摘要目的:探讨角膜穿孔伤术后高阶像差的变化对视力的影响。方法:回顾性研究。以2018年1月至2020年1月河北省眼科医院眼外伤科角膜穿孔伤58例(58只眼)为观察组，对侧健眼为对照组。随访3个月以上，观察两组视力、角膜曲率、散光、高阶像差、彗差、球差及余差等。结果:末次随访时观察组的视力明显低于对照组( t＝8.07， P<0.05)，陡峭角膜曲率及角膜散光明显高于对照组( t＝2.660， P＝0.013)；观察组全角膜、前角膜及后角膜高阶像差、彗差、球差、余差均高于对照组( P<0.05)；矫正视力的差值与彗差的差值呈强正相关( r＝0.732， P<0.001)，角膜前表面高阶像差及彗差与角膜总高阶像差及彗差呈极强正相关( r＝0.993，0.957；均 P<0.001)。 结论:角膜穿孔伤术后散光明显增大，其中陡峭角膜曲率显著升高，同时角膜的高阶像差显著增高，彗差增加最为显著，与矫正视力呈强相关，高阶像差与彗差的改变主要发生在角膜前表面。

abstractsObjective:To investigate the influences of higher order aberration changes on visual acuity after surgery for corneal perforation injury.Methods:This was a retrospective case study.A total of 58 eyes of 58 cases with corneal perforation injury from Jan.2018 to Jan.2020 in Hebei Eye Hospital were included as the observation group.The contralateral healthy eyes of the same cases were included as the control group.The follow-up period was over 3 months after treatment.The visual acuity, corneal curvature, astigmatism, higher order aberration, coma aberration, spherical aberration and other aberrations of the two groups were observed.Results:At the end of the follow-up period, the visual acuity of the observation group was significantly lower than that of the control group ( t=8.07, P<0.05). The steep corneal curvature and corneal astigmatism of the observation group were significantly higher than those of the control group.And the differences were statistically significant ( t=2.660, P=0.013). The total corneal, anterior corneal and posterior corneal higher order aberration, coma aberration, spherical aberration and other aberrations of the observation group were higher than those of the control group.And the differences were statistically significant ( P<0.05). The difference of best corrected visual acuity was strongly correlated with the difference of coma aberration ( r=0.732, P<0.001). The higher order aberration and coma aberration on the anterior surface of the cornea were strongly correlated with the total higher order aberration and coma aberration ( r=0.993, 0.957; all P<0.001). Conclusion:After corneal perforation surgery, astigmatism is significantly increased, in which the steep keratomery of the cornea is significantly increased.Meanwhile, the higher order aberration is significantly increased, especially the coma aberration, which is strongly correlated with best corrected visual acuity.The changes of higher order aberration and coma aberration occur mainly on the anterior surface of the cornea.