黄色非球面人工晶状体植入术后视觉质量的临床分析

Contrast sensitivity and glare sensitivity after implantation of AcrySofIQ Natural aspherical intraocular lens

目的观察老年性白内障患者植入黄色非球面人工晶状体AcrySof IQ术后对比敏感度和眩光敏感度。方法前瞻性临床对照研究。56例（56只眼）老年性白内障患者，随机分为三组，分别植入非球面人工晶状体AcrySof IQ（sN60wF）及球面人工晶状体Acrysof Natural（SN60AT）、Acrysof（SA60AT）。术后2月行最佳矫正视力、像差及对比敏感度检查。结果三组患者术后最佳矫正视力≥20／30。IQ组与球面晶状体组比较，球差均显著性减少（P〈0．05），高阶像差及彗差无统计学意义（P〉0．05）。在非眩光状态下，低频时IQ组的对比敏感度（10g值）显著高于球面晶状体组（P〈0．05），中频2．5deg时IQ组的对比敏感度显著高于SA60AT组（P〈0．05）。在眩光状态下，低频时IQ组的对比敏感度也显著高于球面晶状体组（SN60AT组：P〈0．01，SA60AT组：6．3degrees P〈0．01，4．0degrees P〈0．05）。结论非球面人工晶状体可以减少球面像差，提高低频尤其是眩光状态下的对比敏感度从而获得更好的视觉质量。滤蓝光晶状体与普通晶状体比较对比敏感度差异无统计学意义，不能明显改善视功能。

Objective To compare contrast sensitivity and glare sensitivity in pseudophakic eyes with a yellow-tinted aspherical intraocular lens （IOL） and conventional spherical IOL. Methods Fifty six patients who had phacoemulsification in a prospective trial were randomized to receive an AcrySof IQ SN60WF IOL, AcrySof Natural SN60AT IOL, or AcrySof SA60AT IOL. At 2 months postoperatively,best corrected visual acuity, high-order aberration and contrast sensitivity were examined. Results All of the eyes had best corrected visual acuity （BCVA） 〉20/30. The AcrySof IQ IOL showed statistically significant less induction of spherical aberration （P 〈0.05 ） when compared with the AcrySofNatural IOL and AcrySof SA60AT IOL,but had no difference in high-order aberration and coma （P 〉0.05 ）. Without glare, the AcrySof IQ group had significantly higher contrast sensitivity at 6.3 degrees、4.0 degrees, 2.5 degrees compared to SA60AT group （P 〈0.05）; and had significantly higher contrast sensitivity at 6.3 degrees,4.0 degrees compared to SN60AT group （P 〈0.05 ）. With glare, the AcrySof IQ group had significantly higher glare sensitivity at 6.3 degrees,4.0 degrees （SN60AT group： P 〈0.01, SA60AT group： 6.3 degrees P 〈0.01,4.0 degrees P 〈0.05 ）. Conclusion Implantation of an aspherical IOL resulted in reduced ocular spherical aberration and improved contrast sensitivity and led to better subjective quality of vision. The yellow-tinted IOL has similar spherical aberration and contrast sensitivity with standard IOL, and so has similar vision performance.