基于模型眼的球面人工晶状体单色像差分析

Research on the monochromatic aberrations of intraocular lenses in a model eye

目的运用基于Hartmann—Shack原理的模型眼来评价球面人工晶状体（IOL）单色像差。方法前瞻性研究。本研究分为2个部分。①选取SA60AT（美国Alcon公司）系列IOL5片，屈光度分别为＋10、＋15、＋20、＋25、＋30D；②选取IOL3片，屈光度均为＋20D，分别为SA60AT、AkreosAdapt（美国博士伦公司）、AR40e（美国AMO公司）。搭建模型眼光路，将待测IOL置于光路中，以电子耦合设备（CCD）图像传感器接受像点，测出在436、486、525、546、589、660、710nm不同波长下的像点图，经Matlab软件进行处理，采用双因素Pearson相关分析及单因素方差分析评价IOL的单色像差。结果第一部分：SA60AT系列IOL的球差（Z12，r=0．599，P〈0．05）、垂直彗差（Z7，r=0．817，P〈0．05）、水平彗差（Z8，r=0．488，P〈0．05）与屈光度呈正相关，总高阶像差均方根值（RMSh）与屈光度不相关（r=0．007，P〉0．05）；波长与球差（r=一0．213，P〉0．05）、垂直彗差（r=-0．074，P〉0．05）、水平彗差（r=0．021，P〉0．05）及RMSh（r=-0．322，P〉0．05）均不相关。第二部分：3种IOL的球差（F=74．637，P〈0．05）、水平彗差（F=6．719，P〈0．05）及RMSh（F=11．768，P〈0．05）差异有统计学意义，垂直彗差差异无统计学意义（F=1．295，P〉0．05），AR40e的球差、水平彗差及RMSh相对最小；波长与各IOL的球差（r=0．007，P〉0．05）、垂直彗差（r=-0.312，P〉0．05）、水平彗差（r：-0．238，P〉0．05）及RMSh（r=0．246，P〉0．05）均不相关。结论利用Hartmann—Shack原理设计的模型眼可以便捷地检测IOL的单色像差，为临床上IOL的选择及其光学设计的改进提供了参考依据。

Objective To evaluate monochromatic aberrations （MA） with intraocular lenses （IOLs） using a model eye and Hartmann-Shack aberrometry for measurement. Methods This was a prospective study. Part I： There were 5 different IOL refractive powers （Alton, SA6OAT, ＋10 D, ＋15 D, ＋20 D, ＋25 D and ＋30 D）. Part II： There were three different ＋20 D IOLs （SA60AT; Akreos Adapt, Bausch ＆ Lomb; AR4Oe, AMO）. IOLs were tested in a fluid-filled model constructed to replicate the optical conditions of a pseudophakic human eye at different wavelengths of 436, 486, 525, 546, 589, 660 and 710 nm. Those images were caught by CCD and analyzed in MATLAB. A single-factor analysis of variance and Pearson correlation analysis were used for statistical evaluation. Results Part I： Positive correlations were found between IOL refractive power and aberrations for spherical aberrations （SA, Z12, r=0.599, P〈O.05）, vertical coma （VC, Z7, r=0.817, P〈O.05） and horizontal coma （HC, Z8, r=0.488, P〈O.05）. There was no correlation between IOL refractive power and root mean square of total higher-order aberration （RMSh, r=O.007, P〉O.05）. No correlation was found between wavelength and aberrations for SA （r=--0.213, P〉0.05）, VC （r=-0.074,μM）.05）, HC （r=0.021, /9〉0.05） and RMSh （r=-0.322, P〉0.05）. Part II： There was a significant difference among the 3 IOLs in aberrations, SA （F=74.637, P〈0.05）, HC （F=6.719, P〈0.05） and RMSh （F=11.768, P〈0.05）. There was no difference in VC （F=1.295, P〉0.05）. AR40e had the least SA, HC and RMSh of the three IOl,s. There w^ls no correlation between wavelength and aberrations for SA （r=0.007, /＂〉0.05）, ／C （r=-0.312. P〉0.05）, tIC （r=-0.238, 1＇〉0.05） and RMSh （r=0.246, P〉0.05）. Conclusion The MA ~Jt 1OI,s can be ewdualed in lhis model eye. This is usefid for an improvement iu lhe optical qualily of＂ IOl^s ~md ~lso eouht be a bener choice for patients.