Evaluation of visual quality of spherical and aspherical intraocular lenses by Optical Quality Analysis System

AIM： To evaluate the impact of spherical and aspherical intraocular lenses on the postoperative visual quality of age-related cataract patients using Optical Quality Analysis System （OQAS）. METHODS： Seventy-four eyes with age-related cataracts were randomly divided into spherical and aspherical lens implantation groups. Best-corrected visual acuity （BCVA） was measured preoperatively, one day, one week, two weeks, one month and two months after surgery. A biometric systems analysis using the OQAS objective scattering index （OSI） was performed. RESULTS： There were no significant differences in visual acuity （P〉0.05） before and after spherical and aspheric lens implantation. There was a negative linear correction between the OSI value and BCVA （t-=-0.634, P=-0.000）, and positive corrections between the OSI value and the lens LOCUS III value of nucleus color （NC）, nucleus opacity （NO）, cortex （C） and posterior lens capsular （P） （r=0.704, P=0.000; r=0.514, P=0.000; r=0.276, P=0.020; r=0.417, P=-0.000, respectively）. OSI values of spherical vs aspherical lenses were 11.5±3.6 vs 11.8±3.4, 4.1±0.9 vs 3.3±0.8, 3.5±0.9 vs 2.7±0.7, 3.3±0.8 vs 2.6±0.7, 3.2±0.7 vs 2.5±0.8, and 3.2±0.8 vs 2.50.8 before and ld, 1, 2wk, 1 and 2mo after surgery, respectively. All time points varied significantly （P〈0.01） between the two groups. CONCLUSION： Aspherical IOLs does not significantly affect visual acuity compared with spherical IOLs. The OSI value, was significantly lower in the aspherical lens group compared with the spherical lens. This study shows that objective visual quality of aspheric IOLs is better than that of the spherical lens by means of OQAS biological measurement method.

Visual function and higher order aberration after implantation of aspheric and spherical multifocal intraocular lenses:a meta-analysis

AIMTo assess the visual outcomes of aspheric multifocal intraocular lenses (IOLs) compared with spherical multifocal IOL after cataract surgery.

Visual and optical performance of eyes with different corneal spherical aberration implanted with aspheric intraocular lens

AIM: To compare the visual and optical performance of eyes with different corneal spherical aberration (SA) implanted with spherical aberration-free intraocular lens (IOLs). METHODS: Thirty-six patients with different corneal SA had phacoemulsification with implantation of spherical aberration-free IOLs. Patients were divided into 3 groups according to the value of preoperative corneal SA. Eyes with corneal SA <0.10 mu m were assigned to group A, those with 0.10 <= corneal SA <0.20 mu m to Group B, and those with 0.20 <= corneal SA <0.35 mu m to Group C. Best-corrected visual acuity (BCVA), contrast sensitivity, corneal SA, total ocular aberrations, and depth of focus were recorded 3 months postoperatively. Distance-corrected near and intermediate visual acuity was studied to measure depth of focus. RESULTS: BCVA and contrast sensitivity were similar between groups. There were no significant differences in distance-corrected near or intermediate visual acuity. Corneal SA was similar before and 3 months after surgery in the 3 groups. With a 5.0mm pupil diameter, root mean square values for total ocular higher-order aberrations (HOAs) were lower in groups A and B than in group C. Total ocular SA was lower in group A than in groups B and C. SA was also lower in group B than in group C. Coma and trefoil were similar between the groups. CONCLUSION: Implantation of spherical aberration-free IOLs in eyes with different corneal SA results in similar visual performance at BCVA, contrast sensitivity and depth of focus.

Personalized aspheric intraocular lens implantation based on corneal spherical aberration: a review

With the evolution of cataract surgery from visual rehabilitation to refractive surgery, aspheric intraocular lenses(IOLs) are being increasingly used in the field of ophthalmology. This increased use can be attributed to negative or zero spherical aberrations with unique optical designs, which counteract some of the positive spherical aberrations of the cornea. These alterations reduce the total spherical aberration of human eyes and improve the visual acuity in patients with cataract postoperatively. At present, various types of aspheric IOLs are used worldwide. Although the implantation of aspheric IOL is beneficial to the patients who need correction of spherical aberrations, much controversy is still associated with ocular residual spherical aberrations that facilitate the best visual quality for patients postoperatively. In order to provide reference for future clinical work and scientific research, this report reviews the relationship between the ocular residual spherical aberration of human eyes and visual quality.

Clinical study inpatient-reported outcomes after binocular implantation of aspheric intraocular lens of different negative spherical aberrations

Objective: To compare patient-reported outcomes after implantation of the ZA9003 intraocular lens(IOLs), or the MCX11 ASP IOLs or the spherical IOLs(HQ-201HEP). Methods: Prospective nonrandomized controlled trial was used. A total of 105 patients(210 eyes) were divided into three groups according to the type of IOLs: ZA9003(35 patients, 70 eyes), MCX11 ASP(35 patients, 70 eyes) or HQ-201HEP(35 patients, 70 eyes). The main outcome was scores of Catquest nine-item short-form questionnaire. Additional outcome was best corrected visual acuities, spherical aberration(SA) and total higher-order aberrations(HOAs). Results: The global score was significantly lower in the spherical IOL group than the aspherical IOL group of-020 μm SA(P < 0.05) and the aspherical IOL group of-027 μm SA(P < 0.05), and no significant difference was found in the global score between the aspherical IOL group of-020 μm SA than the aspherical IOL group of-027 μm SA(P > 0.05). Significant differences were also found in question 2, question 5, question 6 and question 8 between the spherical IOLs and the aspherical IOLs. Conclusion: Implantation of an aspherical IOL could improve vision-related quality of life compared with a spherical IOL. However, there were no statistically significant differences in vision-related quality of life between aspheric IOLs with different negative spherical aberrations.

Higher order aberration comparison between two aspherical intraocular lenses: MC6125AS and Akreos advanced optics

AIM: To compare higher order aberrations in two aspherical intraocular lenses(IOLs): Akreos advanced optics(AO) and Dr. Schmidt Microcrystalline 6125 aspheric anterior surface(MC6125AS) with each other. METHODS: Forty eyes of 39 patients underwent phacoemulsification and Akreos AO and MC6125 AS were implanted in their eyes in a random manner. Three months post-operatively, higher order aberrations including spherical aberration, coma aberration, and total aberrations were measured and compared.RESULTS: The total aberration was 0.24±0.17 in eyes with Dr. Schmidt and 0.20 ±0.01 in eyes with Akreos AO(P =0.361). The mean of coma aberration was 0.17 ±0.21 and 0.09 ±0.86 in Dr. Schmidt and Akreos lenses,respectively(P =0.825). Total spherical aberration was almost the same in both groups(mean: 0.05, P =0.933).Best corrected visual acuity in Akreos AO(0.10±0.68) and Dr. Schmidt(0.09±0.67) did not differ significantly(P =0.700). CONCLUSION: There is no statistically significant difference in the higher order aberrations between these two aspherical lenses.

Comparison of visual quality after implantation of Al-UV and SN60WF aspheric intraocular lens

AIM:To compare the visual performance of pseudophakic eyes implanted with Al-UV and SN60WF aspheric intraocular lens(IOL),and to investigate the correlations between visual quality parameters and pupil size.METHODS:This prospective comparative study included 105 eyes of 90 patients with age-related cataract who underwent uneventful phacoemulsification.The subjects were divided into two groups according to the implanted IOL type.Three months postoperatively,visual acuity and contrast sensitivity were measured,wave-front aberrations were assessed using a KR-IW aberrometer(Topcon),and objective optical quality parameters were performed using an optical quality analysis system-OQAS Il(Visiometrics).Independent sample Mest and Spearman correlation analysis were used for data analysis.RESULTS:There were no significant differences found in visual acuity,contrast sensitivity and visual quality parameters between the two groups(P>0.05).The measured intraocular spherical aberration(SA)in Al-UV IOL eyes of-0.19±0.05 pm was close to the designed SA value of-0.20 pm.The modulation transfer function cutoff,Strehl ratio and OQAS values were negatively correlated with pupil size in both groups(P<0.01).CONCLUSION:The subjective and objective visual quality in pseudophakic eyes with A1-UV and SN60WF IOLs are comparable.For aspheric IOL eyes,visual quality decreases with increasing pupil size.

Clinical outcomes of a new diffractive multifocal intraocular lens

AIM：To evaluate clinical outcomes after implantation of a new diffractive aspheric multifocal intraocular lens（IOL） with ＋3.00 addition power.METHODS：This is a retrospective,consecutive case series of cataract patients who underwent bilateral implantation of the Optiflex MO/HF D012（Moss Vision Inc.Ltd,London,UK） multifocal IOL.Patients followed for 6 mo were included in the study.Data on distance,intermediate and near visual acuity,refractive error [manifest spherical equivalent（MSE）],contrast sensitivity,adverse events,subjective symptoms,spectacle independence and patient satisfaction [visual function questionnaire（VFQ）-25 questionnaire] were retrieved from electronic medical records and analyzed.RESULTS：Forty eyes of 20 patients with a mean age of 66.7±8.5 y（range：53-82） were included in the study.Mean uncorrected distance,near and intermediate visual acuity remained stable through postoperative visits and was 0.19±0.19 log MAR,Jaeger 4 and Jaeger 3 respectively at the 6 mo visit.At the end of postoperative 6 mo,MSE was-0.14±0.42 diopters（D） and 98% of the eyes were within 1.00 D of target refraction.Postoperative low contrast（10%） visual acuity remained stable（P=0.54） through follow up visits with a mean of 0.35±0.17 log MAR at the 6 mo visit.There were no reported adverse events.None of the patients reported subjective symptoms of halo or glare.Spectacle independence rate was 90%.Mean VFQ-25 questionnaire score was 93.5±6.12.CONCLUSION：The Optiflex MO/HF-DO12 IOL was safely implanted and successfully restored distance,intermediate and near visual acuity without impairing contrast sensitivity.High levels of spectacle independence were achieved at all distances including intermediate distance.

Design of double-zone aspheric diffractive intraocular lens with extended depth of focus

A double-zone aspheric diffractive intraocular lens （IOL） was designed and manufactured aiming to regain a continuous range of clear vision for pseudophakic presbyopia. After obtaining the IOL structure parameters through optimization based on an aphakic model eye, its imaging performances were analyzed in the model eye. The modulation transfer function at 50 cycles/mm remained above 0.29 within ±5° field of view for object distance ranging from 6 to 0.66 m. In addition, the imaging qualities are robust for pupil changes, polychromatic light, and different corneal asphericities. The manufactured IOL exhibits the abilitv to extend depth of focus.

超声乳化术联合SBL-3区域折射型非球面IOL治疗年龄相关白内障的效果及对视觉质量的影响

目的 探究超声乳化术联合SBL-3区域折射型非球面人工晶状体(IOL)治疗年龄相关白内障的效果及对视觉质量的影响。方法 选取2022年1—12月收治的年龄相关白内障110例,采用随机数字表法分为单焦点组55例和SBL-3组55例,单焦点组予超声乳化术联合ADAPT AO非球面单焦点IOL植入,SBL-3组给予超声乳化术联合SBL-3区域折射型非球面IOL植入。比较2组术后3个月对比敏感度[明光、暗光、明光炫光、暗光炫光],术前和术后3个月视觉质量[客观散射指数(OSI)、斯特列尔比(SR)、调制传递函数截止频率(MTF cut off)]、视力[最佳矫正近视力(BCNVA)、最佳矫正远视力(BCDVA)、远视矫正下的近视力(DCNVA)]及生活质量[视功能与生存质量问卷(VF-QOL)]。结果 术后3个月,SBL-3组对比敏感度高于单焦点组(P<0.05);术后3个月,2组OSI、BCNVA、BCDVA、DCNVA水平均较术前降低,SBL-3组低于单焦点组(P<0.05);术后3个月,2组SR、MTF cut off水平及VF-QOL评分均较术前升高,SBL-3组高于单焦点组(P<0.05)。结论 超声乳化术联合SBL-3区域折射型非球面IOL能够提高年龄相关白内障患者对比敏感度及视觉质量,改善视力水平及生活质量。

Comparison of higher-order aberrations and contrast sensitivity between Tecnis Z9001 and CeeOn 911A intraocular lenses:a prospective randomized study

Background The advent of wavefront technology in the past five years has provided some insight into the optical outcomes of cataract surgery. The Tecnis Z9001 intraocular lens （Tecnis IOL, AMO） with a modified prolate anterior surface was claimed to reduce or even eliminate ocular spherical aberration to improve the visual quality. The purpose of this study was to determine whether Tecnis IOLs can improve the quality of vision as evaluated by measuring visual acuity, wavefront aberration, and contrast sensitivity. Methods In an intraindividual prospective study, 20 patients with bilateral cataract were randomly assigned to receive a modified prolate anterior surface IOL （Tecnis Z9001, AMO） in one eye and a biconvex spherical surface IOL （CeeOn 911A, AMO） in the other. After 3 months, the following were investigated： best corrected visual acuity, pupil diameter, photopic and mesopic contrast sensitivity, and wavefront aberration of the whole eye （ocular）, cornea, and internal plane. Results The differences in the best corrected visual acuity and pupil diameter between the two groups were not statistically significant. Negative 4th-order spherical aberration （Z4^0） was found in the Tecnis group, whereas positive Z4^0 found in the CeeOn group for the internal and ocular plane. Statistically significant differences were found at the ocular higher-aberrations between the two IOLs. Contrast sensitivity testing showed significantly better results in the Tecnis group at visual angles higher than 1.0 degree under photopic conditions and at visual angles higher than 1.6 degree under mesopic conditions both without glare and with glare in comparison with the CeeOn group. Conclusions The Tecnis Z9001 IOL with a modified prolate anterior surface produces negative spherical aberration and consequently reduces the higher-order aberrations in pseudophakic eyes. This leads to enhanced contrast sensitivity and improved functional vision compared to conventional spherical IOLs.

基于Zemax非球面单透镜的优化设计

非球面光学元件具有增加光学设计自由度、校正像差、减少光学元件数量和质量、简化光学系统结构等优点,已经广泛应用于放大镜、眼镜镜片、照相透镜、天文光学系统、军用光电系统等领域。基于平行光束中球面单透镜的三级球差理论,针对最小球差和平凸单透镜两种情况,理论分析结果表明:消球差单透镜的二次曲面面形参数只和单透镜的弯曲形状、折射率有关,和单透镜表面曲率无关。文章在光学设计软件Zemax中对单个非球面透镜光学系统进行优化设计,仿真结果表明非球面单透镜光学系统球差大幅减小,在0°、3.5°和5°三个视场下光斑的几何半径分别为11.7796μm、12.5355μm和12.9464μm,场曲和畸变明显减小,系统的整体成像质量提高。

球面及非球面散光矫正型人工晶状体植入术后的裸眼视力对比

目的:比较术前伴有角膜散光的白内障患者在植入球面散光矫正型人工晶状体和非球面散光矫正型人工晶状体术后的裸眼视力,并探讨术前角膜散光的程度对散光矫正型人工晶状体植入术后裸眼远视力的提高程度的影响。方法:收集患者44例57眼的病例资料,其中球面组有23例27眼,非球面组有21例30眼,记录术前及术后1d裸眼远视力(UDVA)、术前角膜散光度数、人工晶状体型号及等效球镜度数、术中人工晶状体轴位。比较两组术前与术后1d裸眼远视力(LogM AR)差别以及术后1d裸眼视力0.4以上患者的比例,并按散光度数进行分层,散光度数小于2.0D为低散光层,散光度数≥2.0D为中高散光层,比较两组术后裸眼远视力的提高效果。结果:球面组和非球面组术后1d裸眼远视力0.4以上患者比例分别为92.6%、93.3%,与术前14.8%、13.3%相比明显增加。两组术前、术后1d裸眼远视力比较,差异无统计学意义(P>0.05);两组术后1d裸眼远视力与术前相比均明显提高,差异有统计学意义(P<0.01)。各散光层内两种人工晶状体植入术后裸眼视力的差异无统计学意义(P>0.05);植入术后1d裸眼远视力与术前相比均明显提高,差异有统计学意义(P<0.01)。术前不同程度散光的白内障患者在植入散光矫正型人工晶状体后,术后裸眼远视力之间的差异无统计学意义(P>0.05);植入术后1d裸眼远视力与术前相比均明显提高,差异有统计学意义(P<0.01)。结论:球面及非球面散光矫正型人工晶状体植入可以有效地提高白内障合并角膜散光患者的裸眼远视力,但在提高裸眼视力方面,非球面散光矫正型人工晶状体并不优于球面散光矫正型人工晶状体。

非球面人工晶状体植入术后视觉质量评价

目的评价非球面设计的人工晶状体AcrySofIQ对提高老年性白内障患者术后视功能的作用。方法采用同期临床对照研究,超声乳化白内障吸出联合人工晶状体植入术后的老年性白内障患者132例（160眼）,其中植入AcrySofIQ IOL60例76眼,为IQ组;植入AcrySof Natural 72例84眼,为Natural组。观察患者的术后视力、对比敏感度和眩光敏感度、球差和并发症,问卷调查患者不良视觉症状和满意度。结果术后3个月,IQ组裸眼视力（uncorrected visual acuity,UCVA）为4.92±0.10,最佳矫正视力（best corrected visual acuity,BCVA）为5.02±0.10;Natural组UCVA为4.89±0.12,BCVA为5.00±0.09;差异均无统计学意义（P〉0.05）。低、中、高各频段对比敏感度和眩光敏感度IQ组为47.44±10.95、27.72±6.69、7.62±2.04和40.61±10.48、22.73±6.88、6.38±1.22;Natural组为31.55±6.68、24.67±5.49、6.17±1.43、27.27±5.78、17.62±3.90、4.83±0.82,差异有统计学意义（P〈0.01）。球差IQ组为（0.09±0.04）μm,Natural组为（0.52±0.17）μm,差异有统计学意义（t=22.15,P=0.000）。问卷结果显示IQ组较Natural组术后眩光、光晕的发生率低,患者满意度高。结论非球面人工晶状体AcrySof IQ在一定程度上平衡了角膜的正球差,减少了人工晶状体眼的球差,提高了对比敏感度和眩光敏感度,改善了视觉质量,获得了患者满意的效果。

不同球差非球面人工晶状体植入术后的视觉质量分析

目的比较个性化选择0、-0.20μm、-0.27μm三种不同球差非球面人工晶状体(intraocular lens,IOL)及其随机植入术后的视觉质量,探讨最佳矫正球差值。方法前瞻性病例对照研究。选取就诊于我科的白内障患者125例(145眼),术前使用i Trace全视觉功能分析仪测量角膜高阶像差,根据角膜球差(spherical aberation,SA)值的不同分为A、B、C三组,分别植入三种不同SA非球面IOL,对照组(D组)随机植入非球面IOL。术后3个月分析全眼及角膜的高阶像差、调制传递函数(modulation transfer function,MTF)、斯泰尔比值(Strehl ratio,SR)、最佳矫正视力(best corrected visual acuity,BCVA)。结果 (1)手术前后角膜SA差异无统计学意义(P>0.05),全眼慧差(Coma)、三叶草差(Trefoil)及总高阶像差(total high order aherration,t HOA)手术前后的变化与角膜SA的变化相似。(2)三组患者BCVA差异无统计学意义(P>0.05)。(3)3 mm瞳孔直径下,四组IOL眼的角膜SA、全眼MTF t HOA及SR差异均无统计学意义(均为P>0.05);全眼SA差异有统计学意义(P=0.019),A组、B组、C组间差异无统计学意义(P>0.05),但均<D组(P=0.000)。(4)5 mm瞳孔直径下,四组IOL眼角膜SA差异无统计学意义(P>0.05);全眼SA、t HOA差异均有统计学意义(均为P=0.000),A、B、C三组间差异无统计学意义(P>0.05),但均<D组(P=0.000);全眼MTF t HOA及SR差异均有统计学意义(均为P<0.05),A、B、C三组间差异无统计学意义(P>0.05),但均>D组(P=0.000)。结论超声乳化白内障吸出术前后角膜高阶像差无差异。小瞳孔直径下,不同SA设计非球面IOL眼术后视觉质量比较无差异。大瞳孔直径下,根据术前SA个性化选择较随机植入非球面IOL眼可获得较好的视觉质量。

非球面AcrySof ReSTOR +3.0D多焦点人工晶状体的临床应用

目的:比较白内障超声乳化联合植入非球面AcrySofReSTOR+3D与非球面AcrySof ReSTOR+4D术后人工晶状体眼的视功能状态及患者的主观满意度,评价非球面AcrySof ReSTOR+3D人工晶状体的临床效果及应用价值。方法:收集我院超声乳化联合非球面+3D植入56例60眼为实验组,非球面+4D58例60眼为对照组。术后3mo行裸眼远、中、近视力及最佳矫正远、近视力,角膜散光度,对比敏感度检查及问卷调查(视觉干扰、满意度及脱镜率),并对数据进行统计学分析。结果:两组术后裸眼远、近视力及最佳矫正远、近视力无明显差异(P>0.05),中距离视力实验组(0.68±0.13)明显优于对照组(0.55±0.08),差异显著(P<0.05);术前散光0.75±0.13D,单切口术后角膜散光0.41±0.15D;术前散光1.25±0.18D,双切口术后角膜散光0.72±0.21D,术前术后比较差异有统计学意义(P<0.05)。各空间频率对比敏感度组间无明显差异(P>0.05)。两组术后均无明显夜视力下降、眩光、光晕等视觉干扰现象(P>0.05),在满意度评价上,视远及视近方面两组患者满意度无明显差异(P>0.05),中距离实验组满意度明显高于对照组(P<0.05),实验组脱镜率明显高于对照组(P<0.05)。结论:非球面AcrySof ReSTOR+3D人工晶状体为患者提供良好的远、中、近全程视力和视觉质量,尤其中距离视力比+4D有明显改善,实现了患者高度满意率和脱镜率。因此我们认为非球面AcrySof ReSTOR+3D有良好的临床效果及广泛的临床应用价值。

非球面与球面人工晶状体植入术后对比敏感度的比较

目的观察非球面人工晶状体(IOL)和球面IOL植入术后在视力相同的情况下其对比敏感度的差异。方法收集行超声乳化联合IOL植入术的年龄相关性白内障患者49例(60眼),其中植入非球面IOL Tecnis ZA9003者24例30眼,植入球面IOLSensar AR40e者25例30眼,所有病例术后裸眼LogMAR视力均>0.1。术后3个月时采用CSV-1000对比敏感度测试仪分别测量明视、暗视和眩光状态下的对比敏感度,用F.A.C.T对比敏感度表测量近距离对比敏感度。结果在明视和暗视状态下的对比敏感度,非球面IOL组均高于球面IOL组,两组在空间频率6、12、18周/度时的差异均有统计学意义(P<0.05);暗视眩光状态下的对比敏感度,非球面IOL组高于球面IOL组,两组在各空间频率的差异均有统计学意义(P<0.05)。F.A.C.T对比敏感度测试卡测得的对比敏感度,非球面IOL组高于球面IOL组,两组在各空间频率的差异均有统计学意义(P<0.05)。结论在传统的视力表检查视力正常和相同的情况下,非球面IOL植入术后较球面IOL植入术后患眼具有较好的对比敏感度,提示非球面IOL可以提高功能视力。

年龄相关性白内障人群角膜球面像差的分布及影响因素

目的：探讨年龄相关性白内障患者角膜球面像差的分布情况及其影响因素,旨在为非球面人工晶状体在白内障患者术中应用提供科学的理论依据。方法：回顾性研究在我院眼科住院的年龄相关性白内障患者509例610眼,iTrace视觉功能分析仪检查角膜球面像差、角膜曲率、角膜散光及角膜Q值,采用SPSS 16.0统计软件进行统计学分析。结果：角膜球面像差波动范围为0~1.800μm;角膜球面像差平均值为0.266±0.010μm;角膜球面像差与年龄、角膜曲率及角膜散光无明显相关性（r=0.71,0.56,0.93,P〉0.05）;角膜球面像差与Q值呈正相关（r=0.086,P=0.03）。结论：年龄相关性白内障患者角膜球面像差存在明显的个体化差异,在选择消除角膜正球差的非球面人工晶状体时,要根据患者的个体差异来做出个性化的选择。

非球面人工晶状体囊袋内植入术后稳定性变化的对比研究

目的探讨非球面人工晶状体(IOL)不同的设计类型对其囊袋内植入术后眼内稳定性的影响。方法选取我院2016年6月至2017年10月期间行白内障超声乳化吸除联合IOL囊袋内植入术患者120例(120只眼),随机分为4组,分别植入4种不同类型非球面IOL [四襻亲水丙烯酸酯IOL (AO) 31只眼,一片式平板丙烯酸酯IOL (36A) 30只眼,一片式双襻丙烯酸酯IOL (IQ) 29只眼,三片式双襻硅胶混合物IOL (KS-AiN) 30只眼],测量各组术后1周、1个月、3个月时IOL在囊袋内的偏心量和倾斜度,并进行比较。结果术后1周内,4组IOL平均偏心量由小到大依次为AO、36A、IQ、KS-AiN,平均倾斜度由小到大依次为36A、AO、IQ、KS-AiN,差异均有统计学意义(均P <0.01)。术后1周、1个月、3个月,各组IOL的平均偏心量、平均倾斜度的组内差异均有统计学意义(P <0.05),且随时间推移各组IOL的平均偏心量、平均倾斜度均呈递增趋势。结论多襻支撑IOL眼内稳定性优于双襻支撑,一片式优于三片式,丙烯酸酯材料优于硅凝胶材料。

非球面与球面人工晶状体植入术后高阶像差及对比度视力的比较

目的:比较非球面和球面人工晶状体植入术后波前像差、裸眼远视力、最佳矫正远视力、对比度视力的差异。方法:年龄相关性白内障患者46例50眼,将其随机分成两组,球面人工晶状体组(A组)23例24眼术中植入ACR6DSE球面人工晶状体;非球面人工晶状体组(B组)23例26眼术中植入具有负球面像差Acri.Smart36A非球面人工晶状体。术后3mo,观察两组患者的裸眼视力、最佳矫正视力、暗背景(25cd/m2)和高亮背景(255cd/m2)下的对比度视力、瞳孔直径(6mm)时的球面像差、彗差和高阶像差的均方根是否存在差异。结果:两组患者术后裸眼远视力、最佳矫正远视力比较差异无统计学意义,亮背景下各对比度视力以及暗背景下100%,25%对比度视力两组比较差异无统计学意义,暗背景下5%,10%低对比度时B组视力好于A组。瞳孔直径6mm时,B组高阶像差的均方根(RMS)、球差、彗差和A组比较差异均有统计学意义,B组RMS、球差、彗差低于A组。结论:Acri.Smart36A非球面人工晶状体植入术后与ACR6DSE球面人工晶状体比较可以明显的减少患者的高阶像差,改善患者的术后暗环境下的低对比度视力。