非球面人工晶状体与球面人工晶状体临床应用的对比研究

Clinical comparison study of aspheric and spherical intraocular lenses

目的比较前表面光学改良的非球面人工晶状体与传统球面人工晶状体对超声乳化白内障吸除人工晶状体植入眼球差和视觉功能的影响。方法将169例（169只眼）拟行超声乳化白内障吸除人工晶状体植入术的老年性白内障患者随机分为2组，分别植入非球面人工晶状体（试验组）和传统球面人工晶状体（对照组）。术后检测人工晶状体眼的球差、矫正远视力、矫正远视力后的近视力、对比敏感度、眩光敏感度和表观调节力；随访时间为3个月。结果术后3个月，瞳孔直径5mm情况下人工晶状体眼的总球差试验组为（0．024±0．076）μm，对照组为（0．217±0．137）μm，差异有统计学意义（P〈0．05），而两组角膜球差的差异无统计学意义（P〉0．05）。4．0°和2．5°视角的对比敏感度试验组分别为39．18±11．94和28．30±12．07，对照组分别为33．28±11．84和24．50±8．20，差异有统计学意义（P〈0．05）；6．3°、4．0°、2．5°和1．6° 视角的眩光敏感度试验组分别为30．90±9．21、27．09±8．45、19．20±8．71和12．08±4．44，对照组分别为27．08±8．24、23．30±6．24、15．53±4．37和10．04±4．20，差异有统计学意义（P〈0．05）；两组的矫正远视力、矫正远视力后近视力、表观调节力比较，差异均无统计学意义（P〉0．05）。结论与传统球面人工晶状体比较，非球面人工品状体可以减少人工晶状体眼的球差，提高视觉对比度，改善白内障患者术后的视觉质母。

Objective To compare spherical aberration and visual quality in pseudophakic patients with a modified prolate aspheric intraocular lens （IOL） with patients with a spherical IOL Methods A prospective study of 169 consecutive cases （169 eyes ） was conducted. All cataract patients underwent phaocoemulsification were randomized to receive an aspheric IOL or a spherical IOL. The following investigations were performed to assess the spherical aberrations of total eye and cornea, best corrected visual acuity （BCVA）, near visual acuity （NVA）, contrast sensitivity, glare sensitivity and apparent accommodation. Results The mean spherical aberration in eyes with a Tecnis IOL [ （0. 024 ± 0. 076 ）μm ] was significantly lower than that of eyes with a spherical IOL [ （ 0. 217 ± 0. 137 ） μm, P = 0. 000 ]. In addition, Tecnis IOL provided improved contrast sensitivity at 4. 0° （39. 18±11.94 versus 33.28 ± 11.84, P=0. 009） and 2. 5° （28.30± 12. 07 versus 24. 50 ±8. 20, P =0. 033） visual angles, and improved glare sensitivity at 6. 3° （30. 90 ±9. 21 versus 27.08 ±8.24, P =0. 022）, 4. 0° （27.09 ±8.45 versus 23.30 ± 6.24, P=0.008 ）, 2.5° （19.20 ±8.71 versus 15.53 ±4.37, P=0.005） and 1.6° （12.08±4.44 versus 10.04± 4. 20, P = 0.014） visual angles. The difference of BCVA, NVA and apparent accommodation between these two groups was not significant. Conclusions The present clinical results demonstrated that an aspheric IOL may reduce the spherical aberration and improve visual performance of pseudophakic eyes as compare to conventional spherical IOL.