非球面人工晶状体眼的视觉质量

Clinical study of the optical quality of eyes implanted with aspherical IOLs

目的 比较年龄相关性白内障患者植入两种不同光学面设计的人工晶状体（intraocular lens，IOL），即非球面和球面IOL眼的最佳矫正视力（best corrected visual acuity，BCVA）、对比敏感度及波前像差，分析人工晶状体光学面设计对人工晶状体眼视觉质量的影响。方法 连续选取2005年1月-2006年1月年龄相关性白内障患者43例（60眼）作为观察对象，随机分为两组，行超声乳化白内障摘除联合人工晶状体植入术，分别植入非球面人工晶状体（试验组，21例，30眼）和球面型人工晶状体（对照组，22例，30眼）。术后第2个月回访患者，行医学验光、对比敏感度和波前像差检查。对所得的数据行配对t检验。结果 试验组的BCVA为5.00±0.09，对照组的BCVA为5.00±0.05，两组差异无统计学意义﹙t=0.254，P=0.801﹚。试验组在夜视、夜视加眩光条件下的对比敏感度明显高于对照组，两组差异有统计学意义﹙P＜0.05）。在瞳孔直径5.0 mm状态下，试验组的球差、第四阶像差、第五阶像差、第六阶像差及总体高阶像差均方根值明显低于对照组﹙P＜0.05）。结论 非球面人工晶状体眼视觉质量明显优于球面人工晶状体眼。

Objective To compare the best corrected visual acuity （BCVA）, contrast sensitivity and total higher-order wavefront aberrations in 60 pseudophakic eyes implanted with two different types （aspheric and spheric） of intraocular lenses （IOL）; to obtain an objective evaluation of the optical quality of these pseudophakic eyes. Methods Forty-three patients （60 eyes） were randomly selected to undergo phacoemulsification and implants with either aspheric IOLs （test group, 30 eyes） or spheric IOLs （control group, 30 eyes）. Examinations of the BCVA, contrast sensitivity and total higher-order wavefront aberrations were carried out at 2 months after cataract surgery. Results The difference in BCVA between these two groups was not significant. In an examination of contrast sensitivity under nighttime and nighttime with periglare conditions, eyes implanted with aspherical IOLs were significantly better in than eyes with spherical IOLs （P〈0.05）. For a 5.0 mm optical zone, spherical aberrations, RMS4, RMS5, RMS6 and RMSh in eyes implanted with aspherical IOLs showed significant reductions﹙P〈0.05）. Conclusion This study shows that the optical quality of eyes implanted with aspherical IOLs was significantly better than that with spherical IOLs.