人工晶状体眼波阵面像差变化

CHANGE OF WAVEFRONT ABERRATION AFTER PHACOEMUSIFICATION AND IOL IMPLANTATION

目的 研究超声乳化联合人工晶状体植入术对术眼波前像差及成像质量的影响。方法选择白内障患者96人（104眼），随机分为两组进行手术（植入不同类型直径的人工晶状体）。术后分别于1W与4W及12W观察术眼波阵面像差及其他相关变化。结果 不同光学结构的人工晶状体均存在单色光像差，其中球差的影响最明显。Z4、Z9、Z12和Z24值在手术前后有显著性差异（P〈0．05）；RMS1～6、RMSg、RMSh值术后较术前均呈显著性下降（P〈0．001）。折叠人工晶状体的类型（三片、一片）与术后RMS 3（r=-0．319）、RMS 4（r=-0．475）、RMS 5（r=-0．304）和RMSh（r=-0．408）值呈显著相关性（P均〈0．05）。结论 波前像差技术可以帮助揭示术后出现相关视觉问题的原因。白内障术后各阶像差较术前均显著性减小，光学成像质量提高，具特征性的改变是三叶草形的像差和四阶球差；三片式折叠人工晶状体眼的高阶像差小于一片式折叠人工晶状体眼。

To investigate the effect of wavefront aberration in cataract pftients after phacoe mulsification and IOL implantation and image quality of eyes. Methods 96 patients （104 eyes）were selected randomly to accepte phacoemulsification and implanted different diameter IOL. The wavefront aberrations were measured at 3 month after operation,the eyes underwent objective wavefront aberration examination by the same technician. The parameters included 27 Zemike coefficients of six orders （Z1 -Z27 ） ,root mean square of to sixth -order （RMS1 -RMS6）, global root mean square （RMSg） and higher- order root mean square （RMSh）. Results Monochromatic aberration can not be reduced to zero but can be minimied, especially spherical aberration. Z4, Z9, Z12 and Z24 were significant1 ychanged postoperatively（ P 〈 0.05 ）. RMS1 -6, RMSg and RMSh decreased significantly postoperativel（0. 001 ）. Conclusion Wavefront aberration technique can be used to help us revealing the real reasons of such postoperative visual problems. After phacoe mulsification and IOL implantation, ocular aberration of every order decreases significantly, and optic image quality on retina is improved. Trefoil and spherical aberration characterize the changes . Higher - order aberration of three - piece IOL is smaller than that of one - piece IOL.