可植入式接触镜术后眩光幻影与Zernike多项式像差的特征分析  

Dysphotopsia and Zernike polynomials' aberrations after implantable contact lens surgery

作　　者：周吉晗 陈开建[1] 徐洁[1] 白继[1] 叶剑[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所眼科,重庆400042

出　　处：《第三军医大学学报》2017年第21期2115-2119,共5页Journal of Third Military Medical University

摘　　要：目的观察可植入式接触镜(implantable contact lens,ICL)术后患者眩光幻影程度,探讨其形成原因。方法利用全眼球像差仪(OPD-ScanⅢ)检测22例患者44眼ICL术后3个月暗瞳及散瞳情况下Zernike多项式各像差值,对每只眼眩光幻影严重程度分4级计分,再对二者进行相关性分析。结果暗瞳时,患者瞳孔直径(5.75±0.75)mm,无眩光幻影33例(75%),轻度10例(23%),中度1例(2%),无重度眩光幻影。眩光幻影分别与二级散光(r=0.541、r=0.465,P<0.05)、球差(r=5.802,P<0.05)、散光(r=0.314、r=0.313,P<0.05)、失焦(r=0.569,P<0.05)、三叶草差(r=0.382,P<0.05)、彗差(r=0.422、r=0.310,P<0.05),以及四叶草差(r=0.303、r=0.455,P<0.05)等不同程度正相关,与其余各项指标不相关。散瞳时,患者瞳孔直径(8.21±0.15)mm,且全部有眩光幻影,其中轻度13例(28.6%),中度19例(43%),重度12例(27.4%),并且眩光幻影仅与失焦呈正相关(r=0.473,P<0.05),与其余各项指标不相关。结论眩光幻影程度与失焦像差呈正相关,主要与瞳孔散大时ICL晶体光学区外未矫正区域的屈光不正有关。Objective To observe the severity of dysphotopsia in patients after implantable collamer lens （ICL） surgery, and investigate its causes. Methods A total of of 22 patients （44 eyes） undergoing ICL surgery in our department from September 2016 to January 2017 were recruited in this study. In 3 months after the surgery, Zernike polynomials’ aberrations with mesopic pupil and mydriasis were investigated with Nidek OPD-Scan Ⅲ. Dysphotopsia was divided into 4 levels and rated the score 0 to 3.Then the correlation between Zernike polynomials and dysphotopsia was analyzed. Results The pupil size was 5.75±0.75 mm at dark condition. There were 33 eyes （75%） without dysphotopsia, 10 eyes （23%） with mild dysphotopsia, 1（2%） moderate, and none severe. The dysphotopsia was positive correlated with secondary astigmatism （r=0.541, r=0.465, P〈0.05）, spherical （r=5.802, P〈0.05）, astigmatism （r=0.314, r=0.313, P〈0.05）, defocus （r=0.569, P〈0.05）, trefoil （r=0.382, P〈0.05）, coma （r=0.422, r=0.310, P〈0.05）, and tetrafoil （r=0.303, r=0.455, P〈0.05） separately, but not with other parameters. Under mydriasis, the mean pupil size was 8.21±0.15 mm. All eyes experienced dysphotopsia, with 13 eyes （28.6%） mild, 19（43%） moderate, and 12（27.4%） severe. The dysphotopsia was positively correlated with defocus （r=0.473, P〈0.05）, though not with other parameters of Zernike polynomials. Conclusion The severity of dysphotopsia is positively correlated with defocus, which mainly due to defocus caused by none correction area of ICL under mydriasis.

关 键 词：眩光幻影 ZERNIKE多项式 像差 可植入式接触镜 

分 类 号：R619[医药卫生—外科学] R778.3[医药卫生—临床医学]