球面与非球面IOL在不同瞳孔直径时的对比敏感度与眩光对比敏感度

Contrast sensitivity and glare contrast sensitivity of spherical and aspherical intraocular lens at different pupil diameters

目的比较球面与非球面人工晶状体（intraocularlens,IOL）在环境照度为85cd.m-2时在3种瞳孔直径：2.0-2.5mm、4-5mm、8mm下的对比敏感度（contrast sensitivi-ty,CS）和眩光对比敏感度（glare contrast sensitivity,GS）的差异。方法收集年龄相关性白内障患者48例（60眼）,行白内障超声乳化吸除或小切口手法摘出联合后房型IOL植入术。根据植入IOL的不同将患者分为2组：球面组和非球面组。30例（35眼）植入球面IOL,18例（25眼）植入非球面IOL。术后1个月检查2组患者在3种瞳孔直径下分别在低频3cycle/degree（cpd）、中频（6cpd）、高频（12cpd、18cpd）时的CS和GS。结果球面IOL组：瞳孔2.0-2.5mm时,各个空间频率的CS与GS之间的差异均无统计学意义;瞳孔4-5mm时,在6cpd、12cpd的CS与GS之间的差异有统计学意义;瞳孔8mm时,全部频率的CS与GS之间的差异均具有统计学意义。非球面IOL组：3个瞳孔直径下各个空间频率的CS与GS之间的差异均无显著性意义。球面与非球面IOL的比较：瞳孔直径2.0-2.5mm及5mm时,在高频段球面与非球面IOL的CS之间的差异有统计学意义;瞳孔8mm时,在低频段两者之间的GS差异有统计学意义,在中频段两者的CS及GS之间差异均具有统计学意义。结论在球面IOL组,随着瞳孔直径的增大,CS及GS均下降,且瞳孔越大,附加眩光时引起CS的下降效应越明显。在非球面IOL组,在各个瞳孔直径时附加眩光均不引起CS的明显下降。瞳孔直径越大,非球面IOL补偿正性球差、减少球面像差的作用越明显。

Objective To compare the differences of contrast sensitivity （CS） and glare contrast sensitivity （GS） of spherical and aspherical intraocular lens （IOL） at different pupil diameters ：2.0 - 2.5 mm, 4 - 5 mm and 8 ram. Methods Sixty eyes of 48 patients with age-related cataract,which having phacoemulsification or maneuver nuclear fraction through small incision,were assigned to receive a spherical or aspherical foldable intraocular lens. They were divided into two groups according to the different types of IOL： spherical IOL group （ 35 eyes ） and aspherical IOL group （ 25 eyes ）. CS and GS of the two groups were measured at different pupil diameters of 2.0 - 2. 5 mm,4 - 5 mm and 8 mm with low spatial frequency （ 3 cycle/degree, cpd ）, middle spatial frequency （ 6 clad） and high spatial frequency（ 12 cpd, 18 cpd） one month postoperatively. Results In spherical IOL group, there were statistically significant differences between CS and GS at 6 cpd,12 cpd when pupil diameter was 4 - 5 mm,and there were statistically significant differences between CS and GS at all spatial frequencies when pupil diameter was 8 mm. In aspherical IOL group, there were no statistically differences between CS and GS at all spatial frequencies under three pupil conditions. Comparison of spherical and aspherical IOL： the difference of CS was significant between them at high spatial frequencies when pupil diameter was 2.0 - 2.5 mm and 5 mm; The difference of GS at low spatial frequencies and the difference of CS and GS at middle spatial frequencies were significant between two groups when pupil diameter was 8mm. Conclusion In spherical IOL group, with increasing of pupil diameter, the values of CS and GS decreases, and the bigger the pupil diameter is, the more obvious decrease of CS when affiliated with glare is. In aspherical IOL group, the decrease of CS under glare conditions is not happen significant at any pupil diameter, and the bigger the pupil diameter is, the more obvious the function of compensating positive spherical aberration and reducing spherical aberration is.