不同人工晶状体设计对人工晶状体眼波前像差的影响

Impact of different intraocular lens design on the wave-front aberration of pseudophakic eyes

目的:评价超声乳化白内障吸除联合人工晶状体植入术后人工晶状体眼的波前像差,讨论不同设计的人工晶状体对术后人工晶状体眼波前像差的影响。方法:选择年龄相关性白内障患者62例(69眼),年龄41～84(平均63.4±4.0)岁。其中男24例(28眼),女38例(41眼),右眼38例,左眼31例。随机平均分为3组,使年龄性别相匹配。其中A组植入三片式人工晶状体(ACRYsofMA60BM),B组植入一片式人工晶状体(ACRYsofSA60AT),C组植入蓝光滤过型一片式人工晶状体(ACRYsofSN60AT)。同一术者,同一超声乳化仪(Alcon INFINITI VISION SYSTEM)和手术显微镜(CarZeissStativS88),术中均采用角膜曲率最高经线上宽3.2mm长1.75mm的角巩膜缘隧道切口。术后1mo使用客观型波前像差仪(NidekOPD-scanARK-10000)进行波前像差检测,得出总体高阶像差的均方根(RMSh)。结果:A组三片式(ACRYsofMA60BM)的RMSh平均达到0.702±0.090μm,B组一片式(ACRYsofSA60AT)的RM-Sh平均达到0.529±0.067μm,C组蓝光滤过型一片式(ACRYsofSN60AT)的RMSh平均达到0.566±0.066μm。三组比较采用单向方差分析,5.0mm瞳孔大小时A组的总体像差值最高(P<0.01),其余两组没有显著性差异(P=0.126)。组间差异有统计学意义。结论:人工晶状体襻的设计对超声乳化白内障吸除联合人工晶状体植入术后人工晶状体眼的像差有明显影响,但光学区染色对单色像差的影响无统计学差异。这一结果对进一步完善白内障手术以及人工晶状体材料和设计的改善提供了有意义的信息。

AIM： To investigate the impact of different intraocular lens design on the wave-front aberration of pseudophakic eyes. METHODS： A total of 69 eyes of 62 patients, with age-related cataract and mean age of 63.4±4.0 years, were included in this study. The eyes were randomly divided into 3 groups according to the type of intraocular lens （IOL） （loop type and optic color） implanted. Multi-piece IOLs（ACRYsof^@ MA60BM）were inserted into the eyes in Group A. Single-piece IOLs（ACRYsof^@ SA60AT） and blue light filtering single-piece IOLs were inserted into the eyes in Group B and C respectively. The same surgeon, phacoemulcifier （Alcon^@ INFINITI VISION SYSTEM）, and operating microscope （Carl Zeiss Stativ S88 ） were employed in the study. The corneoscleral junction tunnel incision was in the highest curvature, with the width of 3. 2mm and the length of 1.75mm. The optical aberrations and the root mean square of high-order wave-front aberrations （RMSh） were measured with the OPD-scan ARK-10000 （Nidek） at one month after the surgery, using a 5. 0mm wave-front aperture diameter for all comparisons, RESULTS： The mean RMSh of Group A was 0. 702±0.090μm, and the values of Group B and Group C were 0.529±0.067μm and 0.566±0.066μm. There was no statistical difference in high-order aberrations between Group B and Group C in which the IOL were of the same design but different colour （P〉0.05）, However, the measured high-order aberrations were significantly higher in Group A in which the IOL had PMMA loop （P〈0.01）. CONCLUSION： The different loop design of IOL contributes a lot to the pseudophakic eyes. There is wave-front aberration of no statistical difference in high-order aberrations between IOL with optical staining and those without.