目的：探讨行飞秒激光联合准分子激光原位角膜磨镶术(FS-LASIK)近视患者的瞳孔大小和中心的动态变化分布， 角膜共轴反光点的偏心量分布规律及其相关性分析。

方法：本研究采用回顾性研究，选择2019-01/05在延边大学附属医院眼科行FS-LASIK的患者225例407眼，术前采用角膜地形图仪测量瞳孔的大小和中心位置，准分子激光机记录患者仰卧位时瞳孔中心与角膜共轴反光点之间的偏移量(P-Dist)。

结果：术前角膜中心与瞳孔中心之间的偏移量分布平均为0.322±0.194mm，262眼(64%)≤0.40mm； P-Dist分布平均为0.225±0.102mm，326眼(80%)≤0.30mm。角膜共轴反光点主要偏向角膜中心的颞上侧138眼(34%)。暗光条件下左眼X轴：-0.061±0.084mm，右眼X轴：-0.016±0.059mm(P=0.002)(左眼暗光下向颞侧位移)。角膜横径(WTW)与瞳孔直径变化呈正相关性(r=0.270， P<0.001)。

结论：左眼应调整切削中心偏向颞侧0.061mm以内的位置上，角膜横径偏大的患者，术中尽量维持较暗光线环境，以便提高瞳孔匹配的效率。

METHODS: Randomly selected 225 patients(407 eyes)who underwent femtosecond laser combined with excimer laser in situ keratomileusis at Yanbian University Hospital in 2019 from January to May, preoperative use of Wavelight Allegro Topolyzer Corneal Topography to measure the pupil size and center position, the German Wavelight EX500 excimer Laser(500Hz)records the deviation between the pupil center and the coaxially sighted corneal light reflex when the patient is supine.

RESULTS:The average displacement distribution between the center of the cornea and the center of the pupil is 0.322±0.194mm, and 64% of the eyes are ≤0.40mm. The average displacement distribution of P-Dist(the eccentricity between the pupil center and the coaxially sighted corneal light reflex point)is 0.225±0.102mm, and 80% of the eyes are ≤0.30mm. The coaxially sighted corneal light reflex point is mainly deviated to the superior temporal side of the corneal center(34%). The X-axis of the left eye in low light conditions: -0.061±0.084mm, and the X-axis of the right eye: -0.016±0.059mm(P=0.002)(the left eye shifted to the temporal side in the dark light). The corneal transverse diameter(WTW)was positively correlated with changes in pupil diameter(dark pupil diameter-bright pupil diameter)(r=0.270, P<0.001).

CONCLUSION: The left eye should be adjusted to a position of the machining center within 0.061mm. If the cornea is too large, try to maintain a dark light environment during the operation to improve the efficiency of pupil matching. This study further confirms the necessity of rationally positioning the cutting center under different angle kappa states.