【摘要】 目的 评估像差仪检测结果在主观验光中的作用。方法 选择2004年5月至2004年11月于本院行近视屈光手术患者129例，252眼。根据患者在睫状肌麻痹前的电脑验光的球镜度数，分成<-6.0D、-6.0~9.0D、>9.0D三组，分别称为一般度数组、高度数组和超高度数组。患者被随机选择先行电脑验光或像差检查，再经综合验光仪（Nidek）行主观验光。对同一眼的球镜量、散光量、轴向在电脑验光、像差测量和综合验光仪检查（均未予睫状肌麻痹）等三种检查方法之间的相关性情况进行分析。结果 ①一般度数组：综合主观验光、电脑验光、像差仪三种方法球镜度数分别为（-3.28±2.52）D、（-3.18±2.93）D、（-2.86±2.89）D；散光度数分别为(-1.24±1.86)D、(-1.99±1.56)D、(-1.35±1.28)D；散光轴向分别为81.68±73.26、70.11±58.99、89.14±78.90，所有参数各种方法之间无明显差异（P >0.05），有很好的相关性（P<0.05）。②高度数组：综合主观验光、电脑验光、像差仪三种方法球镜度数分别为(-7.43±1.27)D、(-7.38±1.03)D、(-7.81±1.19)D；散光度数分别为(-1.16±1.02)D、(-1.12±0.75)D、(-1.41±1.64)D；散光轴向分别为86.50±71.24、94.71±65.03、100.62±74.07，所有参数各种方法之间无明显差异（P >0.05），有很好的相关性（P<0.05）。③超高度数组：综合主观验光、电脑验光、像差仪三种方法球镜度数分别为(-14.07±4.09)D、(-12.12±3.66)D、(-11.75±3.19)D，各种方法之间无明显差异（P >0.05），有很好的相关性（P <0.05）；散光度数分别为(-2.02±1.59)D、(-0.74±0.71)D、(-1.05±0.77)D，各种方法之间有明显差异（P <0.05）；散光轴向分别为86.27±63.87、77.68±57.85、110.36±70.83，各种方法之间无明显差异（P >0.05），有很好的相关性（P <0.05）。结论 在一般近视中，像差仪检查可替代电脑验光作为客观验光的方法，但在超高度近视中偏差则较大。
【关键词】 屈光不正；像差仪；主客观验光；近视
Department of Ophthalmology，EENT Hospital of Fudan University，Shanghai China，200031
［Abstract］ Objective To compare the results of refractive error measurements obtained with a WFA-1000 aberrometer and autorefractor and subjective refraction with a phoropter; to check the accuracy of measuring refractive errors with an aberrometer. Methods Two hundred fifty-two eyes of 129 myopia patients were divided into 3 groups based on refractive error: moderate myopia group (<-6.0 D), high myopia group (-6.0~9.0 D) and hypermyopia group (>9.0 D). Aberrometer measurement, autorefraction and subjective refraction with a phoropter were performed. The degree of spherical error and astigmatism and the axis of astigmatism were recorded and analyzed by statistical software (SAS). Results ①Moderate myopia group：the respective spherical values measured with subjective refraction，autorefraction and an aberrometer were （-3.28±2.52）D，（-3.18±2.93）D and （-2.86±2.89）D while astigmatism values were （-1.24±1.86）D, （-1.99±1.56）D and （-1.35±1.28）D, and the axes of astigmatism were 81.68±73.26，70.11±58.99 and 89.14±78.90. There were no statistically significant differences when these three methods were compared (P>0.05). ②High myopia group：the respective spherical values measured with subjective refraction, autorefraction and an aberrometer were （-7.43±1.27）D, （-7.38±1.03）D and （-7.81±1.19）D, while astigmatism values were （-1.16±1.02）D, （-1.12±0.75）D and （-1.41±1.64）D, and the axes of astigmatism were 86.50±71.24, 94.71±65.03 and 100.62±74.07. There were no statistically significant differences when these three methods were compared (P>0.05). ③Hypermyopia group：the respective spherical values measured with subjective refraction, autorefraction and an aberrometer were （-14.07±4.09）D, （-12.12±3.66）D and （-11.75±3.19）D, while astigmatism values were (-2.02±1.59)D, (-0.74±0.71)D and (-1.05±0.77)D, and the axes of astigmatism were 86.27±63.87, 77.68±57.85 and 110.36±70.83. There were no statistically significant differences in the measurements of the spherical error and the axis of astigmatism when the three methods were compared (P>0.05). But there were statistically significant differences in the degree of astigmatism measured by these three methods (P＜0.05). Conclusion An aberrometer in clinical use can accurately measure the refraction of most myopes but it is not appropriate for hypermyopia patients.
[Key words] refractive error; aberrometer; auto-refraction; subjective refraction； myopia
验光是视光学实践中一项非常重要的内容，是解决许多临床问题的关键。完整的验光过程应该包括：第一阶段的客观验光过程，即检影验光和电脑验光，第二阶段为主观验光过程，即在客观验光基础上，采用试镜片，根据患者的主观判断进行调整。而近年来，广泛应用综合验光仪，进一步将球镜、柱镜测量的精确度提高。由于屈光手术的进展，像差仪在视觉质量评估中的作用受到重视，同时像差仪作为客观验光的作用也引起人们的兴趣。本研究的目的即是将综合验光仪检查的最后结果与传统的客观验光结果如电脑验光与像差仪检查结果比较，以评估像差仪检测结果在主观验光中的作用。
[1] [2] [3] [4] 下一页 |
