应用iTrace视觉功能分析仪测量双眼角膜像差的一致性
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摘要
目的探讨正常人群双眼角膜像差的一致性及其影响因素。方法观察性研究分析。随机选取中国医科大学附属第四医院2016年12月至2017年12月进行体格检查的健康人群240人(480眼),年龄10～70岁,每隔10岁分一组,共分为6组,每组40人,对纳入研究的人群使用i Trace视觉功能分析仪分别测量双眼角膜地形图及波前像差,收集每个人在2 mm、3mm、4 mm、5 mm瞳孔直径下双眼的角膜像差,包括水平三叶草差(Z33)、垂直三叶草差(Z3-3)、水平四叶草差(Z44)、垂直四叶草差(Z4-4)、水平彗差(Z31)、垂直彗差(Z3-1)、水平二次散光(Z42)、垂直二次散光(Z4-2)、球差(Z40),采用配对t检验比较双眼指标间的差异; Pearson相关分析探讨双眼各像差的相关性,Bland-altman比较双眼总角膜像差的一致性。结果总角膜像差在双眼间存在镜像对称并具有一致性,但在不同条件下,双眼角膜像差存在差异:2 mm和3 mm瞳孔直径下,除Z33双眼间差异具有统计学意义(均为P <0. 05)外,其余像差双眼间差异均无统计学意义(均为P> 0. 05); 4 mm瞳孔直径下,Z31、Z4-4、Z42双眼间差异均具有统计学意义(均为P <0. 05); 5 mm瞳孔直径下,Z31、Z4-4、Z42双眼间差异均具有统计学意义(均为P <0. 05); Z40最为稳定,在双眼间的一致性和相关性最高。随着年龄的增加,三叶草差、彗差双眼间的差值均逐渐增大,四叶草差、二次散光、球差随年龄的增加在双眼间变化微小。结论总角膜像差在双眼间具有一致性,但在不同瞳孔直径下双眼角膜像差存在差异。
Objective To investigate the consistency and related factors of corneal aberration in norm al hum an eyes.M ethods An observational study was conducted.A total of 240 healthy peopleaged 10-70 years after physical exam ination at the Fourth Affiliated H ospital of China M edical University from Decem ber 2016 to Decem ber 2017 were random ly selected,and divided those people into 6 groups every10 years,40 people in each group.The iTrace visual function analyzer was used to m easure the corneal topography and wave-front aberration in two eyes.Corneal aberrations of each person were collected at 2 m m,3 m m,4 m m,5 m m pupil diam eter,including horizontal trefoil( Z33),vertical trefoil( Z3-3),horizontal tetrafoil( Z44),vertical tetrafoil( Z4-4),horizontal coma( Z31),vertical coma( Z3-1),horizontal secondaryastigm atism( Z42),vertical secondary astigmatism( Z4-2),spherical aberration( Z40).Paired t-test was used to compare the differences between two eyes,Pearson's analysis to explore the correlation between two eyes,and Bland-altm an was applied to com pare the consistency of total corneal aberration between two eyes.R esults Total corneal aberration was m irror sym m etrical and had consistency between two eyes,but there had differences results under different conditions: For 2 m m and 3 m m pupil diam eter,only Z33 had statistically significant difference( P < 0.05),there was no significant difference in other aberrations between two eyes( all P > 0.05).For 4 m m pupildiam eter,Z31,Z4-4 and Z42 had statistically significant difference( all P < 0.05).For 5 m m pupil diam eter,Z31,Z4-4,Z42 had statistically significant difference( all P < 0.05).Z40 had the highest consistency and correlation between two eyes.W ith the increase of age,the differences between two eyes were gradually increased in trefoil and com a,but the differences of tetrafoil,secondary astigm atism,spherical aberration showed very slight variations between two eyes.Conclusion The total corneal aberration has consistency between two eyes,but for every single corneal aberration,different conditions get different results.
Objective To investigate the consistency and related factors of corneal aberration in norm al hum an eyes.M ethods An observational study was conducted.A total of 240 healthy peopleaged 10-70 years after physical exam ination at the Fourth Affiliated H ospital of China M edical University from Decem ber 2016 to Decem ber 2017 were random ly selected,and divided those people into 6 groups every10 years,40 people in each group.The iTrace visual function analyzer was used to m easure the corneal topography and wave-front aberration in two eyes.Corneal aberrations of each person were collected at 2 m m,3 m m,4 m m,5 m m pupil diam eter,including horizontal trefoil( Z33),vertical trefoil( Z3-3),horizontal tetrafoil( Z44),vertical tetrafoil( Z4-4),horizontal coma( Z31),vertical coma( Z3-1),horizontal secondaryastigm atism( Z42),vertical secondary astigmatism( Z4-2),spherical aberration( Z40).Paired t-test was used to compare the differences between two eyes,Pearson's analysis to explore the correlation between two eyes,and Bland-altm an was applied to com pare the consistency of total corneal aberration between two eyes.R esults Total corneal aberration was m irror sym m etrical and had consistency between two eyes,but there had differences results under different conditions: For 2 m m and 3 m m pupil diam eter,only Z33 had statistically significant difference( P < 0.05),there was no significant difference in other aberrations between two eyes( all P > 0.05).For 4 m m pupildiam eter,Z31,Z4-4 and Z42 had statistically significant difference( all P < 0.05).For 5 m m pupil diam eter,Z31,Z4-4,Z42 had statistically significant difference( all P < 0.05).Z40 had the highest consistency and correlation between two eyes.W ith the increase of age,the differences between two eyes were gradually increased in trefoil and com a,but the differences of tetrafoil,secondary astigm atism,spherical aberration showed very slight variations between two eyes.Conclusion The total corneal aberration has consistency between two eyes,but for every single corneal aberration,different conditions get different results.
引文
[1]APPLEGATE R A,SARVER E J.Are all aberrations equal[J].JRefract Surg,2002,18(5):S556-562.
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[4]HJORTDAL J O,OLSEN H,EHLERS N.Prospective randomized study of corneal aberrations 1 year after radial keratotomy or photorefractive keratectomy[J].J Refract Surg,2002,18(1):23-29.
[5]WANG D Q,DENG Y P.The relation between the pupil dilation and the wavefront aberration after LASIK surgery for myopia[J].Clin J Pract Ophthalmol,2006,24(5):464-466.王大庆,邓应平.瞳孔大小对LASIK手术患者波前像差的影响[J].中国实用眼科杂志,2006,24(5):464-466.
[6]YANG W Y,YUAN Y S.The theory and clinical rearch of aspheric intraocular lens[J].Med Recap,2009,15(24):3761-3764.杨文艳,袁援生.非球面人工晶体的理论及其临床应用研究进展[J].医学综述,2009,15(24):3761-3764.
[7]WANG Y,ZHAO K X.Wavefront aberraion and clinical vision correction[M].Beijing:People’s Military Medical Publisher,2011:118-120.王雁,赵堪兴.波前像差与临床视觉矫正[M].北京:人民卫生出版社,2011:118-120.
[8]ZHU H F,JIA C P,FANG Z L.Design method and optical performance of aspherical IOL[J].Opto-Electr Engin,2009,36(4):56-59.朱海风,贾翠萍,方志良.非球面人工晶体设计及其光学性能的研究[J].光电工程,2009,36(4):56-59.
[9]CHENG X Y.The different age group of corneal wavefront aberration by cross sectional study[D].Wenzhou:Wenzhou Medical University,2016.程雪莹.不同年龄人群角膜像差的横断面研究[D].温州:温州医科大学,2016.
[10]RANDAZZO A,NIZZOLA F,ROSSETTI L.Pharmacological management of night vision disturbances after refractive surgery.Results of a randomized clinical trial[J].J Cataract Refract Surg,2005,31(9):1764-1772.
[11]GOLNIK K C,EGGENBERGER E.Symptomatic corneal topographic change induced by reading in downgaze[J].J Neuroopthalmol,2001,21(3):199-204.
[12]BROWN M S,SIEGEL I M,LISMAN R D.Prospective analysis of changes in corneal topography after upper eyelid surgery[J].Ophthalmol Plast Reconstr Surg,1999,15(6):378-383.
[13]ZHANG F J,KONG F X,YU F L,LU Z L,WANG Y X.High-order aberrations and visual quality analysis in emmetropic eyes of navy and air-force[J].Int Eye Sci,2008,8(3):528-531.张丰菊,孔繁学,于芳蕾,鲁智莉,王岳秀.空海勤人员正视眼高阶像差和视觉质量[J].国际眼科杂志,2008,8(3):528-531.
[14]PAQUIN M P,HAMAM H,SIOMONET P.Objective measurement of optial aberrations in myopic eyes[J].Optom Vis Sci,2002,79(5):285-291.
[15]LEVY Y,SEGAL O,AVNI I,ZADOK D.Ocular higher-order aberrations in eyes with supernormal vision1[J].Am J Ophthalmol,2005,139(2):225-228.
[16]OSHIKA T,KLYCE S D,APPLEGATE R A,HOWLAND H C.Changes in corneal wavefont aberations with aging[J].Invest Ophthalmol Vis Sci,1999,40(7):1351-1355.
[17]MATHERS W D,LANE J A,ZIMMERMAN M B.Tear film changes associated with normal aging[J].Am J Ophthalmol,1996,122(3):229-234.
[2]BRUBAKER B F.Tonometry and corneal thickness[J].Arch Ophthalmol,1999,117(1):104-105.
[3]ARTAL P,BERRIO E,GUIRAO A,PIERS P.Contribution of cornea and internal surfaces to the change of ocular aberration with age[J].J Opt Soc Am A Opt Image Sci Vis,2002,19(1):137-143.
[4]HJORTDAL J O,OLSEN H,EHLERS N.Prospective randomized study of corneal aberrations 1 year after radial keratotomy or photorefractive keratectomy[J].J Refract Surg,2002,18(1):23-29.
[5]WANG D Q,DENG Y P.The relation between the pupil dilation and the wavefront aberration after LASIK surgery for myopia[J].Clin J Pract Ophthalmol,2006,24(5):464-466.王大庆,邓应平.瞳孔大小对LASIK手术患者波前像差的影响[J].中国实用眼科杂志,2006,24(5):464-466.
[6]YANG W Y,YUAN Y S.The theory and clinical rearch of aspheric intraocular lens[J].Med Recap,2009,15(24):3761-3764.杨文艳,袁援生.非球面人工晶体的理论及其临床应用研究进展[J].医学综述,2009,15(24):3761-3764.
[7]WANG Y,ZHAO K X.Wavefront aberraion and clinical vision correction[M].Beijing:People’s Military Medical Publisher,2011:118-120.王雁,赵堪兴.波前像差与临床视觉矫正[M].北京:人民卫生出版社,2011:118-120.
[8]ZHU H F,JIA C P,FANG Z L.Design method and optical performance of aspherical IOL[J].Opto-Electr Engin,2009,36(4):56-59.朱海风,贾翠萍,方志良.非球面人工晶体设计及其光学性能的研究[J].光电工程,2009,36(4):56-59.
[9]CHENG X Y.The different age group of corneal wavefront aberration by cross sectional study[D].Wenzhou:Wenzhou Medical University,2016.程雪莹.不同年龄人群角膜像差的横断面研究[D].温州:温州医科大学,2016.
[10]RANDAZZO A,NIZZOLA F,ROSSETTI L.Pharmacological management of night vision disturbances after refractive surgery.Results of a randomized clinical trial[J].J Cataract Refract Surg,2005,31(9):1764-1772.
[11]GOLNIK K C,EGGENBERGER E.Symptomatic corneal topographic change induced by reading in downgaze[J].J Neuroopthalmol,2001,21(3):199-204.
[12]BROWN M S,SIEGEL I M,LISMAN R D.Prospective analysis of changes in corneal topography after upper eyelid surgery[J].Ophthalmol Plast Reconstr Surg,1999,15(6):378-383.
[13]ZHANG F J,KONG F X,YU F L,LU Z L,WANG Y X.High-order aberrations and visual quality analysis in emmetropic eyes of navy and air-force[J].Int Eye Sci,2008,8(3):528-531.张丰菊,孔繁学,于芳蕾,鲁智莉,王岳秀.空海勤人员正视眼高阶像差和视觉质量[J].国际眼科杂志,2008,8(3):528-531.
[14]PAQUIN M P,HAMAM H,SIOMONET P.Objective measurement of optial aberrations in myopic eyes[J].Optom Vis Sci,2002,79(5):285-291.
[15]LEVY Y,SEGAL O,AVNI I,ZADOK D.Ocular higher-order aberrations in eyes with supernormal vision1[J].Am J Ophthalmol,2005,139(2):225-228.
[16]OSHIKA T,KLYCE S D,APPLEGATE R A,HOWLAND H C.Changes in corneal wavefont aberations with aging[J].Invest Ophthalmol Vis Sci,1999,40(7):1351-1355.
[17]MATHERS W D,LANE J A,ZIMMERMAN M B.Tear film changes associated with normal aging[J].Am J Ophthalmol,1996,122(3):229-234.