球面与非球面人工晶状体植入的视功能学比较

The comparison of visual function in cataract patients after implantation with spherical and aspheric intraocular lens

目的观察非球面人工晶状体植入视功能学方面的临床效果。方法55例(60眼)老年性白内障,随机分成两组。试验组植入非球面人工晶状体,对照组植入传统球面人工晶状体,并分别于术后1周、1月、3月检测两组裸眼远、近视力,最佳矫正远视力,最佳矫正远视力后的近视力,对比敏感度,波前像差,立体视觉等。结果在术后1周、1月,两组裸眼远、近视力,最佳矫正远视力、远视力最佳矫正状态下的近视力比较差异无统计学意义(P>0.05);术后3月,两组裸眼远、近视力,最佳矫正远视力、远视力最佳矫正状态下的近视力比较差异有统计学意义(P<0.05);术后1月、3月,试验组在昼间有无眩光及夜间有无眩光的各频段对比敏感度均明显优于对照组的各频段,差异有统计学意义(P<0.05);术后1月、3月,试验组的四阶球差及高阶像差均低于对照组,差异具有统计学意义(P<0.05);术后1月、3月,两组在最佳矫正视力下的远、近立体视觉的比较,差异无统计学意义(P>0.05)。结论非球面人工晶状体植入能减少球面像差,提高对比敏感度,改善术后的视觉质量。

Objective To evaluate clinical effects of visual function after implantation with aspheric intraocular lens （IOL） in phacoemulsification for cataract. Methods Sixty eyes of 55 patients undergoing cataract surgery were randomly divided into two groups：thirty eyes of 25 tients received aspheric IOLs and thirty eyes of 30 patients received conventional spherical IOLs . At one week, one month, three months after surgery, the following investigations were performed to assess the uncorrected visual acuity （ UCVA）, best corrected visual acuity （BCVA）, near visual acuity （NVA）, contrast sensitivity, wavefront aberration and stereopsis of eyes. Results The difference of UCVA, BCVA and NVA between these two groups was not significant after sugery at one week, one month ;but the UCVA,BCVA and NVA in eyes with an aspheric IOL were obviously better than that of eyes with a spherical IOL at three months postoperatively. After one week and three months, the aspheric IOL provided significantly better contrast sensitivity at almost all spatial frequencies under photopic conditions and mesopie conditions in comparison with the spherical IOL. In these two groups ,the wavefront aberration showed the significant difference after one month and three months. The differences of distance and near stereopisis with BCVA and NVA between these two groups were not significant after sugery at one month and three months. Conclusions The present clinical results demonstrated that the aspheric IOL can improve contrast sensitivity at almost all spatial frequencies under photopic conditions and mesopic conditions and decrease spherical aberration as compare to a spherical IOL.