非球面人工晶状体植入眼的视觉质量分析

Optical quality analysis of aspheric intraocular lens

目的 观察非球面人工晶状体（IOL）、球面IOL植入眼与正常中青年人眼的波前像差和对比敏感度差异.方法 46例（49只眼）老年性白内障患者随机分成两组,分别植入非球面IOL Acrysof IQ（SN60WF）和球面IOL Acrysof Nature（SN60AT）.随机选择同期正常中青年人（年龄20~40岁）作为对照组.分别对术后3月的患者和对照组进行最佳矫正视力、像差和对比敏感度检查.结果 IQ组的球差显著小于Natural组（P ＜0.05）,而和正常中青年组比较无统计学意义（P ＞0.05）;两IOL组的高阶像差和慧差均显著大于正常中青年组（P ＜0.05）.非眩光状态下,IQ组在低频时（6.3degrees）的对比敏感度显著高于Natural组（P ＜0.05）,和正常中青年组比较无统计学意义（P ＞0.05）;眩光状态下,IQ组在低频时（6.3和4.0degrees）的对比敏感度显著高于Natural组（P ＜0.05）,两IOL组在所有视角下的对比敏感度均显著低于正常中青年组（P ＜0.05）.结论 非球面IOL植入能使白内障患者术后眼内球差明显减小,非眩光状态下低频时的对比敏感度明显提高,更接近正常中青年人眼水平,具有比球面IOL更佳的视觉质量.

Objective To study the optical wavefront aberrations and contrast sensitivity in eyes treated with uneventful cataract surgery with in-the-bag implantation of an aspheric Acrysof IQ intraocular lens （IOL） or a spherical Acrysof Natural IOL, and compare the results with those in a group of normal young-middle aged eyes. Methods Forty-six patients with age-related cataract （49 eyes） were randomly divided into two groups： Acrysof IQ IOL group included 27 patients （29 eyes） and Acrysof Natural IOL group included 19 patients （20 eyes）. Normal 30 young-middle aged people （30 eyes） were selected as a control group. The wavefront aberrations and contrast sensitivity were evaluated in 3 months of postoperative patients and in normal control group. Results There was no statistical significance of the mean internal spherical aberration between IQ and control group, but was statistically lower than Natural group （P 〈0.05）. The mean internal high order aberration and coma between IQ and Natural group were similar （P 〉0.05）, but statistically higher than those of control group （P 〈0.05）. The contrast sensitivity （CS） of IQ group was similar to control group in low spatial frequency （6.3degrees, nor glare）（P 〉0.05）, but was statistically lower than control group in other spatial frequency （P 〈0.05）, as well as the results of Natural group in all spatial frequency （under the condition of glare or not）（P 〈0.05）. CS of Natural group were significantly lower than IQ group in low spatial frequency （6.3degrees, no glare; 6.3 and 4.0 degrees, glare）（P 〈0.05）, but without any statistical significance in other spatial frequency. Conclusions IQ Aspheric IOL can not only reduce the spherical aberration of eyes after cataract surgery, but also improve the contrast sensitivity, suggesting aspheric IOL is much better than spherical IOL.