非球面和球面人工晶状体植入术后高阶像差及对比敏感度的对比观察  

Comparative assessment of higher-order aberrations and contrast sensitivity with spherical and aspherical intraocular lenses

作　　者：刘丽丽[1] 施玉英[2] 

机构地区：[1]北京市监狱管理局中心医院眼科,100054 [2]首都医科大学附属北京同仁医院眼科中心

出　　处：《眼科》2008年第2期89-93,共5页Ophthalmology in China

摘　　要：目的 对比观察白内障超声乳化吸除分别植入非球面和球面人工晶状体术后患眼高阶像差及对比敏感度的差异。设计病例系列研究。研究对象单纯老年性白内障患者（除外其他眼病）76例（88眼），依照患者意愿，按照植入非球面或球面人工晶状体的类型不同分为两组：非球面人工晶状体（KS-3Ai）组38例（45眼），球面人工晶状体（KS-3）组38例（43眼）。方法 入选患者均行白内障超声乳化吸除术分别植入预装式非球面（Canon Staar KS-3Ai）或预装式球面（Canon Staar KS-3）人工晶状体。术后3个月观察两组患者视力、最佳矫正视力、人工晶状体居中情况、屈光状态，波前像差仪检查瞳孔6mm的高阶像差（包括四阶像差、球差、总高阶像差均方根、四阶彗差），检查患者的对比敏感度、眩光敏感度。主要指标最佳矫正视力，瞳孔6mm的四阶像差、球差、总高阶像差均方根、四阶彗差，对比敏感度、眩光敏感度。结果 瞳孔6mm时非球面组球差（Z4°）[（0．0182＋0．2068）μm]低于球面组[（0．3254±0．1518）μm]，差异有统计学意义（P=0.000）。四阶像差均方根（RMS4）非球面组[（0．2620±0．1685）μm]低于球面组[（0．4633±0．2352）μm]，二者差异有统计学意义（P=0．004）。高阶像差均方根非球面组[（0．5406±0．2055）μm]低于球面组[（0．8137±0．4442）μm]，二者差异有统计学意义（P=0．012）。但两组间术后最佳矫正视力、对比敏感度及眩光敏感度差异均无统计学意义。结论 非球面人工晶状体（KS-3Ai）较普通的球面人工晶状体（KS-3）能够明显降低包括球面像差在内的高阶像差，但视力及对比敏感度并未发现明显差别。Objective To evaluate whether the aspherical intraocular lens （IOL） with a modified aspherical surface provides better quality of vision than a conventional spherical IOL for the senile cataract patients after phacoemulsification and IOL implantation. Design Case series study. Participants 76 senile cataract patients （88 eyes） were divided into two groups according to the type of IOL at the patients＇s desire： aspherical groups （KS-3Ai） or spherical groups （KS-3）. Methods All patients underwent phacoemulsification and IOL implantation. 3 months after operation, several tests were performed. The parameters included visual acuity, best corrected visual acuity （BCVA）, refraction data, centrality of IOL, the values of contrast sensitivity with Takaci-CGT-1000, 4th -order aspherical aberration Zernike coefficient （Z4°）, root mean square of the 4th order （RMS4） and higher-order root mean square （RMSh）, 4th-order coma （Z7,Z8） with ALLEGRETTO WAVE Analyzer （Wavelight Laser Technologie AG） at 6 mm pupil. Then statistical analyses were done. Main Outcome Measures BCVA, Z4°, RMS4, RMSh, 4th-order coma （Z7,Z8）, contrast sensitivity and glare sensitivity. Results The spherical wavefront aberration on eyes at 6 mm-pupil with KS-3Ai （Canon Staar） IOL get lower Zernike coefficient （0.0182±0.2068 μm） than those with KS-3 （Canon Staar） （0.3254 ±0.1518 μm） （P=0.000）; RMS4： KS-3Ai （0.2620 ±0. 1685 μm）, lower than spherical groups （KS-3） （0.4633 ±0.2352 μm）（P=0.004）; RMSh： KS-3Ai group （0.5406±0.2055μm） were lower than KS-3 group （0.8137±0.4442）（P=0.012）. There were statistical differences. There was no significant difference of BCVA or contrast sensitivity or glare sensitivity between two groups （P〉0.05）. Conclusion A significant reduction in higher-order aberrations including spherical aberration after KS-3Ai IOL implantation was achieved, but visual acuity and contrast sensitivity were not affected by the aspheric

关 键 词：晶状体 人工 高阶像差 对比敏感度 

分 类 号：R779.66[医药卫生—眼科]