机构地区:[1]天津医科大学眼科临床学院天津市眼科医院天津市眼科研究所,300020
出 处:《中国实用眼科杂志》2010年第11期1232-1235,共4页Chinese Journal of Practical Ophthalmology
摘 要:目的 研究超声乳化白内障吸除术后球面和非球面人工晶状体(intraocularlens,IOL)的倾斜和偏心及其对高阶像差(higher-order aberrations,HOAs)和视觉质量的影响.方法 前瞻性研究.取50例单纯性老年性白内障患者60只眼,30只眼随机植入AMO公司的球面IOLSensar AR40e,30只眼植入非球面IOLTecnisZA9003.术后3到4个月,检测患者在5.0mm瞳孔下的HOAs以及5、10、15、20、25、30周每度(cycles per degree,cpd)空间频率下的调制传递函数(modulation transfer function,MTF).通过Scheimpflug像,测量IOL的倾斜与偏心.比较两组间倾斜度和偏心值、HOAs及各空间频率下去除低阶像差的MTF(MTF(HOA))值.使用多元回归分析来确定倾斜和偏心对HOAs和视觉质量的影响.结果 光学部倾斜AR40e组(2.99±0.94)°,ZA9003组(2.98±1.15)°.光学部偏心AR40e组(0.30±0.13)mm,ZA9003组(0.31±0.14)mm.组间倾斜和偏心差异无统计学意义(Z=-0.044,-0.525,P=0.965,0.600,Mann-WhitneyU检验).总4阶球差,AR40e组(0.366±0.163)μm大于ZA9003组(0.027±0.072)μm,差异有统计学意义(t=-10.386,P=0.000).ZA9003组在5.0mm瞳孔直径下各频段的MTF(HOA)值均高于AR40e组,有统计学意义(P<0.05).两组IOL倾斜和偏心对各自的HOAs及各频段的MTF(HOA)值均无明显影响.结论 当IOL的倾斜和偏心在正常限度内时,不会危害非球面IOL对球差的补偿作用,不足以导致视觉质量的下降.Objective To study tilt and decentration of spherical and aspheric IOL implantation after phacoemulsification surgery and effect on higher-order aberrations (HOAs) and visual quality. Methods It was a prospective clinical study. A total of 60 eyes (50 patients) were divided into 2 groups randomly, of 30 eyes in each group, one group with Sensar AR40e (AMO), one group with Tecnis ZA9003 (AMO). Three to four months after surgery, higher-order aberrations (HOAs) and modulation transfer function (MTF) at six spatial frequencies (5, 10, 15, 20, 25, 30 cpd) were measured in 5.0mm pupil size. Tilt and decentration of the IOLs were measured using Scheimpflug photography. The tilt and decentration, HOAs and subtracted lower order aberration MTF (MTF(HOA)) were compared. The effect of tilt and decentration on HOAs and visual quality was assessed using multiple regression analysis. Results The mean optic tilt was (2.99± 0.94)° for AR40e group and (2.98± 1.15)° for the ZA9003 group. The mean optic decentration was (0.30± 0.13)mm, (0.31± 0.14)mm,respectively. No significant differences in IOL tilt or decentration were found (Z= -0.044, -0.525, P =0.965,0.600, Mann-Whitney U test). The total 4th order spherical aberration in AR40e group was larger than it was in ZA9003 group and the differences were statistically significant (t = -10.386, P =0.000). In 5.0mm pupil size,MTF (HOA) at all spatial frequencies in ZA9003 group were larger than they were in AR40e group and the differences were statistically significant (P 〈0.05). Tilt and decentration did not significantly affect HOAs and MTF (HOA) with either IOL. Conclusions When IOL tilt and decentration are within normal limits, hey do not compromise the correction of spherical aberration by the aspheric IOL and the amounts of tilt and decentration of both IOLs are not large enough to cause deterioration of visual quality.
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