不同设计一片式非球面人工晶状体术后倾斜与偏心比较及视觉质量研究  

Comparison of tilt, decentration and visual quality of two different one-piece designed aspheric intraocular lens after surgery

作　　者：张瑞智[1] 宋慧[2] 汤欣[2] 

机构地区：[1]天津医科大学眼科临床学院天津医科大学,300070 [2]天津市眼科医院

出　　处：《中国实用眼科杂志》2014年第4期419-423,共5页Chinese Journal of Practical Ophthalmology

基　　金：天津市卫生局科技基金（2012KR17）

摘　　要：目的比较两种不同设计的一片式非球面人工晶状体（intraocular lens，IOL）植入后1个月和3个月的倾斜和偏心及全眼和眼内高阶像差成分、不同空间频率下的调制传递函数（modulation transfer function，MTF），指导临床两种非球面IOL选择。方法临床病例对照研究。选取2013年3～5月在天津市眼科医院行白内障超声乳化联合IOL植入术的单纯性老年性自内障患者80只眼，根据角膜球差，40只眼植入Tecnis ZCB00 IOL（眼力健公司）；另40只眼植入ADAPT-AOIOL（博士伦公司），分别于术后1个月和3个月行iTrace视觉功能分析仪和Pentacam眼前段分析仪检查。记录6ram瞳孔下两种IOL的全眼及眼内高阶像差成分及MTF值，采用Image-pro plus图像分析软件计算出IOL的偏心值和倾斜度。组间采用独立样本f检验、组内采用配对f检验进行分析比较，各组倾斜度和偏心值行Pearson相关分析。结果2组术后1个月和3个月倾斜和偏心均无相关性差异无统计学意义（P〉0．05）。在倾斜和偏心上，术后1个月和3个月，2组组内及组间比较差异均无统计学意义（P〉0．05）。术后1个月和3个月，在全眼及眼内总高阶像差、彗差和球差上，2组组内比较差异无统计学意义（P〉0．05），但2组相比在全眼及眼内总高阶像差和球差上差异有统计学意义（P值分别为0．005，0．012，0．000，0．000，0．023，0．041，0．014，0．002），P〈0．05；但在眼内彗差上2组比较差异无统计学意义（P〉0．05）。在MTF上术后1个月和3个月，两组组内及组间比较差异无统计学意义（P〉0．05）。结论AO与ZCB00两种不同设计的一片式非球面IOL术后1个月和3个月均表现出良好的稳定性和居中性，在视觉质量上，ZCB00定程度上优于AO，但长远效果仍需进一步观察。Objective To compare the tilt, decentration, high order aberrations （HOAs） and mod- ulation transfer function （MTF） of two different one-piece designed aspheric intraocular lens （IOL） af- ter the phacoemulsification and 1OL implantation in order to select the better aspheric IOLs. Meth- ods Eighty eyes were received the phacoemulsification and IOL implantation surgery. According to the spherical aberration of corneal, 40 eyes were implanted Tecnis ZCB00 IOL, other 40 eyes were implanted ADAPT-AO IOL. The tilt, decentration, high order aberrations （HOAs） and modulation transfer function （MTF） of the two IOLs were measured 1 month and 3 months after the surgery by iTrace and Pentacam at 6mm pupil size. The image-pro plus software was used to measure the values of tilt and decentration of the two IOLs. All the values were analyzed by paired t-test in one group and by independent sample t-test, the flit and decentration by Pearson regression analysis. Results There was no linear correlation between tilt and decentration of the two IOLs （P 〉0.05）. About the values of tilt and decentration, no significant difference was found no matter in one group or between two groups 1 month and 3 month after surgery （P 〉0.05）. There was no statistical- ly significance in the high order aberration （HOA）, coma and spherical in one group （P 〉0.05）, but the differences of the high order aberration （HOA） and spherical between two groups were statistical- ly significant in 1 and 3 months after surgexy （P =0.005, 0.012, 0.000, 0.000, 0.023, 0.041, 0.014, 0.002）, And there was no difference statistically between two groups on the coma （P 〉0.05）. The MTF had no significant difference in each group and between two group 1 month and 3 months af- ter surgery （P 〉0.05）. Conclusions The two different one-piece designed aspheric IOLs have shown good stability and centration 1 month and 3 months after surgery. ZCB00 is better than AO in visual quality after surgery in some extent, but l

关 键 词：人工晶状体(IOL) 倾斜 偏心 像差 调制传递函数(MTF) 

分 类 号：R776.1[医药卫生—眼科]