后发性白内障行Nd：YAG激光术前后视觉质量变化  

The effect of Nd：YAG laser posterior capsulotomy on vision quality

作　　者：马忠旭[1] 巩晨[1] 王新[1] 

机构地区：[1]天津市眼科医院,天津300020

出　　处：《中国实用眼科杂志》2013年第8期971-974,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的研究Nd：YAG激光后囊膜切开术对后发性白内障患者光学像差的影响，客观评价视觉质量。方法采用回顾性对照研究。对选择Ⅱ级膜（后囊膜中度混浊，眼底部分模糊不清）20例（25只眼）明显影响视力的后发性白内障患者行Nd：YAG激光后囊膜切开手术，术中选用不同激光脉冲及能量。手术前后采用裂隙灯数码照相机进行眼底红反光照像，激光术后用Adobephotoshop7．0软件联合MB—ruler量截囊口的大小。使用i-Trace波前像差仪进行术前后视觉质量的分析，测量4mm瞳孔波前像差及空间频率为5～30（c／pd）调制传递函数（MTF）值的改变。记录患者激光术前后患者在自然瞳孔下最佳矫正视力。结果Nd：YAG激光后囊膜截开术后最佳矫正视力均明显提高，由平均LogMAR视力0．62改变为0．20；术前总高阶像差均方根值0．589（SD0．108），其中三叶草像差占高阶像差的主要部分为0．315（SD0．094）。激光手术1月后总、高阶像差及各阶像差对应的均方根值较术前明显减小（P〈0．05）。5-30c／d空间频率下MTF值激光后囊膜切开术前后比较差异有统计学差异，MTF值均有明显提高（P〈0．05）。结论Nd：YAG激光后囊膜切开术治疗后发性白内障患者，术后最佳矫正视力明显提高，同时与术前比较光学波前像差降低，术后可以重新获得较好视觉质量。Objective To evaluate the effect of Nd：AG laser posterior capsulotomy on ocular wavefront aberrations and assess the vision quality objectively. Methods A prospective comparative study. Twentyfive eyes of 20 consecutive pseudophakic patients with symptomatic PCO, which im paired the visual acuity severely, who presented for Nd：AG laser posterior capsulotomy at our clin ic, were included in this study. According to the different type, different laser parameter was chosen. Before and after Nd：YAG laser posterior capsulotomy, using slitlamp digital camera and then the Adobe photograph7.0 software combined with MBruler to calculate the diameter of the opening size. The wavefront aberrations of the entire optical path of 25 pseudophakic eyes of 20 patients be fore, and 1 month after, Nd：YAG laser posterior capsulotomy were measured using iTrace visual function analyzer. Total, highorder aberrations, and total coma, trefoil, spherical aberrations were ana lyzed statistically. The changes in best corrected visual acuity were also measured. Results Signifi cant improvement in visual acuity was observed after Nd：YAG laser posterior capsulotomy, mean log MAR visual acuity 0.62 to 0.20. Before the procedure, the total higherorder aberrations root meansquare （RMS） wave front aberration was 0.589 （SD 0.108）m, with trefoil being a major con tributor at 0.315 （SD 0.094）μm. One month after the procedure, significant decreases in total, highor der aberrations, and total coma, trefoil, spherical aberrations were noted （P 〈0.05）. Additionally, MTF （tHOA） values at 530cpd got significantly improvement after Nd：YAG laser posterior capsulot omy （P 〈0.05）. Conclusions Nd：YAG laser posterior capsulotomy, best corrected visual acuity is improved and caused significant decrease in ocular wavefront aberrations measured using iTrace visual function analyzer, which can account for a better optical quality after the procedure.

关 键 词：Nd YAG激光 后囊膜切开术 后发性白内障 像差 调制传递函数 

分 类 号：R779.63[医药卫生—眼科]