目的:讨论近视散光眼人群在暗室自然扩瞳和使用药物散瞳后所得到波面像差的差别.方法:使用基于Shack-Hartmann原理设计的COAS(completeophthalmicanalysissystem)波面像差仪检查62只眼,分别在暗室自然扩瞳和通过滴加美多丽-P散瞳液后的波面像差.并使用COAS波面像差仪自带软件分别计算在三个分析瞳孔尺寸下的二～六阶像差系数.运用双因素方差分析(twowayANOVA)方法研究各阶均方根(rootmeansquare,RMS)和各种类型像差在药物作用和分析瞳孔尺寸?饬礁鲆蛩赜跋煜碌谋浠欠窬哂邢灾?同时考虑二因素的交互作用.结果:药物散瞳对二、三阶像差均方根的影响没有显著意义(P>0.10),但在测量更高阶像差--四、五、六阶时,与暗室自然扩瞳所得波面像差的差异具有显著性意义;虽然不同瞳孔尺寸对各阶波面像差均方根变化具有显著意义(P<0.01),但对研究药物散瞳对波面像差的影响无显著意义(P>0.10).结论:药物散瞳与暗室自然扩瞳在高阶像差测量时的差异均有显著意义,临床上建议尽量使用暗室自然扩瞳.

Objective: To investigate the difference between wavefront measurements in dark and after dilated with mydriatic of the myopic with astigmatism. Methods: Using COAS(Complete Ophthalmic Analysis System)based on Shack-Hartmann technology, we measured 62 eyes in dark with and without mydriatic respectively. Then recomputed wavefront aberrations at different optical zones and the 2~(nd) to 6~(th) order aberrations were analyzed. We chose Two way ANOVA to test whether mydriatic and different analyzing optical zones will lead the the root mean square and every type of aberrations of each order to show significant differences, in the mean time, we considered the interaction between mydriatic and its optical zones. Results: The RMS difference of 2~(nd) and 3~(rd) order caused by mydriatic is not significant (P>0.10), while RMS difference of 4th to 6th order caused by it is statistically significant (P<0.05). Different analyzing pupil sizes changed each order RMS remarkably (P<0.01), but had little effects on analyzingpupil sizes,and it is suggested to take wavefront measurement in dark in clinic application.