目的：探究轻中度和高度近视患者飞秒激光制瓣准分子激光原位角膜磨镶术(FS-LASIK)术后角膜前后表面和整体角膜高阶像差的变化。方法：对2018-12/2019-12在我院行FS-LASIK手术的近视患者129例129眼进行回顾性病例研究，按术前等效球镜度(SE)分为轻中度近视组(SE<-6.00D，76眼)和高度近视组(SE≥-6.00D，53眼)。分别于术前和术后6mo用Pentacam眼前节分析系统测量角膜前后表面和整体角膜的高阶像差。结果：术后6mo，两组角膜前表面和整体角膜的总高阶像差、球差和水平彗差较术前增加，且高度近视组高于轻中度近视组(均P<0.01)； 两组角膜后表面的水平彗差较术前有差异(均P<0.01)，且高度近视组高于轻中度近视组(P<0.01)。两组患者角膜前表面和整体角膜的术源性总高阶像差、球差和水平彗差与术前SE有明显相关性(均P<0.01)。结论：FS-LASIK术后6mo角膜前表面及整体角膜的总高阶像差、球差和水平彗差均较术前增加，且与术前SE明显相关； 角膜后表面高阶像差除水平彗差外无明显变化，其远期变化有待进一步研究。

AIM: To investigate the early changes of corneal higher-order aberrations(HOAs)of the anterior surface, posterior surface, and total cornea after femtosecond laser-assisted in situ keratomileusis(FS-LASIK)in mild to moderate myopic and high myopic patients. METHODS: This retrospective study included 129 patients(129 eyes)underwent FS-LASIK surgery from December 2018 to December 2019. Treated eyes were divided into two groups, according to the preoperative spherical equivalent(SE): mild to moderate myopic group(<-6.0D, 76 eyes)and high myopic group(≥-6.0D, 53 eyes). Corneal HOAs of the anterior surface, posterior surface, and total cornea were measured by Pentacam anterior segment analysis system preoperatively and 6mo postoperatively. RESULTS: The tHOAs, spherical aberrations and horizontal coma of the anterior surface and total cornea, significantly increased in both groups 6mo postoperatively(all P<0.01). And more tHOAs, spherical aberrations and horizontal coma of the anterior surface and total cornea were induced in high myopic group than mild to moderate myopic group postoperatively(all P<0.01). The horizontal coma of the posterior surface, significantly increased in both groups 6mo after operation(all P<0.01). And more horizontal coma of the posterior surface were induced in high myopic group than mild to moderate myopic group postoperatively(P<0.01). Changes in anterior surface and total corneal tHOAs, spherical aberrations and horizontal coma were related to the SE(all P<0.01).CONCLUSION:Anterior and total corneal tHOAs, spherical aberrations and horizontal coma, significantly increased after FS-LASIK, and aberration changes were related to SE. Whereas posterior corneal HOAs remained stable except horizontal coma. The long-term effect should be investigated in the future.

安徽省卫生厅科研计划项目(No.2018SEYL025); 安徽省教育厅自然科学研究一般项目(No.12925KJ2018B11)