多焦点人工晶状体Nd：YAG激光损伤后光学成像质量变化  

Optical imaging quality change of muitifocal intraocular lens following Nd：YAG laser damage

作　　者：孙岩秀[1] 郝燕生[1] 解江冰 王曌 郭淑艳 周建 田芸 Sun Yanxiu, Hao Yansheng , Xie Jiangbing , Wang Zhao , Guo Shuyan, Zhou Jian, Tian Yun Department of Ophthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital,Beijing 100191, China(Sun YX, Hao YS） ; Eyebright Medical Technology Co. , Ltd. , Beifing 102200, China （ Xie JB, Wang Z, Guo SY, Zhou J, Tian Y)

机构地区：[1]北京大学第三医院眼科眼部神经损伤重建保护与康复北京市重点实验室,100191 [2]爱博诺德(北京)医疗科技有限公司,102200

出　　处：《中华实验眼科杂志》2018年第3期176-180,共5页Chinese Journal Of Experimental Ophthalmology

基　　金：北京市科学技术委员会资助项目（Z151100002115048）

摘　　要：目的研究Nd：YAG激光损伤多焦点人工晶状体（IOL）后IOL的光学性能表现。方法选用3个制作多焦点IOL的疏水性丙烯酸酯材料片圆片并依序排列，采用Nd：YAG激光从低能量（0 mJ）逐渐递增的方法依序击射各材料的后表面、中间平面（后表面与前表面之间）和前表面，确定3个材料片不同平面的损伤阈值。选取8个相同材料制作的多焦点IOL，分别在1、2、3、4号IOL的自中心直径为3.0 mm的圆周上12个钟点位和5、6、7、8号IOL自中心直径1.0 mm的圆周上的2：00、4：00、6：00、8：00、10：00、12：00位造成激光点痕损伤以建立IOL激光损伤的物理模型，在标准模型眼上分别观察激光损伤前后IOL在2.0、3.0和4.5 mm通光孔径下的平均调制传递函数（MTF）、线扩散函数（LSF）曲线和美军标（美国空军分辨率测试标靶）的变化，以评估激光损伤对IOL视觉质量的影响。 结果每个疏水性丙烯酸酯材料片圆片间各平面损伤阈值的总体比较差异无统计学意义（F＝1.100，P＝0.337），引起材料前表面、中间平面和后表面损伤的激光能量阈值总体比较差异有统计学意义（F＝195.279，P＝0.000），其中前表面损伤阈值明显高于中间平面和后表面，中间平面损伤阈值明显低于后表面，差异均有统计学意义（均P〈0.01）。2.0、3.0和4.5 mm通光孔径下，1～4号IOLs和5～8号IOLs损伤后远、近焦点的MTF曲线和LSF曲线与未损伤IOLs具有很好的一致性；各通光孔径下1～4号IOLs和5～8号IOLs与未损伤IOL美军标成像质量无明显差别，通光直径为4.5 mm条件下IOL损伤前后近焦点美军标均出现眩光。 结论激光对焦于IOL材料中间平面最易对IOL造成损伤，激光对焦于IOL前表面时损伤阈值最高。在标准模型眼模拟不同瞳孔直径下，激光损伤对IOL的MTF、LSF和美军标成像质量无明显影响。ObjectiveTo study the optical imaging quality of multifocal intraocular lens （IOL） following Nd： YAG laser damage. MethodsThree hydrophobic acrylate discs used to make multifocal IOL were placed in line, and the Nd： YAG laser was used to emit the posterior surface, mid-plane and anterior surface of the discs by gradually increasing the emitting energy to determine the damaged threshold energy of various planes.Eight multifocal IOLs were divided into 2 groups.IOL damage models were established by emitting 12 points along 12 clocks on circle of 3.0 mm in diameter in the group 1 （IOLs NO.1, 2, 3, 4） and 6 points with 1-clock interval on circle of 1.0 mm in diameter in the group 2 （IOLs NO.5, 6, 7, 8） with Nd： YAG laser.The modulation transfer function （MTF）, line spread function （LSF） and United States air force （USAF） test target images of the IOLs were tested under the optical aperture at 2.0, 3.0 and 4.5 mm.ResultsThe damage thresholds of laser power were not significantly different among three hydrophobic acrylate discs （Fgroup=1.100, P=0.337）, and the thresholds were significantly different among different planes in the discs （Fposition=195.279, P=0.000）, with the highest damage threshold in the anterior surface and the lowest damage threshold in the mid-plane of the discs（all at P〈0.01）. The shifts of far focus and near focus MTF curves, LSF curves and USAF target images of the IOLs under the 2.0, 3.0 and 4.5 mm optical aperture after laser damage were in coincidence with those before laser damage both in group 1 and group 2.The glare phenomenon of the USAF target image was observed at near focus under the 4.5 mm optical aperture both before and after laser damage.Conclusions Multifocal IOL is vulnerable to injury when the laser beam focuses on the mid-plane, and the anterior surface of IOL can tolerate certain degree of damage.In standard model eye, the MTF curves, LSF curves and USAF target images of multifocal IOL was not impacted by laser induced spots injuries

关 键 词：ND:YAG激光 人工晶状体 成像质量 调制传递函数 线扩散函数 美国空军分辨率测 试板 标准模型眼 

分 类 号：R318.18[医药卫生—生物医学工程]