不同原理波前像差仪测量人工晶状体眼像差的比较

Comparison of different wavefront aberrometers for measuring the wavefront aberrations of eyes with intraocular lenses

目的比较激光光束追踪(laser ray tracing,LRT)、Hartmann-Shack(H-S)感受器以及空间分辨折射仪(spatially resolved refractometer,SRR)三种不同像差仪测量人工晶状体(intraocular lens,IOL)眼像差的差异。方法临床选取行白内障超声乳化摘除联合IOL植入术后的患者24例(34眼)。年龄为50～80岁,最佳矫正视力≥4.9。暗室条件下瞳孔直径均为5mm。术后第3个月,对患者行三种像差仪的检查,顺序不定,测量结果采用完全随机资料的方差分析和秩和检验进行统计学方法。结果三组的总像差、高阶像差、彗差、三叶草以及2～6阶像差的均方根值比较,差异均无统计学意义(P>0.05);LRT组与SRR组球差的均方根值差异有统计学意义(t=2.29,P<0.05)。Zernike系数的比较:Z3项LRT组与H-S组,H-S组与SRR组间差异有统计学意义(P<0.05);Z4项三组间差异均有统计学意义(P<0.05);Z6项和Z12项H-S组与SRR组间差异有统计学意义(P<0.05);Z11项和Z20项LRT组与SRR组间差异有统计学意义(P<0.05);其余Zernike系数比较,差异均无统计学意义(P>0.05)。结论LRT、H-S和SRR三种像差仪测量IOL眼像差结果存在部分差异。每种仪器都有各自的优缺点,使用时应根据不同的目的选用适合的波前像差仪。

Objective To compare three techniques for measuring the optical aberrations of eyes with intraocular lenses （IOL）： laser ray tracing （LRT）, the Hartmann-Shack （H-S）, and the spatially resolved refractometer （SRR）. Methods Twenty-four patients （34 eyes） who had undergone phacoemulsification with IOL implantation participated in this study. The age range of the patients was 50~80 years old. All uncorrected and corrected visual acuity was better than 4.9. Pupil diameter was 5 mm under dark room conditions. All eyes were measured with all three instruments in a random order three months after cataract surgery. All data were analyzed statistically using one-way ANOVA or a rank sum test. Results There were no statistically significant differences among the three techniques in the RMS of the total wave aberration, HOA, coma, trefoil and from the 2nd to the 6th order （P〉0.05）. The RMS of spherical aberrations showed a statistically significant difference between LRT and SRR （t=2.29, P〈0.05）. There were statistically significant differences between H-S and both LRT and SRR in Z3 （P〈0.05）. There were statistically significant differences among the three techniques in Z4 （P〈0.05）. H-S significantly differed from SRR in Z6 and Z12 （P〈0.05）. LRT significantly differed with SRR in Z11 and Z20 （P〈0.05）. The other Zernike coefficients showed no statistically significant differences among them （P〉0.05）. Conclusion There are some differences in the Zernike coefficients obtained by LRT, H-S and SRR. Each aberrometer has advantages and disadvantages depending on the particular application.