Pentacam与iTrace像差仪在白内障患者角膜像差测量中的应用  

Comparison of Pentacam and ultrasound biomicroscope for measurement of cornea aberrations

作　　者：张帅[1] 汤欣[2] 张一凡[1] 穆凤平[1] 李穗玲[1] 赵伟[1] 李彦国[1] 

机构地区：[1]秦皇岛市第一医院眼科,066000 [2]天津市眼科医院,300020

出　　处：《眼科研究》2010年第10期984-988,共5页Chinese Ophthalmic Research

摘　　要：目的探讨利用Pentacam系统测量超声乳化白内障摘出联合人工晶状体(IOL)植入术手术前后角膜前表面高阶像差的变化,比较Pentacam系统与iTrace像差仪测量的术后角膜前表面像差的差异。方法研究为诊断性试验研究。对年龄相关性白内障患者60例79眼行小切口超声乳化白内障摘出联合折叠型IOL植入术,应用Pentacam系统分别于术前和术后2个月测量角膜前表面的像差,观察手术前后角膜前表面像差的变化。术后2个月对所有患者行iTrace像差仪检查,记录总高阶像差、彗差、三叶草像差及球差的均方根(RMS)值。所有手术和检查均由同一位医师操作。所有患者均签署书面知情同意书。结果 Pentacam测量方法检查结果显示,角膜前表面的总高阶像差术前较术后轻度增加,但手术前后变化差异无统计学意义(t=0.717,P>0.05);其余各项球差、彗差、三叶草像差以及3～6阶像差手术前后的变化与总高阶像差的检测结果相似,差异均无统计学意义(P>0.05)。Pentacam和iTrace测量术后角膜前表面的像差发现,Pentacam测量的球差、三叶草像差测量结果较iTrace轻度增加,但差异无统计学意义(P>0.05);而Pentacam和iTrace所测量的总高阶像差、球差、3～6阶像差的比较差异均有统计学意义(P<0.05)。结论小切口超声乳化白内障摘出联合IOL植入术后角膜前表面高阶像差的变化不影响患者的视觉质量,Pentacam和iTrace测量的角膜波前像差结果存在部分差异。Background Wavefront aberration technology has been applied in phacoemulsification with intraocular lens（IOL） implantation surgery to improve the subjective symptoms after operation.Some methods have been used for the measurement of wavefront aberration.How to evaluate these methods is a problem.Objective Present study was to investigate the effect of phacoemulsification with IOL implantation surgery on high order aberrations（HOAs） of the cornea and compare the difference of HOAs from the anterior surface of cornea measured by Pentacam and Tracey wavefront aberrometer.Methods This is a diagnostic test study.Seventy-nine eyes of 60 patients with age-related cataract were enrolled in this study.Small-incision phacoemulsification with foldable IOL implantation was performed.THOA,spherical aberration（SA）,coma,trefoil,3rd,4th,5th,6th order aberrations were measured with Pentacam and Tracey before operation and two months after cataract surgery.Written informed consent was obtained before any medical process.The operation and examination was carried out by the named doctors.Results The root-mean-square（RMS） of tHOA of corneal anterior surface was insignificantly increased from（1.025±0.213） μm preoperatively to（1.050±0.280） μm postoperatively（t=0.717,P0.05）.The changes of coma,trefoil and from 3 order to 6 order aberrations were similar to that of tHOA before and 2 months after surgery（P0.05）.The RMS of tHOA spherical aberration and from 2 order to 6 order aberrations showed statistical differences between Pentacam and Tracey（P0.05）.The RMS of coma,trefoil by Pentacam were higher than those of Tracey,but the differences were no statistically significant between them（P0.05）.Conclusion Phacoemulsification with IOL implantation does not systematically degrade the optical quality of the anterior corneal surface.Some differences are found in Zernike coefficients between Pentacam and Tracey methods.

关 键 词：角膜 波前像差 超声乳化白内障摘出联合人工晶状体植入术 PENTACAM iTrace 

分 类 号：R779.66[医药卫生—眼科]