非球面人工晶状体偏心和倾斜以及视觉质量的对比研究  

Comparative study of decentration,tilt and visual quality after implantation of aspherical intraocular lenses

作　　者：钱玖林 廖萱[1] 唐玉玲 谭青青[1] 周桂梅 兰长骏[1] Qian Jiulin;Liao Xuan;Tang Yuling;Tan Qingqing;Zhou Guimei;Lan Changjun(Department of Ophthalmology,Affiliated Hospital of North Sichuan Medical College,Medical School of Ophthalmology&Optometry,North Sichuan Medical College,Nanchong 637001,China)

机构地区：[1]川北医学院附属医院眼科,川北医学院眼视光医学院,南充637001

出　　处：《中华眼科杂志》2022年第7期521-528,共8页Chinese Journal of Ophthalmology

基　　金：四川省卫健委重点课题项目(18ZD022);南充市校合作重大攻关项目(18SXHZ0492)。

摘　　要：目的比较4种非球面人工晶状体(IOL)植入术后IOL偏心和倾斜的差别及术眼的客观视觉质量。方法前瞻性非随机对照研究。连续纳入2020年4至6月在川北医学院附属医院眼科拟行超声乳化白内障吸除IOL植入术的年龄相关性白内障患者,按植入的IOL类型(ZCB00、SN60WF、A1-UV、AO)分为4个组,每组右眼与左眼各30只。于术前及术后1 d、1周和1个月测量晶状体或IOL的偏心值与倾斜度(使用CASIA2扫描仪)及术眼波前像差、客观散射指数(OSI)、传递调制函数截止频率(MTF cut off)和斯特列尔比值(SR)。双眼患者均取右眼数据,组间比较采用单因素方差分析,组内比较采用单因素重复测量方差分析。所有纳入眼的眼别间数据比较采用独立样本t检验。结果共招募181例(240只眼)患者,其中169例(224只眼)完成随访(右眼114只,左眼110只),男性77例,女性92例,年龄(69±9)岁。4个组间性别分布、年龄、眼轴长度、术前晶状体偏心值和倾斜度以及IOL度数差异均无统计学意义(均P>0.05)。术后1 d、1周及1个月,4个组间IOL偏心值差异均有统计学意义(F=7.11、6.12、4.66,均P<0.05);进一步两两比较,SN60WF组术后1 d及1周的IOL偏心值均大于另外3个组,术后1个月的偏心值为(0.259±0.101)mm,大于ZCB00组的(0.177±0.099)mm和AO组的(0.163±0.122)mm,差异均有统计学意义(SNK-q检验,均P<0.05)。术后1个月ZCB00组、SN60WF组、A1-UV组和AO组的IOL倾斜度分别为(4.806±1.129)°、(5.080±1.309)°、(4.586±1.338)°、(5.112±1.406)°,术后各时间点4个组间IOL倾斜度差异均无统计学意义(均P>0.05)。各组内术后不同时间的IOL偏心值及倾斜度差异均无统计学意义(均P>0.05)。术后1个月,4个组间IOL偏心值与倾斜度在水平方向及垂直方向上差异均无统计学意义(均P>0.05),各组内右眼与左眼的IOL偏心值及倾斜度差异均无统计学意义(均P>0.05),且均有向鼻下方或向颞下方倾斜的趋势。术后Objective To compare the difference of decentration and tilt among 4 kinds of aspherical intraocular lenses(IOLs),and to analyze their objective visual quality.Methods Prospective non-randomized controlled clinical trial.Age-related cataract patients who planned to undergo phacoemulsification and IOL implantation in the Affiliated Hospital of North Sichuan Medical College from April to June in 2020 were divided into ZCB00 group,SN60WF group,A1-UV group,and AO group according to IOL types.Thirty right eyes and thirty left eyes were selected in each group.Before operation and at 1 day,1 week and 1 month postoperatively,decentration and tilt values were measured by a new swept-source anterior-segment optical coherence tomography device(CASIA2),and wavefront aberrations,objective scatter index(OSI),modulation transfer function cut off frequency(MTF cut off)and Strehl ratio(SR)were also examined.Values of decentration,tilt and visual quality compared among 4 groups were took from the right eye.One-way analysis of variance was used for inter-group comparison,and repeated measurement one-way analysis of variance was used for intra-group comparison.Data between right eyes and left eyes from all the individuals were compared by independent sample t-test.Results A total of 181 patients(240 eyes)were enrolled,and 169 patients(224 eyes)completed the follow-up(114 right eyes and 110 left eyes).There were 77 males and 92 females,with an age of(69±9)years.There was no significant difference in gender,age,axial length,decentration and tilt of crystalline lens and IOL power among 4 groups(all P>0.05).At 1 day,1 week and 1 month postoperatively,there was significant difference in decentration value among 4 groups(F=7.11,6.12,4.66;all P<0.05).For further pairwise comparison,the decentration value of SN60WF group was higher than that of the other 3 groups at 1 day and 1 week postoperatively,and the decentration value of SN60WF group was(0.259±0.101)mm at 1 month postoperatively,which was higher than that of ZCB00 group(0.177±0.09

关 键 词：晶体 人工 晶体植入 眼内 视敏度 体层摄影术 光学相干 偏心 倾斜 

分 类 号：R779.6[医药卫生—眼科]