[综述]
角膜屈光手术的主要目的不仅是提高视力，而且要提高视觉质量，视觉质量是除视力之外更高层次的视觉能力。目前，许多角膜屈光手术主要是以瞳孔中心作为检查及治疗的对准中心，由于体位变化可能会造成患者瞳孔中心移位和眼球旋转，角膜屈光手术术中可能会发生偏心切削，使散光欠矫、诱发散光、增加高阶像差等，影响术后视觉质量。因此，测量体位变化引起的瞳孔中心移位和眼球旋转可指导手术的设计，对加强瞳孔中心定位的准确性、提高手术的安全性和术后视觉质量具有重要意义。本文从瞳孔中心移位和眼球旋转的测量方法、虹膜识别技术测量体位变化下瞳孔中心移位和眼球旋转情况与体位变化引起的瞳孔中心移位和眼球旋转对屈光手术后视觉质量(术后散光、像差和调制传递函数)的影响3个方面展开综述。
The main purpose of corneal refractive surgery is not only to improve vision, but also to improve visual quality, which is a higher level of visual ability except vision.At present, most corneal refractive surgeries take the pupil center as the center of examination and treatment, since changes in body position may result in pupil centroid shifts and eye cyclotorsion and postoperative visual quality can be affected by undercorrected astigmatism, induced astigmatism and increased high order aberration that results from eccentric cutting occurring during corneal refractive surgery.The measurement of centroid shifts and eyeball rotation that can be attributed to the change of body position guiding the design of surgery is of great significance to enhance the accuracy of pupil center positioning, improve the safety of surgery and promote the postoperative visual quality.In this article, the relevant literature on the measurement methods of the pupil centroid shifts and ocular cyclotorsion, pupil centroid shifts and ocular cyclotorsion measured by iris recognition technology in response to changes in body position, and the effects of posture-related pupil centroid shifts and ocular cyclotorsion during refractive surgery on postoperative visual quality (postoperative astigmatism, aberration, and modulation transfer function) were reviewed.
朱青,王雁. 体位变化下瞳孔中心移位和眼球旋转对角膜屈光手术的影响[J]. 中华实验眼科杂志,2021,39(06)：572-576.
DOI:10.3760/cma.j.cn115989-20210310-00157版权归中华医学会所有。
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