The Study Of Corneal Higher-order Aberration After Different Ways Of Refractive Surgery

Objective:To evaluate the changes of Corneal high-order aberration（Including Coma,Spab,RMSh） after LASIK with femtosecondlaser,Sub-Bowman-Keratomileusis and Laser epithelial keratomileusis. Toevaluate the influence of different surgical methods postoperativedifferences and choose the suitable surgical approach for the correctionof myopia.Methods:82myopic patients were aged from19to45years. Sphericalequivalent ranged from-2.00to-12.00D.Corrected vision were from0.8to1.0in myopia. In group A，31(62eyes) myopic patients were treatedby Laser in situ keratomileusis with femtosecond laser. In group B,31(62eyes) myopic patients were treated by Sub-Bowman-Keratomileusis. In groupC,20(40eyes) myopic patients were treated by Laser epithelialkeratomileusis. The Sirius system was used for measuring the comaaberration, spherical aberration, and high order aberration after thepupils were dilated to6mm. Collecting the data of group A and group Bat1day,half-month,1month,3months after surgery. Collecting the dataof group C at1month,3months after surgery. At3months after surgeryself-perceived quality of vision and satisfaction were investigated.Amplitude of accommodation was measured before surgery and after surgery.The SPSS18.0was applied to analyze the data of the there groups.The threesets of Preoperative information were all tested on the balance, and theresults were no difference.Result:1.Vision: The uncorrected visual acuity of the three groups were no diffierence.2. Corneal aberrations:(l)Comparison in the group: Group A: The resultsof Corneal Coma（C7、C8）,Spab,RMSh at1day,half a month,1month,3monthsafter LASIK with femtosecond laser were higher than that before operation；there was no statistic significance beteeen half a month and1month. Therewas a statistic significance among every two groups(P＜0.05). Group B:The results of Corneal Coma（C7C8）,Spab,RMSh at1day,half a month,1month,3months after Sub-Bowman-Keratomileusis.The largest increase wasat1month after (P＜0.05）. There was a statistic significance among everytwo groups(P＜0.05). The results of Corneal Coma(C7C8),Spab,RMSh at1month,3months after LASEK were higher than those before surgery. Theincrease of Corneal Coma,RMSh after1month was higher than that after3months. The increase of Spab after3month3was higher than that after1month. There was a statistic significance among every two groups(P＜0.05).(2)Comparison between the three groups:The result of CornealComa（C7）: group B after1day and3months were significantly higherthan those of groupA(P＜0.05). The result of Corneal Coma（C8）:group Bafter half a month and3months were significantly higher than those ofgroup A(P＜0.05). The result of Corneal Spab: group B after1day and halfa month were significantly higher than those of group A(P＜0.05). GroupA after3months was significantly higher than those of group B(P＜0.05).The result of RMSh: group B after half1day,a month and3months weresignificantly higher than those of group A(P＜0.05). The results ofCorneal Coma（C7、C8）,Spab,RMSh at1day,half a month,1month,3monthsafter LASIK with femtosecond laser, Sub-Bowman-Keratomileusis,LASEK werehigher than that before operation；There was a statistic significanceamong the three groups at3months(P＜0.05).3. All patients had no dysmorphopsia,change of color vision ordistortionafter surgery.13.7%(group A),21.4%(group B)25%and (group C) of the patients at night there will be glare. The patients satisfaction of threegroups at3months after surgery are95.5%（group A），92.8%（group B），90.0%（group C）, and there was no significant difference.Conclusion:(1) compared with SBK, LASEK, LASIK with femtosecond laserhas good visual acuity in early postoperative vision,but there is nostatistical significance at3months.(2) LASIK with femtosecond, SBK and LASEK surgery all increase cornealhigh-order aberration, the increase of corneal high-order aberrationafter LASIK with femtosecond is relatively less.(3) Compared SBK,andLASEK, LASIK with femtosecond do the corneal flap smooth level off, edgeneat involution, destruction of the corneal surface nerve layer smallerdegree,the growth of patient satisfaction is high,it may be anidealsurgical method.