不同人工晶状体眼的波阵面像差比较

Comparison of wavefront aberrations in pseudophakia with three types of intraocular lenses implantation

目的探讨3种不同人工晶状体植入术后晶状体眼的波阵面像差及成像质量的差异。方法超声乳化白内障吸除联合人工晶状体植入术后的老年性白内障患者76例(80只眼)(丙烯酸酯26只眼;水凝胶27只眼;硅凝胶27只眼),术后3个月时使用WASCA波阵面像差仪,在瞳孔直径4.0mm时,测量人工晶状体眼的各项波阵面像差指标,对检查结果中的慧差、球差、总像差、总高阶像差以及从Z(2,-2)到Z(4,-4)的Zernike常数,个组间分别进行独立样本t检验。结果除了丙烯酸酯人工晶状体的总高阶像差(S3+S4)稍高于硅凝胶人工晶状体(P=0.011),丙烯酸酯人工晶状体的Z(3,1)高于水凝胶人工晶状体(P=0.038),其余指标间均无统计学意义。结论老年性白内障患者术后在自然瞳孔下,3种人工晶状体眼的波阵面像差除丙烯酸酯总高阶像差稍高之外,其他指标基本无差异。3种人工晶状体眼的视网膜成像质量可能无区别。

Objective We compared wavefront aberration in pseudophakic eyes with 3 types of intraocular lenses （IOLs） implantation in order to obtain an objective evaluation of the optical quality of these pseudophakic eyes. Methods This prospective study comprised 76 cataract patients （80 eyes） who had phacoemulsification surgery. The intraecular lenses of AcrySof MA30BM, Hydroview H60M, and Canon Staar, KS-1 were implanted in the patients at the numbers of 26, 27 and 27 eyes in each group respectively. Three months after cataract surgery, aberrations in the eyes were measured in un-dilated pupil using a Hartmann-Shack-type aberremeter （Asclepion-Meditec）. The same measurements were done in 26 normal phakic eyes in age-matched persons Individual Zernike polynomials, coma-like aberration, spherical aberration, the RMS value of total aberrations and total high order aberrations in the each group were compared. Results The total high order aberrations （the RMS value of 3rd and 4th aberrations） in AcrySof group was higher than Canon Staar greup（P =0. 011 ）, and the Z（3,1 ） Zernike coefficient in AcrySof group was significant difference compared with Hydroview group （ P = 0. 038 ）. Conclusion No significant differences in higher-order aberrations among eyes are demonstrated after implantation with 3 types IOLs in un-dilated pupil, The results suggest that there is no difference in the retinal image of pseudophakic eyes with 3 types of IOLs in regular condition. （Chin J Ophthalmol, 2006, 42： 387-390）