应用Allegretto波前像差仪对人工晶状体眼的高阶像差分析

Wavefront Analysis in Pseudophakic Eyes by Using Allegretto Wave Analyzer

目的:探讨人工晶状体眼的波前像差变化。方法:应用德国Wavelight Laser Technologie AG公司生产的Allegretto Wave Analyzer波前像差仪观察78例(84只眼)人工晶状体眼的波前像差改变,按术后不同时期分为3组,并与21例(23只眼)晶状体透明眼的波前像差比较。结果:术后1周人工晶状体眼的RMSh为(0.3774±0.2311)μm,术后1个月人工晶状体眼的RMSh为(0.4782±0.3952)μm,术后3个月人工晶状体眼的RMSh为(0.2880±0.1522)μm,而透明晶状体眼的RMSh为(0.3412±0.2048)μm,术后3个月与术后1个月人工晶状体眼高阶像差比较,差异有显著意义(P<0.05),而透明晶状体眼与各组人工晶状体眼间高阶像差比较差异无统计学意义(P>0.05)。结论:眼内植入人工晶状体后光学系统会发生重大变化,白内障术后中心视力提高的同时,视觉质量并没有显著改善,其中高阶像差可能是白内障术后视觉质量没有改善的原因之一,若使用能减少高阶像差的人工晶状体,将更有利于提高患者术后视觉质量。

Purpose ： To analyze the wavefront aberrations of pseudophakic eyes. Methods： Seventy-eight patients （84 eyes） who have undergone phacoemulsification and Alcon Acrysof SA60AT intraocular lens were divided into 3 groups by the stage of post-operation. Allegretto Wave Analyzer （Wavelight Laser Technologie AG, Germany） implanted into the eyes was applied to analyze the wavefront aberrations. Twenty-three healthy normal eyes were involved in the control group. Results ： The higher order aberrations were detected in all the eyes （ 100% ） of Group 1-3. The higher order aberration of Group 1 （the first week of post-operation） was RMSh （0.577 4±0.251 1）μm, which of Group 2 （the first month of post-operation） was RMSh （0.478 2±0.395 2）μm, which of Group 3 （the third month of postoperation） was RMSh （0.288 0±0.152 2）μm. The higher order aberration of the control group was RMSh （0.341 2±0.204 8）μm. The difference of higher order aberration root mean square （RMSh） values between Group 3 and Group 2 has statistical significance （P 〈 0.05）. But the differences of RMsh between the control group and Group 1, 2, 3 apart were no significant （P 〉 0.05）. Conclusion： The higher order aberrations of pseudophakic eyes may be a reason why the visual qualities of phakic eyes are not better than those of normal human eyes statistically when their vision acuity is alike. The IOLs which can reduce higher order aberrations will improve the visual qualities of pseudophakic eyes. Ophthalmologists are looking forward to optimizing and designing individual intraocular lens.