晶状体乳化吸出非球面人工晶状体植入术后视觉质量的临床研究

Clinical investigation of optical performance after phacoemulsification combined with implantation of Tecnis-Z9001 aspherical intraocular lens

目的评价老年性白内障晶状体乳化吸出联合非球面人工晶状体植入术术后的视觉质量,并与普通人工晶状体植入术后进行对比。方法50例(50眼)老年性白内障行晶状体超声乳化吸出术,以随机双盲的方式分别植入Tecn is-Z9001非球面人工晶状体(实验组)和SN60AT普通人工晶状体(对照组)。随访时间2个月,观察术后最佳矫正视力、对比敏感视力、眼内像差及手术并发症。结果术后2个月最佳矫正视力、对比敏感视力、高价像差(主要是球差、彗差)两组间差异有统计学意义。结论临床观察证实了老年性白内障摘出联合非球面人工晶状体植入术术后能够抵消老年人角膜的正球差,从而提高术后视觉质量,尤其是对比敏感度和低对比视力。

Objective To investigate the difference of postoperative aberration and visual performance between two kinds of IOL （Tecnis-Z9001 and SN60AT） in senile cataract therapy. Methods Fifty senile cataract patients （ 50 eyes） were classified randomly into two groups . The cure group was implanted an IOL （Tecnis-Z9001, AMO） and the control group was implanted an IOL （Acrysof- S N60AT, ALCON）. All patients accepted phacoemulsification combined with implantation of IOL by one doctor, by observing best corrected visual acuity （BCVA） , contrast sensitivity, aberration and operative complication. Results Mean best corrected visual acuity（BCVA） of both groups were significantly improved, but the cure group got better BCVA than the control group （P = 0.02 ） . Mean BCVA under contrast 20% , 40% , 60% of the cure group were better than those of the control group and there were significant differences （ P 〈 0.01 ）. Mean aberration of the cure group was smaller than that of the control group when pupil size is 3.0mm , but there was no significant differences （ P 〉 0.01 ）. Mean aspherical aberration,mean vertical coma and mean horizontal coma of two groups when pupil size was 5.5mm had the differences, but the differences were significant by x^2 test analysis, （ P = 0.01,0.04, 0.028） . 50 patients had no postoperative complication. Conclusions The clinical results indicate that the spherical aberration of the eyes after cataract surgery can be eliminated by modifing the anterior surface of the IOL. The Tecnis-Z9001 lens compensates for the positive spherical aberration in elder eyes and improves different contrast visual acuity, thus gets better visual performance.