不同球差非球面人工晶状体植入术后的视觉质量分析  

Analysis of visual quality after different spherical aberration aspherical IOL implantation

作　　者：曾国燕[1] 张远平[1] 赵学英[1] 査旭 李静华[1] 吴国玖[1] 

机构地区：[1]昆明医科大学第二附属医院眼科,云南省昆明市650000

出　　处：《眼科新进展》2016年第11期1042-1046,共5页Recent Advances in Ophthalmology

基　　金：云南省应用基础研究面上项目(编号:2014FZ030)

摘　　要：目的比较个性化选择0、-0.20μm、-0.27μm三种不同球差非球面人工晶状体(intraocular lens,IOL)及其随机植入术后的视觉质量,探讨最佳矫正球差值。方法前瞻性病例对照研究。选取就诊于我科的白内障患者125例(145眼),术前使用i Trace全视觉功能分析仪测量角膜高阶像差,根据角膜球差(spherical aberation,SA)值的不同分为A、B、C三组,分别植入三种不同SA非球面IOL,对照组(D组)随机植入非球面IOL。术后3个月分析全眼及角膜的高阶像差、调制传递函数(modulation transfer function,MTF)、斯泰尔比值(Strehl ratio,SR)、最佳矫正视力(best corrected visual acuity,BCVA)。结果 (1)手术前后角膜SA差异无统计学意义(P>0.05),全眼慧差(Coma)、三叶草差(Trefoil)及总高阶像差(total high order aherration,t HOA)手术前后的变化与角膜SA的变化相似。(2)三组患者BCVA差异无统计学意义(P>0.05)。(3)3 mm瞳孔直径下,四组IOL眼的角膜SA、全眼MTF t HOA及SR差异均无统计学意义(均为P>0.05);全眼SA差异有统计学意义(P=0.019),A组、B组、C组间差异无统计学意义(P>0.05),但均<D组(P=0.000)。(4)5 mm瞳孔直径下,四组IOL眼角膜SA差异无统计学意义(P>0.05);全眼SA、t HOA差异均有统计学意义(均为P=0.000),A、B、C三组间差异无统计学意义(P>0.05),但均<D组(P=0.000);全眼MTF t HOA及SR差异均有统计学意义(均为P<0.05),A、B、C三组间差异无统计学意义(P>0.05),但均>D组(P=0.000)。结论超声乳化白内障吸出术前后角膜高阶像差无差异。小瞳孔直径下,不同SA设计非球面IOL眼术后视觉质量比较无差异。大瞳孔直径下,根据术前SA个性化选择较随机植入非球面IOL眼可获得较好的视觉质量。Objective To compare the visual quality after three different spherical aberration 0, - 0.20 μm and - 0.27 μm aspherical intraocular lens （IOL） implantation personalizedly and randomly, and discuss the best corrected spherical aberration. Methods Prospective case control study. 125 cases （145 eyes） cataract patients in our department were selected, the preoperative higher order aberrations of the cornea were measured by iTrace full visual function analyzer. According to the corneal spherical aberration （SA） values,the cases were divided into group A,B and C. Three different spherical aberration aspherical IOL were implanted, and the three aspherical IOL randomly were implanted in the control group D. The all eye and corneal high-order aberration, modulation transfer function （ MTF）, strehl ratio （SR） and best corrected visual acuity （BCVA） were measured and analyzed after 3 months of operations. Results （ 1 ） The difference in SA before and after operation was not statistically significant （P 〉 0. 05 ） ,the changes of total coma,trefoil and higher order aberrations （tHOA） were also similar to it. （ 2 ） The difference in BCVA of four groups patients was no statistically significant （P 〉 0.05 ）. （ 3 ） Under the pupil diameter of 3 mm, the differences in corneal SA, MTF and SR value in the four groups IOL eyes was not statistically significant （ all P 〉0.05 ） ; The difference in total SA was statistically significant （P = 0. 019 ） and the differences among three experimental groups was not statistically significant （P 〉 0. 05 ）, but they were all less than group D （P = 0.000 ）. （4） Under the pupil diameter 5 mm,the differences in corneal SA in the four groups IOL eyes was not statistically significant （P 〉 0.05 ） ; The differences in total SA and tHOA were statistically significant （ all P = 0. 000 ） and the difference among three experimental groups was not statistically significant （P 〉 0.05 ）, but they were all less than

关 键 词：球面像差 非球面人工晶状体 调制传递函数 最佳矫正球差 

分 类 号：R776[医药卫生—眼科]