全眼球差对人工晶状体眼视觉质量的作用

Effect of ocular spherical aberration on vision quality in pseudophakic eyes

目的比较非球面和球面人工晶状体(intraocular lens,IOL)植入眼全眼球差、调制传递函数(modulation transfer function,MTF)、焦深(depth of focus,DOF)的差异,分析全眼球差与MTF值及DOF的相关性,客观评价全眼球差对视觉质量的影响。方法选取单纯性老年性白内障患者72例(77眼),随机分为3组:Ⅰ组25例(26眼),植入Tecnis ZA9003非球面IOL;Ⅱ组23例(26眼),植入Acrysof IQ非球面IOL;Ⅲ组24例(25眼),植入Acrysof SN60AT球面IOL。术后3个月散瞳后使用iTrace视觉功能分析波阵面像差仪测量6mm瞳孔直径下全眼球差及各空间频率(5c·d-1、10c·d-1、15c·d-1、20c·d-1、25c·d-1、30c·d-1)下MTF值及离焦MTF曲线(DOF的测量),采用单因素方差分析进行统计学处理,两两比较采用SNK-q法,采用Pearson进行相关性分析。结果 6mm瞳孔直径下,Ⅰ组、Ⅱ组、Ⅲ组全眼球差差异有统计学意义(P<0.05),且两两比较,Ⅰ组<Ⅱ组<Ⅲ组(均为P<0.05);各空间频率下3组MTF(tHOA)值差异均有统计学意义(均为P<0.05),且两两比较,Ⅰ组>Ⅲ组(均为P<0.05),Ⅱ组>Ⅲ组(均为P<0.05);DOF值3组间差异有统计学意义(P<0.05),且两两比较,Ⅲ组>Ⅰ组(P<0.05),Ⅲ组>Ⅱ组(P<0.05);全眼球差(绝对值)与各空间频率MTF(tHOA)值均呈负相关(均为P<0.05),与DOF值呈正相关(r=0.388,P=0.003)。结论负球差设计非球面IOL眼有较高的MTF(tHOA)值,球面IOL眼有较大的DOF;全眼球差(绝对值)与MTF(tHOA)值呈负相关,与DOF值呈正相关;术后预留少量的正球差有利于提高视觉质量。

Objective To compare the difference of spherical aberration,modulation transfer function（MTF） and depth of focus（DOF） in eyes implanted with aspherical and spherical intraocular lens（IOL）,and then analyze the relationship between ocular spherical aberration,MTF and DOF to subjectively evaluate the ocular spherical aberration on vision quality.Methods A total of 72 patients（77 eyes） with age-related cataract were divided into 3 groups randomly.GroupⅠ（25 cases,26 eyes） implanted with Tecnis ZA9003 IOL,Group Ⅱ（23 cases,26 eyes） implanted with Acrysof IQ IOL,Group Ⅲ（24 cases,25 eyes） implanted with Acrysof SN60AT IOL.The iTrace was used to measure the ocular spherical aberration,MTF under each spatial frequency（5 c·d-1,10 c·d-1,15 c·d-1,20 c·d-1,25 c·d-1,30 c·d-1） and defocus MTF curve at 6 mm pupil diameter.One-way AVONA and Spearson correlation analysis were used to assess the date.Results At 6 mm pupil diameter,there was statistical difference in the ocular spherical aberration among three groups（P0.05）,which in group Ⅰwas less than group Ⅱ,and group Ⅱ was less than group Ⅲ,there were statistical differences（both P0.05）.There were statistical differences in MTF（tHOA） value among three groups under each spatial frequency（both P0.05）,which in group Ⅰand Ⅱwere all higher than group Ⅲ,there were statistical differences（both P0.05）.There was statistical difference in DOF value among three groups（P0.05）,which in group Ⅰand Ⅱwere all less than group Ⅲ,there were statistical differences（both P0.05）.The MTF（tHOA） value under each spatial frequency was negative correlated with ocular spherical aberration（all P0.05）,positive correlated with DOF value（r=0.388,P=0.003）.Conclusion The eyes implanted with aspherical IOL with negative spherical aberration have a high value of MTF（tHOA）,while eyes implanted with spherical IOL have a high value of DOF.The ocular spherical aberration is negative correlated with MTF（tHOA） value,and positive correlated with DOF value.It is better to reserve some spherical aberration for improving the visual quality.