不同人工晶状体植入术后倾斜和偏心及视觉质量的临床研究  

Effect of tilt and decentration of intraocular lens asphericity on visual quality

作　　者：王莹[1] 马忠旭[2] 刘汝瑜[2] 张伟 

机构地区：[1]天津医科大学研究生院,天津300070 [2]天津市眼科医院,天津300020

出　　处：《天津医科大学学报》2011年第4期521-524,共4页Journal of Tianjin Medical University

摘　　要：目的：研究白内障超声乳化吸除术植入不同球差人工晶状体（IOL）的倾斜和偏心对高阶像差（HOAs）和调制传递函数（MTF）的影响。方法：前瞻性研究。选取老年性白内障患者69例（85只眼），随机分成3组，25例（30只眼）植入球面IOL Sensar AR40e，19例（25只眼）植入零球差IOL Soflec HD，30只眼植入负球差IOL Tecnis ZA9003。术后3～4个月随访，使用iTrace像差仪采集患者在5．0mm瞳孔下的HOAs以及5、10、15、20、25、30周每度（cpd）空间频率下的MTF。应用Pentacam三维眼前段分析仪测量IOL的倾斜度与偏心量。比较3组IOL倾斜度和偏心量、HOAs及各空间频率下去除低阶像差的MTF（MTF（HOA））值。使用多元线性回归分析来确定倾斜和偏心对HOAs和MTE（HOA））的影响。结果：3组IOL倾斜度和偏心量组间比较差异均无统计学意义（F=0．001，F=0．050；P=0．999，P=0．952）。3组间总HOAs和总慧差比较差异无统计学意义（P〉0．05），3组间总球差比较差异有统计学意义（F=65．68，P=0．000），而后采用LSD检验行两两比较，差异均有统计学意义（P〈0．05）。3组IOL在5．0mm瞳孔直径下各频段的MTE（HOA））值比较差异有统计学意义（P〈0．05），而后采用LSD检验行两两比较，Softec HD组和ZA9003组差异无统计学意义（P〉0．05），两组MTF（HOA））值均较AR40e组高，差异有统计学意义（P〈0．05）。3组IOL倾斜和偏心对各自的HOAs及各频段的MTE（HOA）值均无明显影响。结论：零球差IOL和负球差IOL均较球面IOL减少了全眼球差，提高了视觉质量，零球差IOL可能较负球差IOL受倾斜和偏心的影响要小。IOL轻微的倾斜和偏心不会影响非球面IOL对球差的补偿作用，不足以导致视觉质量下降。Objective： To analyze the effect of tilt and decentration of intraocular lenses （IOLs） asphericity on visual quality after phacoemulsification surgery and IOLs implantation. Methods： It was a prospective clinical study. A total of 85 eyes of 69 patients with IOLs implantation and 3 to 4 months after surgery were analyzed in this study, including 30 eyes with spherical IOL of Sensar AR4Oe, 25 eyes with aspherically neutral IOL of Softec HD and 30 eyes aspheric IOL of Tecnis ZA9003 with negative spherical aberration. At postoperat ive follow-up visits, higher-order aberrations （HOAs） and modulation transfer function（MTF） at six spatial frequencies （5,10,15,20,25,30cpd） were measured in 5.0 mm pupil size. Tilt and decentration of the IOLs were measured using Scheimpflug photography（Pentacam ,Oculus）. The tilt and decentration, HOAs and subtracted lower order aberration MTF（MTF（ HOA））were compared. The effect of tilt and decentration on HOAs and MTF（ HOA） was assessed using multiple regression analysis. Results： No significant differences in IOL tilt or decentration were found（ F=0.001, F=0.050 ;P=-0.999, P=-0.952）.The spherical aberration in AR40e group was largest and the differences were statisti- cally significant（F= 65.68, P=0.000）. In 5.0 mm pupil size,MTF（HOA）/at all spatial frequencies in AR40e group were lowest and the differ ences were statistically significant（P〈0.05 ）. Tilt and decentration did not significantly affect HOAs and MTF（HOA）. Conclusion： The amounts of tilt and decentration of both IOLs are not large enough to affect the correction of spherical aberration and cause deterioration of visual quality.

关 键 词：晶体 人工 非球面性 倾斜 偏心 像差 调制传递函数 

分 类 号：R776.1[医药卫生—眼科]