白内障超声乳化联合人工晶状体植入术后眼高阶像差与对比敏感度的相关性研究

Correlation of high-order aberrations and contrast sensitivity after phacoemulsification and intraocular lens implantation surgery

目的观察白内障超声乳化联合人工晶状体(IOL)植入术后眼高阶像差与对比敏感度(CS)、眩光对比敏感度(GS)之间的关系,探讨改善白内障术后视觉质量的方法。方法采用Zywave波前像差仪检测白内障超声乳化联合IOL植入术后129例129眼的总高阶像差、球差、彗差等各高阶像差均方根值(RMS),采用CSV-1000E对比敏感度测试仪检测其CS和GS,对白内障超声乳化联合IOL植入术后高阶像差与CS或GS间的相关性进行Spearman秩相关分析。结果白内障超声乳化联合IOL植入术后,眼高阶像差与无眩光CS之间相关性较小,总高阶像差与12 c/d CS之间(r=0.23,P<0.05)、Z400与3 c/d CS之间(r=0.17,P<0.05)均呈正相关;Z440与9 c/d CS之间(r=-0.21,P<0.05)、Z550与12 c/d CS之间(r=-0.18,P<0.05)均呈负相关。眼高阶像差与GS之间多呈负相关,包括Z331与6 c/d之间(r=-0.18,P<0.05),Z420与9 c/d之间(r=-0.25,P<0.05),Z420与12 c/d之间(r=-0.21,P<0.05),Z440与9 c/d之间(r=-0.21,P<0.05),Z440与12 c/d之间(r=-0.23,P<0.05),Z510与9 c/d之间(r=-0.18,P<0.05),Z530与12 c/d之间(r=-0.23,P<0.05)均呈负相关,但Z441与9 c/d之间呈正相关(r=0.19,P<0.05),与GS相关的高阶像差主要集中在4阶,与高阶像差相关的GS主要集中在中高空间频率段。结论白内障超声乳化联合IOL植入术后眼高阶像差的变化不影响无眩光CS,但能影响GS。

Background The increase of higher order aberration may be an important cause of blurred,bad night vision and glare after cataract and intraocular lens（IOL） implantation surgery.However,seldom study on the relationship between higher order aberration and contrast sensitivity after cataract surgery is published.ObjectiveThe study aimed to investigate the correlation of high-order aberrations with contrast sensitivity（CS） and glare contrast sensitivity（GS） after phacoemulsification and IOL implantation.MethodsOne hundred and twenty nine eyes received phacoemulsification and IOL implantation for age-related cataract with the post-operation vision ≥0.8 were collected in this study.The uncorrect vision,best correct vision,the opacification of lens,intraocular pressue were examined in 3 months after surgery.The high-order aberrations such as general high-order aberrations,spherical aberration,and coma by Zywave wavefront instrument were detected.The correlation of higher order abbration and contrast sensitivity,glare contrast sensitivity was analyzed by Spearman rank correlation analysis.Written informed consent was obtained from subjects before any medical process.ResultsThe positive correlations were found between total higher order abbration and CS at 12c/d（r=0.23,P0.05） or Z400 and CS at 3c/d（r=0.17,P=0.05）.The negative correlations were seen between Z440 and CS at 9c/d（r=-0.21,P0.05） or Z550 and CS at 12c/d（r=-0.18,P0.05）.In additional,the positive correlations were found between Z441 and GS at 9c/d（r=0.19,P0.05）,and the negative correlations were found between Z331 and GS at 6c/d（r=-0.18,P0.05）,Z420 and GS at 9c/d（r=-0.25,P0.05）,Z420 and GS at 12c/d（r=-0.21,P0.05）,Z440 and GS at 9c/d（r=-0.21,P0.05）,Z440 and GS at 12c/d（r=-0.23,P0.05）,Z510 and GS at 9c/d（r=-0.18,P0.05）,Z530 and GS at 12c/d（r=-0.23,P0.05）.The 4-order high-order aberrations relevant to GS mainly focused on middle and high spatial frequency bands.There were only scattered correlations between aberrations and CS.ConclusionThe changes of high-order aberrations do not influent CS after phacoemulsification and IOL implantation surgery,but it influent the GS.