角膜Q值与非球面人工晶状体选择的相关研究  

A study of the relationship between corneal Q value and selection of aspheric intraocular lens

作　　者：孙小银[1] 李一壮[2] 钱涛[2] 

机构地区：[1]南京市中西医结合医院眼科,210014 [2]南京大学医学院附属鼓楼医院眼科,210008

出　　处：《中华实验眼科杂志》2013年第9期875-880,共6页Chinese Journal Of Experimental Ophthalmology

摘　　要：背景非球面人工晶状体（IOL）旨在降低白内障术后眼球球差，以获得更好的视觉质量。如何个性化地选择非球面IOL是尚待解决的问题。目的对比分析白内障患者植入负球差IOL和零球差IOL后术眼波前像差及视觉质量的差异。观察角膜Q值与术后眼球球差的相关性，推测角膜Q值能否作为选择非球面IOL的参数。方法收集年龄相关性白内障患者90例104眼，采用随机数字表法将患眼分为2个组，负球差IOL组46例52眼植入TecnisZ9001型负球差IOL，零球差IOL组44例52眼植入AkreosAO型零球差IOL。术前测量所有患者角膜Q值，计算平均值（Q），将负球差IOL组中术前角膜Q值≤Q及〉Q的患者分别亚分为A1组25眼，A2组27眼；零球差IOL组中术前角膜Q值≤Q及〉Q的患者分别亚分为B1组29眼，B2组23眼。术后3个月检查各组患者角膜Q值，5mm瞳孔直径下眼球球差、彗差及总高阶像差的均方根（RMS）值及暗视条件下6him瞳孔直径时对比敏感度（cs）及眩光对比敏感度（GS）。结果手术前与手术后角膜Q值差异无统计学意义（t=1．447，P=0．151）。负球差IOL组眼球球差（0．059±0．047）Ixm，低于零球差IOL组（0．110-＋0．066）p．m，差异有统计学意义（t=-4．567，P=0．000），负球差IOL组中频段、高频段CS好于零球差IOL组，差异均有统计学意义（t=2．495、2．359，P〈0．05）。2个组彗差、总高阶像差差异均无统计学意义（P〉0．05）。2个组患者手术前、手术后角膜Q值分别与术后眼球球差均呈弱相关（术前：r=0．277、0．292，术后：r=0．285、0．325，P〈0．05）。A1与A2组，B1与B2组之间眼球球差，CS、GS间差异均无统计学意义（P〉0．05）。结论负球差IOL眼拥有比零球差IOL眼更小的球羞和更好的暗视cs。角膜Q值可能不宜单独作为选择非球面IOL的参数。Background Aspheric intraocular lens （IOL）is designed to reduce the spherical aberration of the eye after cataract surgery and to obtain better visual quality. However,the selection of a personalized aspheric IOL is a problem to be solved. Objective This study was to compare the wavefront aberration and quality of vision of patients between the implantation of negative spherical aberration IOL and non-aberration IOL,and to investigate the relationship between corneal Q values and postoperative spherical aberration. Methods One hundred and four eyes of 90 patients with age-related cataract were randomized into two groups. Fifty-two eyes of 46 patients who received a Tecnis Z9001 IOL implantation were assigned as the negative spherical aberration IOL group and 52 eyes of 44 patients who received Akreos AO IOL without aberration were assigned as the non-aberration IOL group. The preoperative corneal Q values were measured and the mean Q value（Q）was computed. Then the patients in the two groups were further divided into 2 subgroups,respectively,based on their Q values were over or below Q. The corneal Q values, root mean square （RMS） of ocular spherical aberration, coma and total higher-order aberrations （HOAs） for 5 mm diameter pupil,scotopic contrast sensitivity with or without glare at 6 mm pupil diameter were measured 3 months after surgery. Results The pre-and post-operative corneal Q values were insignificantly changed （ t = 1. 447, P = 0. 151 ）. The spherical aberration in the negative spherical aberration IOL group was（0. 059±0. 047 ）pma, and that in the non-aberration IOL group was （0. 110_±0. 066）p,m, with a statistically significant difference between them （t = -4. 567,P= 0. 000 ）. Scotopic contrast sensitivities at intermediate and high frequencies were significantly better in the negative spherical aberration IOL group than in the non-aberration IOL group （ t = 2. 495, t = 2. 359, P〈0.05 ）. There was no significant difference in coma and HOAs between the two groups

关 键 词：人工晶状体 非球面 球差 视觉质量 角膜Q值 对比敏感度 白内障 

分 类 号：R779.66[医药卫生—眼科]