目的探讨准分子激光原位角膜磨镶术(LASIK)和准分子激光角膜上皮瓣下磨镶术(LASEK)对眼波阵面像差的影响并作对比分析。方法随机选取在我院屈光手术研究治疗中心就诊并行LASIK或LASEK治疗的近视患者各18例(18只眼),使用WFA-1000型主观式波阵面像差仪分别于术前、术后10d、1和3个月行波阵面像差检查,应用Matlab5.3软件计算1到35项各项的Zernik系数,计算出各高阶(3~7阶)和总高阶像差的均方根(RMS)。应用统计软件SPSS10.0对所得结果进行组间方差分析并做两两比较。结果全部患者术后3个月时裸眼视力均达到或超过术前最佳矫正视力,无危害视力的并发症发生。LASIK术后10d时各高阶和总高阶像差较术前增加,1个月时明显减小,3个月时轻微增加。LASEK术后波阵面像差随时间推移逐渐减小,1个月时除3阶像差外均小于术前,3个月时所有高阶像差均小于术前。LASIK手术前后分阶方差分析,3阶、4阶和总高阶像差差异有统计学意义。两两比较3阶像差术后10d和术前差异有统计学意义,而术后1个月及术后3个月时和术前差异无统计学意义,两者之间差异也无统计学意义;4阶和总高阶像差同样如此。LASEK手术前后各高阶和总高阶像差差异均有统计学意义,两两比较与LASIK相似。结论LASIK和LASEK术后早期均会引起眼波阵面像差增加,但随时间推移逐渐减小,术后1、3个月时和术前比较已无统计学意义。与LASIK相比,LASEK术后眼波阵面像差增加的幅度较小。(中华眼科杂志,2005,41:966-971) Objective To investigate the effects of laser in situ keratomileusis (LASIK) and excimer laser keratomileusis (LASEK) on the wavefront aberrations of the eye wave and to compare and analyze them. Methods Eighteen cases (18 eyes) of myopia treated with LASIK or LASEK were randomly selected in the Refractive Surgery Research and Treatment Center of our hospital. WFA-1000 subjective wavefront aberrometer was used to evaluate the effect of preoperative and postoperative 10d, 1 and 3 months traveling wavefront aberration inspection, using Matlab5.3 software to calculate the Zernik coefficient of 1 to 35 items to calculate the high order (3 to 7) and the total higher-order aberrations are Root square (RMS). Application of statistical software SPSS10.0 on the results of the analysis of variance between groups and do a comparison. Results All patients had visual acuity of uncorrected visual acuity at or above preoperative best corrected visual acuity at 3 months postoperatively, with no complications of visual acuity. At 10 days after LASIK, the higher-order and higher-order aberrations increased more than preoperatively, decreased significantly at 1 month and slightly increased at 3 months. The wavefront aberrations of LASEK decreased gradually with the passage of time, except for the third order aberrations at one month, all the higher order aberrations were less than the preoperative ones at three months. Stratified analysis of variance before and after LASIK surgery showed that there were significant differences between the third order, the fourth order and the total higher order aberrations. There was a statistically significant difference between preoperative and postoperative 10d and 3h postoperatively of the third order aberrations, while there was no significant difference between preoperative and postoperative one month and three months postoperatively Meaning; 4th order and total high order aberrations the same. LASEK before and after the high-order and total high-order aberrations were statistically significant differences between each two and LASIK similar. Conclusion Both LASIK and LASEK can cause the wavefront aberrations to increase in the early postoperative period, but decrease gradually with the passage of time. There is no significant difference between preoperative and postoperative one and three months postoperatively. Compared with LASIK, LASEK ophthalmic wavefront aberrations increased less. (Chinese Journal of Ophthalmology, 2005,41: 966-971)