有晶状体眼前房虹膜夹型人工晶状体植入矫治高度近视术后波阵面像差  

Wavefront aberrations in phakic eyes with the anterior chamber iris-claw intraocular lens transplantation for high myopia

作　　者：易全勇[1] 王勤美[1] 薛安全[1] 孙涛[1] 吕帆[1] 

机构地区：[1]温州医学院眼视光学院,浙江省温州市325027

出　　处：《眼科新进展》2006年第12期930-933,共4页Recent Advances in Ophthalmology

摘　　要：目的评价有晶状体眼前房虹膜夹型人工晶状体植入矫治高度近视术后的波前像差,以阐明其术后的视觉质量。方法采用对照研究的方法,实验组为有晶状体眼前房虹膜夹型人工晶状体植入矫治高度近视术后的患者20例32眼,年龄18～40岁。对照组选择年龄匹配的普通近视眼17例30眼,年龄18～39岁。使用客观型像差仪进行波前像差检测,获得整体像差、各分阶像差的均方根(RMS),及Z7、Z8、Z12项系数和像差图。结果实验组术后1月整体高阶像差(Rh)及各分阶像差的RMS均较对照组高,其中3、4阶高出最明显,差异均有显著性(P<0.05)。实验组术后3月Rh及各分阶像差的RMS均较对照组大(P<0.05),其中3、4阶增高最明显,差异均有显著性。实验组术后3月的Rh、RMS3、RMS4、RMS5、RMS7较术后1月均降低,差异均无统计学意义(P>0.05);第3阶降低最明显;RMS6较术后1月增高,差异无统计学意义(P>0.05)。实验组术后1、3月的Rh与球面屈光度显著正相关(r=0.963、P=0.000;r=0.952、P=0.000)。术后1月的Rh与术前柱面屈光度呈显著正相关(r=0.428、P=0.042)。结论有晶状体眼前房虹膜夹型人工晶状体植入矫治高度近视术后眼的高阶像差高于正常眼。随着时间的推移,除RMS6外,术后1月较高的像差在术后3月时均不同程度的减少。术前球面、柱面屈光度越高,术后1月的Rh越高;术前球面屈光度越高,术后3月的Rh越高。Objective To investigate the visual quality of the phakie eye by measuring the wavefront aberrations of the eye after the insertion of an irisclaw phakic intraocular lens for high myopia and to compare the aberrations with those of normal controls. Methods Iris-claw phakic intraocular lens transplantation was performed on 32 eyes of 20 high myopic patients ranging from 18 to 40 years of ages. Wavefront aberrations of the patients at 2 st and 3 rd postoperative months,and those of 30 eyes of 17 normal controls ranging from 18 -- 39 years of age were measured using an aberrometer （WASCA）. The aberrometer is an objective instrument which provides wavefront aberration maps and 35 values of zernike functions. We obtained the RMS values of the overall wavefront errors （Rh）,the RMS in each order（3nd to 7nd） and ZT, 7,8, Z12 values of zernike functions. Results One month and 3 months after surgery, the Rh and the RMS in each order（3nd to 7nd） were greater than those for the normal controls. The differences in RMS values between the phakie eyes and the normal controls were also statistically significant（ P 〈 0.05 ）. Three months after operation, the Rh and the RMS in each order （3nd to 7nd ）were decreased except for RMS6. But there was no statistically significant difference （P 〉 0.05 ）. There was a significant positive correlation between severity of myopia and Rh of the phakic eyes after 1 st and 3 rd month（ r = 0.963,P = 0.000;r = 0.952, P = 0.000）. There was a significant positive correlation between severity of astigmatism and Rh of the phakic eyes after 1 month. Conclusion The wavefront aberrations of the eyes after the insertion of an iris-claw phakic intraocular lens for high myopia showed stronger aberrations than norrnal eyes. Itigher order aberrations after surgery may tend to decreased as time goes by. The higher severity of myopia, the higher order aberrations 3 months after surgery.

关 键 词：波前像差 有晶状体眼 前房虹膜夹型人工晶状体 高度近视 

分 类 号：R779.64[医药卫生—眼科]