目的：评估Topcon KR-1W、i.Profiler、OPD-Scan Ⅲ三种波前像差仪测量成年近视患者角膜高阶像差的一致性。

方法：前瞻性临床研究。收集2022-06/08在广西壮族自治区人民医院视光中心就诊的成年近视患者92例92眼，分别采用Topcon KR-1W、i.Profiler、OPD-Scan Ⅲ测量4、6mm瞳孔直径下角膜三、四阶像差，评估三种波前像差仪的差异性和一致性。

结果：三种像差仪6mm瞳孔直径下测量值均高于4mm瞳孔直径下测量值。4mm瞳孔直径下三种像差仪Z^-4₄、Z^-2₄测量值均无差异(P>0.05)，其余测量值均有差异(P<0.05)； 6mm瞳孔直径下三种像差仪测量值均有差异(P<0.05)。4mm瞳孔直径下三阶像差测量值、6mm瞳孔直径下三、四阶像差(除Z^-2₄)测量值的95%LoA>0.1μm，一致性相关系数P_c<0.90，显示一致性较差。三种像差仪4、6mm瞳孔直径下角膜高阶像差测量值相关性差异较大(r_4mm=0.215～0.805，P_4mm<0.05； r_6mm=0.561～0.916，P_6mm<0.001)。

结论：Topcon KR-1W、i.Profiler与OPD-Scan Ⅲ测量4、6mm瞳孔直径下角膜三、四阶像差时测量结果存在差异性，一致性较差，临床应用中三种像差仪不可相互替代。

METHODS:A prospective clinical study. A total of 92 adult patients(92 eyes)with myopia in the department of optometry, the People's Hospital of Guangxi Zhuang Autonomous Region from June to August 2022 were enrolled. The third-order and fourth-order corneal aberrations at the pupil diameter of 4 and 6mm were measured by Topcon KR-1W, i.Profiler, and OPD-Scan Ⅲ, respectively. The difference and agreement of the three aberrometers were evaluated.

RESULTS: The measurements at 6mm pupil diameter were all greater than those at 4mm pupil diameter. Although there were no statistical differences in the measurements of Z^-4₄、Z^-2₄ by the three aberrometers at 4 pupil diameter(P>0.05), there were statistical differences in other measurements(P<0.05). The aberration results measured by the three aberrometers were statistically different at the 6mm pupil diameter(P<0.05). The 95% limit of agreement(95%LoA)of the measurements of higher-order aberration, including the third-order aberrations at 4mm pupil diameter and the third-order and fourth-order aberrations at 6mm pupil diameter(except for the Z^-2₄)were greater than 0.1μm. The concordance correlation coefficient(P_c)was lower than 0.90, indicating a poor consistency. The correlation coefficients of corneal higher-order aberrations were significantly different among the three aberrometers at 4 and 6mm pupil diameter(r_4mm=0.215～0.805, P_4mm<0.05; r_6mm=0.561～0.916, P_6mm<0.001).

CONCLUSION:There were significant differences in the measurements of the third- and fourth-order corneal aberrations at 4 and 6mm pupil diameter among Topcon KR-1W, i.Profiler, and OPD-Scan Ⅲ, and the agreements were poor, so they are not interchangeably in clinical applications.