不同球差非球面人工晶状体眼高阶像差比较

Comparison of high order aberrations in pseudophakia with spherical intraocular lens and aspheric intraocular lens implantation

目的球面及不同球差非球面人工晶状体植入后,比较患者眼角膜、眼内及全眼球的高阶像差,为个性化选择人工晶状体(IOL)提供依据。方法年龄相关性白内障患者112例(160眼)分为4组,分别植入AMO Sensor AR40 IOL(AR40组,26例40眼)、AM O Tecnis ZA9003 IOL(ZA9003组,31例40眼)、Bausch&Lomb Sof Port AO IOL(AO组,28例40眼)、Alcon SN60WF IQ IOL(IQ组,27例40眼)。测量术后3个月4 mm及6 mm瞳孔直径下的角膜、眼内和全眼的总高阶像差(t HOA)、球差(SA)、慧差及三叶草像差。结果术后3个月,各组间患者术后裸眼及最佳矫正视力差异无统计学意义。4 mm及6 mm瞳孔直径下各组间角膜t HOA、SA、coma及trefoil差异均无统计学意义。4 mm瞳孔直径下各组间眼内SA及coma差异有统计学意义,各组间眼内t HOA及trefoil差异无统计学意义;6 mm瞳孔直径下各组间眼内t HOA、SA及coma差异有统计学意义,各组间眼内trefoil差异无统计学意义。4 mm及6 mm瞳孔直径下各组间全眼t HOA及SA差异有统计学意义,各组间全眼coma及trefoil差异无统计学意义。结论超声乳化白内障吸除术后植入非球面IOL可以降低全眼SA,提高患者视觉质量。不同SA的非球面IOL,全眼SA的可预测性较好,为非球面IOL的个性化植入提供了临床依据。

Objective To compare the corneal, internal, and ocular high order aberrations （HOAs） in pseudophakia of spherical intraocular lens （IOL） with aspheric IOL implantation, and to provide evidence for individual selection of as- pheric IOL. Methods A prospective, non-randomized, controlled clinical study was conducted on 112 age-matched cataract patients （160 eyes）. Patients were divided into four groups, and implanted with AMO Sensor AR40 IOL （group AR40, 40 eyes of 26 patients）, AMO Tecnis ZA9003 IOL （group ZA9003,40 eyes of 31 patients）, Bausch ＆ Lomb SofPort AO IOL （group AO, 40 eyes of 28 patients）, or Alcon SN60WF IQ IOL （group IQ, 40 eyes of 27 pa- tients）. The corneal, intemal, and ocular HOAs including total HOA （tHOA）, spherical aberration （SA）, coma, and trefoil were measured at three months postoperatively with a pupil diameter （PD） of 4 mm or 6 mm. Result There were no statistically significant differences in postoperative uncorrected visual acuity and best corrected visual acuity, and in postoperative corneal tHOA, SA, coma, and trefoil at 4 mm or 6 mm PD among the four groups. At 4 mm PD, there were significant differences in internal SA and coma but no differences in tHOA and trefoil; at 6 mm PD, there were significant differences in internal tHOA, SA, and coma but no differences in trefoil. In addition, there were sig- nificant differences in ocular tHOA and SA but no differences in coma and trefoil at 4 mm or 6 mm PD among the four groups. Conclusion Phacoemulsification of the cataract and implantation of an aspheric IOL can reduce corneal SA, resulting in enhanced visual quality. For aspheric IOLs with other SAs, the predictability of corneal SA is exact, which provides a clinical basis for personalized implantation of aspheric IOLs.