白内障超声乳化并人工晶状体植入术后高阶像差变化及意义

The changes and significance of high-order aberrations ofpseudophakic eye after phacoemulsification surgery

目的 观察白内障超声乳化并人工晶状体植入术后眼高阶像差的变化,探讨其临床意义.方法 采用 Zywave 波前像差仪,检测129例（129只眼）白内障超声乳化并人工晶状体植入术后（非球面人工晶状体60例,球面人工晶状体69例）患者与107例（107只眼）对照人群的眼总高阶像差、球差 （Z400）、彗差（Z310、311）等各高阶像差均方根值（RMS）,行协方差分析检验.结果 与对照组相比,人工晶状体眼组的总高阶像差、Z331、Z311、Z441、Z400、Z420、Z440、Z511、Z510、Z550的均方根值（RMS）的差异具有统计学意义（P＜0.05）.其中,与对照组相比,非球面人工晶状体亚组的总高阶像差、Z331、Z441、Z400、Z440、Z511、Z510、Z550的均方根值（RMS）差异具有统计学意义（P＜0.05）,除了Z331、Z400,其余6个高阶像差均表现增高;球面人工晶状体亚组的总高阶像差、Z331、Z311、Z400、Z420、Z440、Z511、Z550的均方根值（RMS）差异具有统计学意义（P＜0.05）,且均表现增高.结论 白内障超声乳化并人工晶状体植入术后眼总高阶像差在内的多数高阶像差均明显增高;根据植入人工晶状体类型的不同,增高的分阶像差会略有差异,但总高阶像差、Z331、Z400、Z440、Z511、Z550等始终表现增高;非球面人工晶状体能有效降低白内障术后眼的球差.

Objective To observe the changes of high-order aberrations of pseudophakic eye after phacoemusification surgery, and to explore their clinical significance.Methods By Zywave wavefront instrument,the high-order aberrations such as general high-order aberrations,spherical aberration,coma were detected their root mean square （RMS） of 129 surgical cases（129 eyes）（60 asperical intraocular lens,69 spherical intraocular lens） and 107 control persons （107 eyes）. Analysis of covariance was then committed. Results Compared with the control, the RMS values of general high-order aberration, Z331, Z311, Z441, Z400, Z420,Z440,Z511,Z510,Z550 of the surgical cases were statistically significant （P〈0.05）; the RMS values of general high-order aberration,Z331,Z441,Z400,Z440,Z511,Z510,Z550 of the aspherical cases were statistically significant （P〈0.05）; the RMS values of general high-order aberration,Z331,Z311,Z400,Z420, Z440, Z511,Z550 of the spherical cases were statistically significant （P〈0.05）. Conclusions The majority of high-order aberrations of pseudophakic eye after phacoemusification surgery is significantly increased; the sub order aberrations increase differently according to the different lens, while the general high-order aberration, Z331,Z400,Z440,Z511,Z550 always increase; the aspherical lens can effectively reduce spherical aberration of pseudophakic eye.