目的：比较不同程度糖尿病视网膜病变(diabetic retinopathy，DR)干眼症患者波前像差的变化，探讨糖尿病视网膜病变干眼症患者视觉质量下降的原因。

方法：随机选取本院就诊的不同程度糖尿病视网膜病变干眼症患者各40眼，正常对照组40眼。采用Topcon KR-1W视觉质量分析仪记录瞳孔直径4mm和6mm的角膜总高阶像差、彗差、球差及三叶草像差的均方值。采用方差分析比较不同程度糖尿病视网膜病变干眼症患者波前像差及与对照组像差值。

结果：4mm和6mm瞳孔直径下无明显糖尿病视网膜病变(nondiabetic retinopathy，NDR)干眼症组、非增殖性糖尿病视网膜病变(nonproliferative diabetic retinopathy，NPDR)干眼症组及增殖性糖尿病视网膜病变(proliferative diabetic retinopathy，PDR)干眼症组较对照组眼总高阶像差、彗差及三叶草像差均有明显升高(P<0.01)，且PDR干眼症组较NDR干眼症组和NPDR干眼症组总高阶像差、球差、彗差及三叶草像差均有明显升高(P<0.01)。

结论：不同程度糖尿病视网膜病变干眼与波前像差的增高密切相关，波前像差增高可能是降低糖尿病视网膜病变干眼症患者视觉质量的原因之一，为糖尿病干眼视功能下降提供了依据。

METHODS: We randomly selected 40 eyes in our hospital for treatment with DR and varying degrees of dry eye, and 40 eyes of normal control group. Topcon KR-1W visual quality analyzer was used to record the mean square the total high order corneal aberration, spherical aberration, comatic aberration and trefoil aberration of cornea with pupil diameters of 4mm and 6mm. Analysis of variance were used to compare the wavefront aberrations and the aberration values in the control group and in patients with diabetic retinopathy and with different degrees of dry eye.

RESULTS: For 4mm and 6mm pupil diameters, nondiabetic retinopathy(NDR)with dry eye group, the nonproliferative diabetic retinopathy(NPDR)with dry eye group and proliferative diabetic retinopathy(PDR)dry eye group had significantly increased tHOA, coma and trefoil compared with the contrast group(P<0.01), and PDR dry eye group were significantly higher than NDR with dry eye group and NPDR with dry eye group in tHOA, spherical aberration(SA), coma and trefoil(P<0.01).

CONCLUSION: Dry eye of diabetic retinopathy with different degrees is closely related to the increase of wavefront aberration. Increased wavefront aberration may be one of the reasons to reduced visual quality in patients with diabetic retinopathy and with dry eye, and provide the basis for the decline of visual function of diabetic patients with dry eye.