角膜Q值引导下个体化人工晶状体植入术后视觉质量的临床观察  

Clinical observation of visual quality after the individual implantation of intraocular lens guided by corneal Q value

作　　者：蔡芳菲[1] 郑广瑛[1] 王华君[1] 李莉[1] 刘玥[1] 

机构地区：[1]郑州大学第一附属医院眼科,450052

出　　处：《中华眼科杂志》2017年第11期814-820,共7页Chinese Journal of Ophthalmology

摘　　要：目的 探讨角膜Q值引导下个体化人工晶状体（IOL）植入的可行性及残留不同球差的患者术后视觉质量情况.方法 前瞻性研究.选取郑州大学第一附属医院眼科就诊实施白内障摘除术的白内障患者120例（177只眼）,其中男性62例（90只眼）,女性58例（87只眼）,平均年龄（66.2±8.2）岁.术前行角膜地形图检查,通过角膜Q值计算患眼球差,个性化选择合适的非球面IOL,使术后全眼球差为＋0.1μm（正球差组）或0.0μm（零球差组）,对照组依据患者的意愿选择IOL.术后观察患者球差及1、3个月的裸眼视力、最佳矫正视力、对比敏感度（包括无眩光和有眩光）和立体视.统计学处理组间差异采用单因素方差分析,组间多重比较采用LSD法对数据进行统计学分析.结果 术后球差：正球差组为（0.111±0.023）μm,零球差组为（0.020±0.019）μm,对照组为（0.299±0.073）μm;1个月、3个月裸眼视力、最佳矫正视力组间比较,差异无统计学意义（t=0.474,1.607;P〉0.05）;3个月有眩光和无眩光的对比敏感度检查均显示：在全空间频率正球差组对比敏感度优于零球差组和对照组,差异有统计学意义（F=32.885,35.493,19.969,20.572;P〈0.05）,中低频率占主要优势;而在3、6 c/d零球差组对比敏感度优于对照组,差异有统计学意义（F=6.506,7.521;P〈0.05）,在12、18 c/d零球差组与对照组间差异无统计学意义（F=2.662,0.848;P〉0.05）;术后1个月、3个月立体视觉3个组比较差异有统计学意义（F=9.494,157.265;P〈0.05）.结论 角膜Q值引导下的个体化IOL植入具有可行性,且术后保留＋0.1μm球差能达到最佳对比敏感度及立体视觉,而术后保留0.0μm球差较传统方法也能提高术后对比敏感度和立体视觉,但其优势主要体现在中低空间频率.Objective To describe the feasibility of individual IOL implantation guided by corneal Q value and observe patients postoperative visual quality under different residual spherical aberration. Methods Prospective study. One hundred and twenty cases （171 eyes）cataract patients in our hospital were selected for the individual implantation of intraocular lens guided by corneal Q value which obtained by Oberscan before operation. Based on spherical aberration calculated by corneal Q value, choose appropriate IOL personalitily to make postoperative whole eye surface aberration＋0.1μm （group of positive spherical aberration） or 0 μm （group of zero spherical aberration）. To observe spherical aberration, the uncorrected visual acuity, best corrected visual acuity and contrast sensitivity （including no glare and glare） 1 month and 3 months after surgery. Dates were analyzed with one-way ANOVA and LSD method for multiple comparisons between groups. Results Spherical aberration after operation： group of positive spherical aberration：（0.111±0.023）μm, group of zero spherical aberration：（0.020±0.019）μm, control group：（0.299 ± 0.073）μm. At 1 months and 3 months, uncorrected visual acuity, and corrected visual acuity were not statistically different between groups （t=0.474, 1.607, P〉0.05）. Contrast sensitivity （including no glare and glare） 3 months after surgery display：at whole space frequency, the group of positive spherical aberration （reserved＋0.1μm spherical aberration） contrast sensitivity is better than that of the group of zero spherical aberration（reserved 0.0 μm spherical aberration） and the control group（F=32.885, 35.493, 19.969, 20.572,P〈0.05）. The group of zero spherical aberration is better than control group at space frequency of 3 and 6 c/d （F=6.506, 7.521, P〈0.05）. Conclusions The individual implantation of introcular lens guided by corneal Q value is feasible.＋0.1μm spherical aberration after surgery can achieve the best contras

关 键 词：晶体 人工 个体化医学 角膜波前像差 对比敏感度 深度知觉 

分 类 号：R779.65[医药卫生—眼科]