AcrySof IQ Restor Toric人工晶状体植入术后对视觉质量的影响  

Effects of AcrySof IQ ReSTOR Toric intraocular lens implantation on visual quality

作　　者：陈祥菲[1] 陆燕[1] 段娴艺 施宇华[1] 陈银[1] 黄振平[1] 

机构地区：[1]南京大学医学院临床学院(南京军区南京总医院)眼科,江苏省南京市210002

出　　处：《眼科新进展》2014年第4期337-340,344,共5页Recent Advances in Ophthalmology

基　　金：国家自然科学基金面上项目(编号:81270979)~~

摘　　要：目的探讨Acrysof IQ Restor Toric人工晶状体植入术前后患眼散光、像差及调制传递函数(modulation transfer function,MTF)值变化,评价此种晶状体对术眼视觉质量的影响。方法观察在我院行白内障超声乳化摘出联合IQ Restor Toric IOL植入的白内障合并角膜散光≥1.0 D的患者8例(10眼),分别于术前、术后1个月、3个月测量裸眼远中近视力、最佳矫正远近视力、等效球镜、残余散光及IOL轴位、总低阶像差和高阶像差、MTF值并问卷调查视觉满意度等。结果术后3个月,裸眼远视力为0.85±0.30,最佳矫正远视力为0.92±0.27,裸眼近视力为0.73±0.22,最佳矫正近视力为0.76±0.20,裸眼中视力为0.62±0.18;等效球镜度数≤±0.5 D者9眼(90%)。术后3个月全眼总散光由术前的(1.50±0.41)D降至(0.28±0.43)D(t=6.124,P=0.000),与术前预计残留散光(0.13±0.09)D相比差异无统计学意义(P>0.05)。术后3个月,IOL轴位偏离(3.20±1.55)°。所有瞳孔直径下,总像差、低阶像差、高阶像差、球差与术前相比均有显著下降(均为P<0.05),术后3 mm瞳孔直径下的总像差、低阶像差和高阶像差(P=0.034、0.044、0.005)以及5 mm瞳孔直径下的总像差、低阶像差、散光像差(P=0.048、0.033、0.046)随时间推移仍有显著降低,余像差随时间变化虽有下降,但差异均无统计学意义(均为P>0.05)。不同瞳孔直径下,MTF值在各个空间频率下与术前相比均有显著提高(均为P<0.05)。结论 Acrysof IQ Restor Toric多焦点散光型人工晶状体能为白内障患者提供良好的全程视力和有效的散光矫正,减少了全眼高阶像差和球差,从而提高了患者的术后视觉质量。Objective To discuss the changes of astigmatism, aberration and modulation transfer function （MTF）before and after Acrysof IQ Restor toric intraocular lenses （IOL） implantation, and evaluate the visual function of the treated eyes. Meth- ods Ten eyes from 8 cataract patients with corneal astigmatism equal to or higher than 1.0 D underwent phacoemulsification with Acrysof IQ Restor toric IOL implanta- tion in our hospital were chosen. The uncorrected distant visual acuity, uncorrected in- termediate visual acuity, and uncorrected near visual acuity, corrected distant visual a- cuity and corrected near visual acuities, spherical equivalent refraction, residual astig- matism, rotational stability of IOL, total lower order aberrations and higher order aber- rations, MTF value and questionnaires were measured at pre-operation and postopera- tive 1 month and 3 months. Results At postoperative 3 months, the uncorrected dis- rant visual acuity was 0.85 ± 0.30, the corrected distant visual acuity was 0.92 ± 0.27, the uncorrected near visual acuity was 0.73 ± 0.22, the corrected near visual aculties was 0.08 ± 0.07 and the uncorrected intermediate visual acuity was 0.62± 0. 18 ; The spherical equivalent refraction within ± 0.50 D were in 9 eyes （90%）. The residual a- stigmatism at postoperative 3 months was significantly reduced to （0.28 ± 0.43 ） D from （ 1.50 ± 0.41 ） D before surgery （ t= 6. 124, P = 0. 000）, there was no statistical differ- ence compared with anticipated residual astigmatism （0.13 ± 0.09 ） D （ P 〉 0.05 ）. The mean IOL axis rotation at postoperative 3 months was 3.20 ± 1.55 degrees. Postopera- tive total order aberration, lower order aberration, higher order aberration and spheri- cal aberration under all pupil diameter were more obviously decreased than pre-opera- tion （ all P 〈 0.05 ）. At postoperative 3 months, total order aberration, lower order ab- erration, higher order aberration at 3 mm pupil diameter （P = 0. 034,0. 044,0. 005 ） aswell as 5 mm

关 键 词：多焦点散光型人工晶状体 白内障 散光 像差 

分 类 号：R776.1[医药卫生—眼科]