CAJ | 학술논문

目的比较两种非球面人工晶状体(intraocular lens,IOL)植入眼6mm瞳孔直径下全眼高阶像差及调制传递函数(modulation transfer function,MTF)值以及不同高阶像差影响下MTF值的变化,分析两组IOL眼MTF值的差异及导致差异的主要高阶像差因素以及影响各组MTF值的主要高阶像差因素.方法临床病例对照研究.对2010年9月至2011年3月在天津眼科医院就诊的病人,选取单纯性老年性白内障患者74例(80只眼),随机分组植入IOL,Ⅰ组Akreos AO;Ⅱ组TecnisZA9003.术后3个月散瞳后行iTrace视功能分析仪测量两组IOL眼6mm瞳孔直径全眼高阶像差、总高阶像差(tHOA) MTF值及分别去除Zernike主要项C3-3～C3+3、C40以及不同阶S3、S4、S5后高阶像差的MTF值,独立样本t检验比较两组高阶像差、MTF (tHOA)及去除不同高阶像差后的MTF值,配对样本t检验比较各组内去除不同高阶像差后的MTF值与MTF (tHOA)的差异.结果 (1)6 mm瞳孔直径,两组全眼球差C40差异有统计学意义.两组MTF (tHOA)差异有统计学意义,去除C40后的MTF值差异无统计学意义,分别去除C3-3～C3+3各项后的MTF值差异均有统计学意义.(2)Ⅰ组去除C3-3～C3+3、C40后MTF值在(5～30) c/d均有提高,去除C40后MTF值在(5～30) c/d提高最为显著；Ⅱ组去除C3-3～C3+3后MTF值在(5～30) c/d均有提高,去除C40后MTF值在(5～30) c/d无明显变化,去除C3-3后MTF值在(5～30) c/d提高最为显著.(3)Ⅰ组去除S3、S4后MTF值在(5～30) c/d均提高,去除S5后MTF值在(5、10) c/d提高,S3、S4对MTF值的影响大于S5.Ⅱ组去除S3后MTF值在(5～30) c/d提高最为显著.结论 6 mm瞳孔直径下,两组MTF (tHOA)存在差异,球差C40是导致差异的主要高阶像差因素；C40及S4、S3对Akreos AO IOL眼MTF值影响较大,垂直三叶草C3-3及S3对Tecnis ZA9003 IOL眼MTF值影响较大.
목적 비교량충비구면인공정상체(intraocular lens,IOL)식입안6mm동공직경하전안고계상차급조제전체함수(modulation transfer function,MTF)치이급불동고계상차영향하MTF치적변화,분석량조IOL안MTF치적차이급도치차이적주요고계상차인소이급영향각조MTF치적주요고계상차인소.방법 림상병례대조연구.대2010년9월지2011년3월재천진안과의원취진적병인,선취단순성노년성백내장환자74례(80지안),수궤분조식입IOL,Ⅰ조Akreos AO;Ⅱ조TecnisZA9003.술후3개월산동후행iTrace시공능분석의측량량조IOL안6mm동공직경전안고계상차、총고계상차(tHOA) MTF치급분별거제Zernike주요항C3-3～C3+3、C40이급불동계S3、S4、S5후고계상차적MTF치,독립양본t검험비교량조고계상차、MTF (tHOA)급거제불동고계상차후적MTF치,배대양본t검험비교각조내거제불동고계상차후적MTF치여MTF (tHOA)적차이.결과 (1)6 mm동공직경,량조전안구차C40차이유통계학의의.량조MTF (tHOA)차이유통계학의의,거제C40후적MTF치차이무통계학의의,분별거제C3-3～C3+3각항후적MTF치차이균유통계학의의.(2)Ⅰ조거제C3-3～C3+3、C40후MTF치재(5～30) c/d균유제고,거제C40후MTF치재(5～30) c/d제고최위현저；Ⅱ조거제C3-3～C3+3후MTF치재(5～30) c/d균유제고,거제C40후MTF치재(5～30) c/d무명현변화,거제C3-3후MTF치재(5～30) c/d제고최위현저.(3)Ⅰ조거제S3、S4후MTF치재(5～30) c/d균제고,거제S5후MTF치재(5、10) c/d제고,S3、S4대MTF치적영향대우S5.Ⅱ조거제S3후MTF치재(5～30) c/d제고최위현저.결론 6 mm동공직경하,량조MTF (tHOA)존재차이,구차C40시도치차이적주요고계상차인소；C40급S4、S3대Akreos AO IOL안MTF치영향교대,수직삼협초C3-3급S3대Tecnis ZA9003 IOL안MTF치영향교대.
Objective To analyze higher-order aberration,modulation transfer function (MTF)and the changes of MTF value with or without different mode higher-order aberration in eyes implanted with two different types of intraocular lens (IOL) at 6mm pupil diameter. Methods A total of 80 eyes (74 patients) were divided into two groups randomly.Group I implanted with Akreos AO IOL,Group Ⅱ implanted with Tecnis ZA9003 IOL.The iTrace was used to measure higher-order aberrations,MTF value of total higher-order aberration (tHOA),MTF value without different Zernike mode (C3-3～C3+3,C40) and different mode of higher-order aberration (S3,S4,S5).The independent samples t test and paired-t test was used to assess the data. Results ①The spherical aberration C40of total eyes was significantly different between the two groups,while the tHOA was not.The MTF value without C40 was not significantly different while the MTF (tHOA) and the MTF value without C3-3～C3+3 respectively was significantly different between the two groups at 6mm pupil diameter.②In group,the MTF value improved at (5～30) cycle per degree (c/d) without C3-3～C3+3,C40 respectively and the MTF value got the most improvement without C40; while in group Ⅱ,the MTF value improved at (5～30) c/d without C3-3～C3+3 respectively and there was no significantly improvement of MTF value without C40 at (5～30) c/d,the MTF value got the most improvement without C3-3.③In group Ⅰ,the MTF value improved at (5～30) c/d without S3,S4 respectively and improved at (5～10) c/d without S5.The MTF value without S3,S4 respectively increased more than without S5;while in group Ⅱ,the MTF value got the most improvement at (5～30) c/d without S3. Conclusions The MTF (tHOA) is different between the two groups,and the spherical aberration C40 is responsible for the difference.C40 and S4,S3 show a more significant effect in the eyes implanted with Akreos AO IOL,vertical trefoil C3-3 and S3 show a more significant effect in the eyes implanted with Tecnis ZA9003 IOL.