非球面型人工晶状体植入术后波阵面像差和对比敏感度的研究

Spherical aberration,contrast sensitivity and color discrimination after cataract surgery with the aspherical intraocular lens

目的:观察和比较非球面型人工晶状体及球面型人工晶状体植入术后对波阵面像差、对比敏感度的影响。方法:连续收集接受白内障超声乳化人工晶状体植入手术,术后随访时间大于3个月,最佳矫正视力≥0.8的患者53例,72只眼,其中植入非球面型人工晶状体(Tecnis Z9001,AMO)25例(38只眼),男10例,女15例,平均年龄(69.92±8.24)岁;植入球面型人工晶状体(Sensar AR40e,AMO)28例(34只眼),男12例,女16例,平均年龄(67.08±6.91)岁。在术后3个月时进行裸眼视力、最佳矫正视力、眼压、裂隙灯眼前节、眼底等一般检查,并应用客观波阵面像差仪(Wavelight Laser Technologie AG,德国)检查客观像差,应用德国罗兰对比敏感度仪(ROLAND BA-4 Contrastometer,德国)进行暗室无眩光和暗室有眩光对比敏感度阈值检测。结果:非球面型人工晶状体组的球面像差C12(构成4阶像差的主要成分)及第4阶像差均方根RMS4均低于球面型人工晶状体组,差异具有统计学意义;总高阶相差RMSh两组间差异无统计学意义。非球面型人工晶状体组的暗室无眩光对比敏感度阈值正常眼所占百分比为51.7%,暗室有眩光对比敏感度阈值正常眼所占百分比为58.6%;球面型人工晶体组暗室无眩光对比敏感度阈值正常眼所占百分比为32.0%,暗室有眩光对比敏感度阈值正常眼所占百分比为52.0%,两组分布差异无统计学意义。结论:非球面人工晶状体植入可明显减少球面像差,但对暗室对比敏感度无明显影响。

Objective：To determine whether implantation of an intraocular lens （IOL） with a modified prolate anterior surface results in reduced spherical aberration and improved contrast sensitivity after cataract surgery. Methods： Consecutively 72 eyes were selected from 53 senile cataract patients who had received phacoemulsification and IOL implantation in Peking University Eye Center. Each was randomly assigned to receive Tecnis Z9001 IOL or Sensar AR40e （both made by AMO）. Three months after operation, the eyes underwent several tests including visual acuity, optometry and wavefront aberration examination. Mesopic contrast sensitivity test was measured with ROLAND BA-4 Contrastometer. Results： The eyes treated with Tecnis Z9001 had significantly less spherical aberration. The eyes treated with Tecnis IOL got lower C12 coefficient and RMS4 than those with Sensar AR40e （P value 〈 0.05 ）. The mesopic contrast sensitivity and color discrimination were not significantly different between the two IOL groups. Conclusion： A significant reduction in spherical aberration after Tecnis Z9001 IOL implantation-was a- chieved, but mesopic contrast sensitivity was not affected by the aspheric silicone IOL as compared with spherical acrylic IOL.