白内障术后同种材料不同直径人工晶状体眼的波前像差

An analysis of the effectiveness of intraocular lens implants with different optical diameters to correct aberrations after phacoemulsification of cataracts

目的利用波前像差检测仪检测行超声乳化并植入同种材料不同直径的折叠式人工晶状体白内障患者术后患眼波前像差的变化,以讨论其相关性。方法随机选取自愿接受超声乳化合并人工晶状体植入手术的白内障患者(排除眼科其他疾病及相关全身疾病)共47例(50眼),随机分为两组:A组35例(35眼)植入光学直径为5.75mm亲水性丙烯酸酯(Rayner)人工晶状体;B组15例(15眼)植入光学直径为6.0mm亲水性丙烯酸酯(Isotechnics)人工晶状体,其中3例双眼分别植入这两种人工晶状体。术后第3个月观察患眼波前像差及其他相关的变化。结果瞳孔直径4.0mm时,两组的高阶像差均方根值(root mean square high,RMSh)分别为(0.36±0.11)#m和(0.30±0.15)#m;瞳孔直径5.0mm时,两组RMSh分别为(0.57±0.12)#m和(0.61±0.17)#m;瞳孔直径6.0mm时,两组RMSh分别为(0.84±0.15)#m和(0.89±0.20)#m;瞳孔直径7.0mm时,两组RMSh分别为(1.49±0.19)#m和(1.42±0.22)#m。经统计学分析,瞳孔直径为4.0mm、5.0mm、6.0mm及7.0mm时,两组的RMSh差异均无显著性(P>0.05)。结论①人工晶状体眼的高阶像差随瞳孔直径增大而增大;②在瞳孔直径4.0mm、5.0mm、6.0mm及7.0mm时,植入同种材料的光学直径5.75mm人工晶状体的患眼的高阶像差均方根值与植入直径6.0mm人工晶状体的患眼的高阶像差均方根值的差异无显著性。

Objective To compare higher-order aberrations in cataract eyes with different intraoeular lens （IOL） implants and to improve the optical designs of lOis for better retinal image quality. Methods Forty-seven patients （50 eyes） who had agreed to undergo phacoemulsifieation and accept IOL implants were randomly selected for the study. Any other eye disease or systemic disease was criteria for exclusion. The patients were divided into two groups based on the diameters of the IOLs. In group A, a 5.75 mm optical diameter Hydrophilic Acrylic IOL （Rayner） was implanted into 35 eyes of 35 patients; in group B, a 6.0mm optical diameter Hydrophilic Acrylic IOL （Isotechnics） was implanted into 15 eyes of 15 patients. Three patients in group A were implanted with a 6.0mm optical diameter Hydrophilic Acrylic IOL in their consenual eyes, Wavefront aberrations were measured at 3 months postopera- tively, Results （1）For a 4.0 mm pupil, the average higher-order root mean square （RMSh） values of the two groups were （0.36± 0.11）μm （group A） and （0.30±15）μm （group B）. For a 5.0 mm pupil, the average RMSh values were （0.57±0.12）μm （group A） and （0.61±0.17）μm （group B）. For a 6.0 mm pupil, the average RMSh values were （0.84±0.15）μm （group A） and （0.89±0.20）μm （group B）. For a 7.0 mm pupil, the average RMSh values were （1.49±0.19）μm （group A） and （1.42±0.22）μm （group B）, （2）For 4.0 mm, 5.0 mm, 6.0 nun and 7.0 mm pupils, the average RMSh values were not significantly different between the two groups（P〉0.05）. Conclusion （1）RMSh values are higher in the pseudophakic eye with larger pupils. （2）For 4.0 mm,5.0 mm,6.0 mm and 7.0mm pupils, there were no significant differences between the average RMSh values of eyes implanted with a 5.75 mm optical diameter IOL and those with a 6.0 mm optical diameter IOL.