有晶状体眼后房型人工晶状体V4c植入术对波前像差的影响

The Influence on Wave-Front Aberrations after the Implantation of an Implantable Collamer Lens with CentraFLOW

目的:探讨有晶状体眼后房型人工晶状体V4c植入术对全眼、眼内及角膜波前像差的影响。方法:前瞻性临床研究。纳入2019年5月至2020年12月在南昌爱尔眼科医院拟行有晶状体眼后房型人工晶状体V4c植入术矫治中高度近视的患者44例(88眼)。使用角膜屈光分析仪测量术前及术后3个月在3、4、6 mm瞳孔直径下的全眼波前像差、角膜波前像差及眼内波前像差值。手术前后全眼、眼内及角膜各波前像差值[如总像差、低阶像差Tilt(S1)值、高阶像差、彗差、三叶草像差、球差]比较采用配对t检验进行分析。结果:术后3个月,手术的安全性指数和有效性指数分别为1.15±0.12和1.11±0.12。在3、4、6 mm瞳孔直径下,术后全眼总像差分别为(0.34±0.14)μm、(0.57±0.23)μm、(1.81±0.83)μm,眼内总像差分别为(0.34±0.11)μm、(0.52±0.16)μm、(1.74±0.68)μm,术后全眼总像差、眼内总像差均较术前明显减少,且差异均有统计学意义(全眼:t=14.67,P<0.001;t=16.68,P<0.001;t=14.35,P<0.001。眼内:t=15.41,P<0.001;t=13.89,P<0.001;t=13.21,P<0.001)。在6 mm瞳孔直径下,术后全眼高阶像差、彗差、球差均较术前增加,差异均有统计学意义(t=-3.62,P=0.001;t=-2.84,P=0.008;t=-2.94,P=0.006);眼内高阶像差、彗差较术前增加,差异有统计学意义(t=-2.65,P=0.013;t=-3.02,P=0.005)。余像差手术前后差异无统计学意义。结论:有晶状体眼后房型人工晶状体V4c植入术矫正中高度近视安全、有效,能降低全眼、眼内总像差,但角膜像差无明显变化。

Objective:To investigate the influence of an implantable collamer lens with CentraFLOW(ICL V4c)on total wave-front aberrations,corneal wave-front aberrations and intraocular wave-front aberrations in moderate and high myopia patients after the implantation.Methods:This was a prospective study of 88 eyes of 44 moderate and high myopia patients who received ICL V4c implants in Nanchang Aier Hospital during May 2019 to December 2020.The Corneal refractive analyzer was used to measure total wave-front aberrations,corneal wave-front aberrations and intraocular wave-front aberrations at 3 mm,4 mm,and 6 mm pupil diameters preoperatively and at 3 months postoperatively.A paired t-test was used to analyze the changes in total,corneal,and intraocular wave-front aberrations from preoperative measurements to measurements at 3 months postoperatively.Measurements included total,Tilt(S1),higherorder,coma,trefoil,and spherical aberrations.Results:At 3 months postoperatively,the safety index and efficacy index of the surgery were 1.15±0.12 and 1.11±0.12,respectively.At 3,4,and 6 mm pupil diameters,the postoperative total aberrations were 0.34±0.14,0.57±0.23,and 1.81±0.83μm,respectively,and total intraocular aberrations were 0.34±0.11,0.52±0.16,and 1.74±0.68μm,respectively,which were significantly reduced compared to preoperative aberrations(total aberrations:t=14.67,P<0.001;t=16.68,P<0.001;t=14.35,P<0.001;total intraocular aberrations:t=15.41,P<0.001;t=13.89,P<0.001;t=13.21,P<0.001),At a 6 mm pupil diameter,the postoperative total higher-order aberrations,coma,and spherical aberrations had increased significantly compared to preoperative eyes(t=-3.62,P=0.001;t=-2.84,P=0.008;t=-2.94,P=0.006).The postoperative intraocular higher-order aberrations and coma had significantly increased compared to preoperative eyes(t=-2.65,P=0.013;t=-3.02,P=0.005).Other aberrations did not show significant changes compared to preoperative eyes.Conclusion:ICL V4c implantation is safe and effective for correcting moderate and high myopia.It can reduce total aberrations and total intraocular aberrations,and there is no significant change in corneal aberrations.