΔRDV 20°-30°与ΔZ4-4及ΔZ44呈正相关(均为P<0.05);ΔTRDV、ΔRDV 40°-53°均与ΔHOA呈负相关(均为P<0.05)。ΔRDV-S与ΔZ3-1及ΔHOA呈负相关(均为P<0.05),与ΔZ44呈正相关(P<0.05);ΔRDV-N与ΔZ4-4呈正相关(P<0.05)。
结论 FS-LASIK能降低近视患者视网膜周边远视离焦,但引入了部分角膜高阶像差,且两者存在一定的相关性。
Abstract:
Objective To explore the changes in periretinal defocus and visual quality after femtosecond laser-assisted in situ keratomileusis (FS-LASIK).
Methods Fifty-one myopic patients (102 eyes) who underwent FS-LASIK at the Ineye Hospital of Chengdu University of Traditional Chinese Medicine from March to May 2023 were selected for the study, including 27 females (54 eyes) and 24 males (48 eyes). The defocus around the retina was measured using a multispectral refraction topography, and the total refraction difference value (TRDV) was recorded. The refraction difference value (RDV) in four quadrants: superior RDV (RDV-S), inferior RDV (RDV-I), nasal RDV (RDV-N), and temporal RDV (RDV-T), as well as the RDV in the concentric ring areas corresponding to 10°, 20°, 30°, 40°, and 53° from the fovea of the macula (represented as RDV 0°-10°, RDV 10°-20°, RDV 20°-30°, RDV 30°-40°, and RDV 40°-53°, respectively) were also recorded. The objective scattering index (OSI), Strehl’s ratio (SR), modulation transfer function (MTF) values (represented as 10 c·d-1 MTF, 20 c·d-1 MTF, and 30 c·d-1 MTF, respectively) and cutoff frequencies (MTF cutoff) at the spatial frequencies of 10 c·d-1, 20 c·d-1 and 30 c·d-1 were measured and recorded using a visual quality analysis system. The data of corneal vertical trefoil (Z3-3), vertical coma (Z3-1), horizontal coma (Z31), horizontal trefoil (Z33), vertical tetrafoil (Z4-4), vertical secondary astigmatism (Z4-2), spherical aberration (Z40), horizontal secondary astigmatism (Z42), horizontal tetrafoil (Z44), and total higher-order aberration (HOA) were measured and recorded using the iTrace aberration meter. The measurement data of patients before surgery, one month after surgery, and three months after surgery were compared, and their correlations were analyzed.
Results TRDV, RDV-S, RDV-N, RDV 20°-30°, RDV 30°-40°, and RDV 40°-53° around the retina of patients decreased one month and three months after surgery compared with those before surgery, and the differences were statistically significant (all P<0.001). There were statistically significant differences in OSI, MTF cutoff, and 10 c·d-1 MTF among patients before surgery, one month after surgery, and three months after surgery (all P<0.05). There were statistically significant differences in corneal Z3-3, Z3-1, Z31, Z33, Z4-4, Z4-2, Z40, Z42, Z44, and HOA among patients before surgery, one month after surgery, and three months after surgery (all P<0.001). The Pearson correlation analysis results showed that, ΔRDV 0°-10° was positively correlated with ΔZ3-3, ΔZ31, ΔZ4-2, ΔZ40, and ΔZ42 (all P<0.05); ΔRDV 10°-20° was positively correlated with ΔZ4-4 and ΔZ4-2 (both P<0.05); ΔRDV 20°-30° was positively correlated with ΔZ4-4 and ΔZ44 (both P<0.05); ΔTRDV and ΔRDV 40°-53° were negatively correlated with ΔHOA (both P<0.05). ΔRDV-S and ΔZ3-1 were negatively correlated with ΔHOA (both P<0.05) and positively correlated with ΔZ44 (P<0.05); ΔRDV-N was positively correlated with ΔZ4-4 (P<0.05).
Conclusion FS-LASIK can reduce periretinal hyperopic defocus in myopic patients, but it introduces corneal HOA, and there is a certain correlation between the two.

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更新日期/Last Update: 2024-07-05