有晶体眼虹膜支撑型Verisyse植入矫正高度近视的视觉质量评价

The evaluation of visual quality in high myopia eyes with the Verisyse phakic iris-fixated intraocular lens

目的评价有晶体眼Verisyse人工晶体植入矫正高度近视的视觉质量。方法15例（25眼）高度近视患者（近视屈光度为-8.25D～-26.25D）植入Verisyse人工晶体矫正高度近视,术前及术后3m使用主观像差仪和自动眩光对比敏感度检查仪对受试者进行波前像差、对比敏感度及眩光敏感度检测。结果术后3m时,所有患者裸眼视力均≥0.5,裸眼视力≥术前最佳矫正视力者占64%（16/25）;最佳矫正视力≥0.8者占88%（22/25）,48%（12/25）最佳矫正视力提高2行或2行以上,总波前像差均方根值由术前（1.52±1.50）μm降为（1.27±0.86）μm（P〉0.05）,高阶像差由术前（0.50±0.22）μm轻度增加至（0.79±0.42）μm（P〈0.05）,其中除7阶外3-6各分阶像差与术前相比差异具有统计学意义,各频段对比敏感度和眩光敏感度尤其是低、中频段较术前明显提高。结论有晶体眼虹膜支撑型Verisyse人工晶体植入矫正高度近视效果显著,没有明显引起高阶像差的增加,大大提高患者的视力和对比敏感度,显著改善视觉质量。

Objective To evaluate the visual quality of the eye before and after the insertion of an Verisyse phakic lens for the correction of high myopia. Methods 15 cases （25 eyes） with -8.25 diapers-26.25 diapers （D） of myopia were implanted with the Verisyse phakic intraocular lens （IOL）, wavefront aberration, contrast sensitivity and glare sensitivity were measured preoperatively as well as 3 months after the IOL implantation by a subjective aberrometer and a contrast glare tester. Results A postoperative uncorrected visual acuity （UCVA） of 0.5 or better was observed in all eyes at 3 months, and 64%（16/25）of UCVA 〉 the postoperative best corrected visual acuity（BCVA）; a BCVA of 0.8 or better was observed in 88%（22/25） eyes, and 48% （12/25） gained 〉 2 lines of BCVA. The root mean square （RMS） of total wavefront aberration decreased from 1.52 ± 1.50μm preoperative to 1.27 μ 0.86μm postoperative （P〉0.05）,the RMS of higher order aberration （HOA）increased from 0.50 ± 0.22μm to 0.79 ± 0.42μm slightly （P〈0.05）, among the total, 3rd order to 6th order HOAs increased after implantation of Verisyse except the 7th order HOA, and the increase was statistically significant. The mean contrast sensitivity and glare sensitivity increased considerably at all spatial frequencies compared with preoperative ,especially at low and midrange spatial frequencies. Conclusion The clinic effect of implanting the Verisyse iris-fixated IOL in phakic eyes to correct high myopia was manifest, inducing less HOAs and increasing visual acuity and contrast sensitivity, and improved the visual quality.