超声乳化白内障吸除术前角膜球差对相对个性化非球面人工晶状体植入的影响  

The influence of preoperative corneal spherical aberration on relatively personalized implantation of aspheric intraocular lens

作　　者：连慧芳[1] 汤欣[1] 宋慧[1] 

机构地区：[1]天津医科大学眼科临床学院天津市眼科医院,300020

出　　处：《中华眼科杂志》2010年第5期410-414,共5页Chinese Journal of Ophthalmology

摘　　要：目的探讨根据患者超声乳化白内障吸除术前角膜球差植人合适的非球面人工晶状体（IOL）使其术后全眼球差为零方法的可行性。方法前瞻性病例系列研究。对46例（57只眼）年龄相关性白内障患者行超声乳化白内障吸除联合非球面IOL植入术前1d，利用iTrace视觉功能分析仪测量6．0mm瞳孔直径的角膜球差（Z4^0），为使患者术后总球差接近于零，对角膜球差小于0．100μm者植入Sofport Advanced OpticlOL（AO组，10只眼），0．100—0．235μm者植入AcrySof IQ IOL（IQ组，20只眼），大于0．235μm者植入Tecnis ZA9003 IOL（Tecnis组，27只眼）。患者均行3．2mm透明角膜切口的超声乳化白内障吸除联合非球面IOL植人术，术后3个月观察患者的裸眼视力、最佳矫正视力、6．0mm瞳孔直径时的全眼及内眼（主要是IOL）球差。采用t检验和方差分析对获得的数据进行统计学分析。结果术后所有患者6．0mm瞳孔直径时的全眼球差为（0．015±0．056）μm[AO组：（0．081±0．013）μm；IQ组：（0．006±0．038）μm；Tecnis组：（0．007±0．070）txm]；所有患者术后全眼球差的预测值与实际值的差异无统计学意义（t=1．983，P=0．052）（Sofport：t=1．957，P=0．082；AcrySof IQ：t=0．030，P=0．976；Tecnis：t=2．031，P=0．053）；所有患者全眼球差的预测值与实际值的差值为（0．0144-0．044）μm[AO组：（0．006±0．012）μm；IQ组：（-0．000±0．037）μm；Tecnis组：（0．027±0．052）μm；F=2．626，P=0．082]。术后3组患者的裸眼视力、最佳矫正视力比较，差异均无统计学意义（F=0．901，P=0．412；F=2．416，P=0．099）。结论根据患者术前的角膜球差植入合适的非球面IOL，术后均能够获得较满意的目标球差，为相对个性化植入非球面IOL方法的应用提供临床依据。Objective To analysis the feasibility of selectively targeting zero total postoperative spherical aberration by selecting the best fit aspheric intraocular lens （IOL） based on preoperative corneal spherical aberration of patients. Methods It was a prospective case series study. The corneal spherical aberration（Z4^0） with 6 mm aperture of 57 eyes （46 patients ） was measured with a iTrace Visual Function Analyzer 1 day before surgery, the target postoperative total spherical aberration was set at zero. Thus, for corneal spherical aberration 〈 ＋ 0. 100 μm, the Sofport Advanced Optic （AO） IOL （ 10 eyes） was selected; for corneal spherical aberration 〉 ＋0. 100 μm but if 〈 ＋0. 235 μm, the AcrySof IQ IOL（20 eyes） was selected; and for corneal spherical aberration 〉 ＋0. 235 μm, Tecnis ZA9003 IOL（27 eyes）was selected. Aspherical IOL was implanted after phacoemulsification through a clear-cornea, 3.2 mm incision without suture. Uncorrected visual acuity, best corrected visual acuity （BCVA）, spherical aberration of the whole eye and internal optics （IOL） at 6 mm pupil diameter were examined at 3 months postoperatively. ANOVA and t-test were used to analyze the data at 3 months postoperatively. Results Total postoperative ocular spherical aberration at 6 mm pupil diameter for the entire population measured （0. 015 ± 0. 056） μm [ AO ： （0. 081 ±0. 013） μm;IQ： （0. 006 ±0. 038） μm;Tecnis： （0. 007 ±0. 070） ±m]. For the entire population, there was no significantly different between the predicted value and actual value of ocular spherical aberration at 6 mm pupil diameter： t = 1. 983, P =0. 052（AO：t = 1. 957, P = 0. 082;IQ： t = 0. 030, P = 0. 976; Teenis ： t = 2. 031, P = 0. 053 ）. For the entire population, the predictive error measured （ 0. 014 ± 0. 044 ） μm[ AO： （0. 006 ±0. 012）μm;IQ： （ -0. 000 ±0. 037） μm; Teenis： （0. 027 ±0. 052） μm;F =2. 626, P = 0. 082]. The postoperative visual activity was not si

关 键 词：超声乳化白内障吸除术 白内障 晶体 人工 角膜地形图 

分 类 号：R779.66[医药卫生—眼科]