中华实验眼科杂志
中華實驗眼科雜誌
중화실험안과잡지
CHINESE JOURNAL OF EXPERIMENTAL OPHTHALMOLOGY
2013年
9期
875-880
,共6页
人工晶状体/非球面%球差%视觉质量%角膜Q值%对比敏感度%白内障
人工晶狀體/非毬麵%毬差%視覺質量%角膜Q值%對比敏感度%白內障
인공정상체/비구면%구차%시각질량%각막Q치%대비민감도%백내장
Intraocular lens/aspheric%Spherical aberration%Visual quality%Corneal Q value%Contrast sensitivity%Cataract
背景 非球面人工晶状体(IOL)旨在降低白内障术后眼球球差,以获得更好的视觉质量.如何个性化地选择非球面IOL是尚待解决的问题.目的 对比分析白内障患者植入负球差IOL和零球差IOL后术眼波前像差及视觉质量的差异.观察角膜Q值与术后眼球球差的相关性,推测角膜Q值能否作为选择非球面IOL的参数.方法 收集年龄相关性白内障患者90例104眼,采用随机数字表法将患眼分为2个组,负球差IOL组46例52眼植入Tecnis Z9001型负球差IOL,零球差IOL组44例52眼植入Akreos AO型零球差IOL.术前测量所有患者角膜Q值,计算平均值(Q),将负球差IOL组中术前角膜Q值≤Q及＞Q的患者分别亚分为A1组25眼,A2组27眼；零球差IOL组中术前角膜Q值≤(Q)及＞(Q)的患者分别亚分为B1组29眼,B2组23跟.术后3个月检查各组患者角膜Q值,5 mm瞳孔直径下眼球球差、彗差及总高阶像差的均方根(RMS)值及暗视条件下6 mm瞳孔直径时对比敏感度(CS)及眩光对比敏感度(GS).结果 手术前与手术后角膜Q值差异无统计学意义(t=1.447,P=O.151).负球差IOL组眼球球差(0.059-±0.047) μm,低于零球差10L组(0.110±0.066) μm,差异有统计学意义(t=-4.567,P=O.000),负球差IOL组中频段、高频段CS好于零球差IOL组,差异均有统计学意义(t=2.495、2.359,P＜0.05).2个组彗差、总高阶像差差异均无统计学意义(P＞0.05).2个组患者手术前、手术后角膜Q值分别与术后眼球球差均呈弱相关(术前:r=0.277、0.292,术后:r=0.285、0.325,P＜0.05).A1与A2组,B1与B2组之间眼球球差,CS、GS间差异均无统计学意义(P＞0.05).结论 负球差IOL眼拥有比零球差IOL眼更小的球差和更好的暗视CS.角膜Q值可能不宜单独作为选择非球面IOL的参数.
揹景 非毬麵人工晶狀體(IOL)旨在降低白內障術後眼毬毬差,以穫得更好的視覺質量.如何箇性化地選擇非毬麵IOL是尚待解決的問題.目的 對比分析白內障患者植入負毬差IOL和零毬差IOL後術眼波前像差及視覺質量的差異.觀察角膜Q值與術後眼毬毬差的相關性,推測角膜Q值能否作為選擇非毬麵IOL的參數.方法 收集年齡相關性白內障患者90例104眼,採用隨機數字錶法將患眼分為2箇組,負毬差IOL組46例52眼植入Tecnis Z9001型負毬差IOL,零毬差IOL組44例52眼植入Akreos AO型零毬差IOL.術前測量所有患者角膜Q值,計算平均值(Q),將負毬差IOL組中術前角膜Q值≤Q及＞Q的患者分彆亞分為A1組25眼,A2組27眼；零毬差IOL組中術前角膜Q值≤(Q)及＞(Q)的患者分彆亞分為B1組29眼,B2組23跟.術後3箇月檢查各組患者角膜Q值,5 mm瞳孔直徑下眼毬毬差、彗差及總高階像差的均方根(RMS)值及暗視條件下6 mm瞳孔直徑時對比敏感度(CS)及眩光對比敏感度(GS).結果 手術前與手術後角膜Q值差異無統計學意義(t=1.447,P=O.151).負毬差IOL組眼毬毬差(0.059-±0.047) μm,低于零毬差10L組(0.110±0.066) μm,差異有統計學意義(t=-4.567,P=O.000),負毬差IOL組中頻段、高頻段CS好于零毬差IOL組,差異均有統計學意義(t=2.495、2.359,P＜0.05).2箇組彗差、總高階像差差異均無統計學意義(P＞0.05).2箇組患者手術前、手術後角膜Q值分彆與術後眼毬毬差均呈弱相關(術前:r=0.277、0.292,術後:r=0.285、0.325,P＜0.05).A1與A2組,B1與B2組之間眼毬毬差,CS、GS間差異均無統計學意義(P＞0.05).結論 負毬差IOL眼擁有比零毬差IOL眼更小的毬差和更好的暗視CS.角膜Q值可能不宜單獨作為選擇非毬麵IOL的參數.
배경 비구면인공정상체(IOL)지재강저백내장술후안구구차,이획득경호적시각질량.여하개성화지선택비구면IOL시상대해결적문제.목적 대비분석백내장환자식입부구차IOL화령구차IOL후술안파전상차급시각질량적차이.관찰각막Q치여술후안구구차적상관성,추측각막Q치능부작위선택비구면IOL적삼수.방법 수집년령상관성백내장환자90례104안,채용수궤수자표법장환안분위2개조,부구차IOL조46례52안식입Tecnis Z9001형부구차IOL,령구차IOL조44례52안식입Akreos AO형령구차IOL.술전측량소유환자각막Q치,계산평균치(Q),장부구차IOL조중술전각막Q치≤Q급＞Q적환자분별아분위A1조25안,A2조27안；령구차IOL조중술전각막Q치≤(Q)급＞(Q)적환자분별아분위B1조29안,B2조23근.술후3개월검사각조환자각막Q치,5 mm동공직경하안구구차、혜차급총고계상차적균방근(RMS)치급암시조건하6 mm동공직경시대비민감도(CS)급현광대비민감도(GS).결과 수술전여수술후각막Q치차이무통계학의의(t=1.447,P=O.151).부구차IOL조안구구차(0.059-±0.047) μm,저우령구차10L조(0.110±0.066) μm,차이유통계학의의(t=-4.567,P=O.000),부구차IOL조중빈단、고빈단CS호우령구차IOL조,차이균유통계학의의(t=2.495、2.359,P＜0.05).2개조혜차、총고계상차차이균무통계학의의(P＞0.05).2개조환자수술전、수술후각막Q치분별여술후안구구차균정약상관(술전:r=0.277、0.292,술후:r=0.285、0.325,P＜0.05).A1여A2조,B1여B2조지간안구구차,CS、GS간차이균무통계학의의(P＞0.05).결론 부구차IOL안옹유비령구차IOL안경소적구차화경호적암시CS.각막Q치가능불의단독작위선택비구면IOL적삼수.
Background Aspheric intraocular lens (IOL) is designed to reduce the spherical aberration of the eye after cataract surgery and to obtain better visual quality.However,the selection of a personalized aspheric IOL is a problem to be solved.Objective This study was to compare the wavefront aberration and quality of vision of patients between the implantation of negative spherical aberration IOL and non-aberration IOL,and to investigate the relationship between corneal Q values and postoperative spherical aberration.Methods One hundred and four eyes of 90 patients with age-related cataract were randomized into two groups.Fifty-two eyes of 46 patients who received a Tecnis Z9001 IOL implantation were assigned as the negative spherical aberration IOL group and 52 eyes of 44 patients who received Akreos AO IOL without aberration were assigned as the non-aberration IOL group.The preoperative corneal Q values were measured and the mean Q value(Q)was computed.Then the patients in the two groups were further divided into 2 subgroups,respectively,based on their Q values were over or below (Q）.The corneal Q values,root mean square(RMS) of ocular spherical aberration,coma and total higher-order aberrations(HOAs) for 5 mm diameter pupil,scotopic contrast sensitivity with or without glare at 6 mm pupil diameter were measured 3 months after surgery.Results The pre-and post-operative corneal Q values were insignificantly changed (t =1.447,P =0.151).The spherical aberration in the negative spherical aberration IOL group was(0.059-±0.047)μm,and that in the non-aberration IOL group was(0.110±0.066)μm,with a statistically significant difference between them (t =-4.567,P=0.000).Scotopic contrast sensitivities at intermediate and high frequencies were significantly better in the negative spherical aberration IOL group than in the non-aberration IOL group (t =2.495,t =2.359,P ＜ 0.05).There was no significant difference in coma and HOAs between the two groups after operation (P ＞ 0.05).Weak positive correlations were seen between the pre-and post-operative corneal Q values and spherical aberration in the two groups(r=0.277,0.292,0.285,0.325,all at P＜0.05).However,no significant differences were found in spherical aberration,contrast sensitivity and scotopic contrast sensitivity between the different subgroups (P ＞ 0.05).Conclusions Negative spherical aberration IOL has lower spherical aberration and better scotopic contrast sensitivity than non-aberration IOL.The results suggest that it may be not enough to choose the corneal Q value only as the single reference criterion for selection of aspheric IOL.
