实测与理论瞳孔直径下全角膜总高阶像差的差异性研究  

Difference between Corneal Higher-order Aberrations Measured at Actual Photopic and Theoretical Pupil Diameter

作　　者：赵丽君 黄渝侃[1] 程胜男 陈华[1] 高慧 李玉芷 Zhao Lijun;Huang Yukan;Cheng Shengnan(Department of Ophthalmology,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China)

机构地区：[1]华中科技大学同济医学院附属协和医院眼科,武汉430022

出　　处：《华中科技大学学报（医学版）》2020年第5期573-578,共6页Acta Medicinae Universitatis Scientiae et Technologiae Huazhong

基　　金：2019年双一流-自主创新-学科医师基金资助项目(No.5001530074)。

摘　　要：目的观察实测瞳孔直径下角膜总高阶像差与4.0 mm中央角膜直径下角膜总高阶像差的差异。方法连续随机观察不同年龄段(20~岁,30~岁,40~岁,50~岁,60~岁,70~岁)共100例受试者,使用Sirius眼前节分析系统检测不同角膜中央直径(2.0、2.5、3.0、3.5、4.0、4.5、5.0、5.5、6.0、6.5、7.0 mm)下的全角膜总高阶像差及明环境下实测瞳孔直径,通过拟合曲线计算出该瞳孔直径下角膜总高阶像差(实测高阶像差),并与中央角膜4.0 mm直径下结果(理论高阶像差)及最接近实测瞳孔大小的上述机测瞳孔直径下角膜总高阶像差值(近似高阶像差)进行差异化分析。结果实测瞳孔直径与年龄呈负相关,组间有显著性差异(r=-0.5866,P<0.01)。角膜总高阶像差与瞳孔直径呈正相关,随瞳孔直径的增大而增大(P<0.05)。在20~,30~及50~岁年龄段中,实测高阶像差与理论高阶像差无统计学差异(P>0.05);在40~,60~,70~岁年龄段,实测高阶像差显著低于理论高阶像差(P<0.01)。各年龄段实测高阶像差与近似高阶像差均无统计学差异(均P>0.05)。在老年人群中,实测高阶像差≥0.3μm占比显著低于理论高阶像差≥0.3μm占比(P=0.038)。结论老年人群中实测高阶像差低于理论高阶像差,此差异与老年人群瞳孔直径偏小相关,依据实测高阶像差将有更多老年患者在选择植入多焦点人工晶状体时符合入选条件。近似高阶像差可以替代实测高阶像差以方便临床应用。Objective To compare the total corneal higher-order aberrations(HOAs)calculated on the central 4.0 mm zone of the corner and the actual measurements.Methods A total of 100 patients at different ages(20-29 years old,30-39 years old,40-49 years old,50-59 years old,60-69 years old,70-79 years old)were measured.Sirius anterior segment analysis system was employed to detect HOAs of the whole cornea based on different machine-provided pupil diameters(2.0 mm,2.5 mm,3.0 mm,3.5 mm,4.0 mm,4.5 mm,5.0 mm,5.5 mm,6.0 mm,6.5 mm,7.0 mm)and to measure pupil size in simulated bright environment.Total corneal HOAs based on the machine-measured pupil diameter(actual HOAs)was calculated through fitting curves.The actual HOAs were compared with central 4.0 mm-based HOAs(theoretical HOAs)and the HOAs based on one of the aforementioned machine-given pupils,the size of which was closest to the actual pupil size(approximate HOAs).Results The measured pupil diameter was negatively correlated with age,and there was significant difference among groups(r=-0.5866,P<0.01).Total corneal HOAs was positively correlated with pupil size,increasing with the pupil size(P<0.05).Among the 20-29,30-39 and 50-59 years age groups,there was no statistical difference between the actual and theoretical HOAs(P>0.05).In the age group of 40-49,60-69 and 70-79 years,the actual HOAs were significantly smaller than its theoretical counterpart(P<0.01).No statistical differences were found between actual and approximate HOAs in different age groups(P>0.05).In elderly population,the proportion of actual HOAs greater than or equal to 0.3μm was significantly lower than that of the theoretical HOAs(P=0.038).Conclusion Actual HOAs in the old subjects are significantly less than theoretical HOAs,which could be ascribed to the relatively small actual mean pupil diameter of the old age patients.More elderly patients tend to implanting the multifocal intraocular lens according to the actual HOAs.Clinically,the approximate HOAs can replace the actual HOAs.

关 键 词：瞳孔直径 高阶像差 多焦点人工晶体 

分 类 号：R779.6[医药卫生—眼科]