中华眼科杂志
中華眼科雜誌
중화안과잡지
Chinese Journal of Ophthalmology
2015年
4期
270-275
,共6页
喻芳%常平骏%李瑾%周用谋%赵云娥
喻芳%常平駿%李瑾%週用謀%趙雲娥
유방%상평준%리근%주용모%조운아
晶体,人工%角膜波前像差%像差测量%视敏度
晶體,人工%角膜波前像差%像差測量%視敏度
정체,인공%각막파전상차%상차측량%시민도
Lenses,intraocular%Corneal wavefront aberration%Aberrometry%Visual acuity
目的 比较白内障摘除术后一片式与三片式非球面人工晶状体(IOL)的偏心量和倾斜度及其对眼内像差的影响.方法 前瞻性临床病例对照研究.根据随机数字表法将49例(72只眼)白内障患者随机分成两组,一组植入Tecnis ZCB00型IOL(美国AMO公司,一片式),即ZCB00组,另一组植入Tecnis ZA9003型IOL(美国AMO公司,三片式),即ZA9003组.术后3个月利用Pentacam三维眼前节成像系统测量IOL的偏心和45°、90°、135°及180°方向上的倾斜度;利用iTrace视觉功能分析仪采集眼内像差.两组IOL的偏心量、倾斜度和眼内像差各指标行独立样本t检验,而倾斜度和偏心量对眼内像差的影响采用Pearson相关进行分析.结果 患者年龄在50～80岁之间.术后3个月两组最佳矫正视力(BCVA)≥0.5,其中ZA9003组的BCVA与3.0 mm和5.0 mm瞳孔直径下眼内的Z3(散光)均呈正相关(r=0.504,P=0.003;r=0.637,P=0.000),而与Z13(四阶散光)均呈负相关(r=-0.476,P=0.005;r=-0.531,P=0.001).ZCB00组在90°和135°方向上的倾斜分别为(0.50±0.33)°、(0.69±0.41)°均较ZA9003组(0.90±0.78)°、(0.98±0.73)°小,差异具有统计学意义(t=2.899,P=0.005;t=2.120,P=0.038).5.0 mm瞳孔下,ZCB00的离焦(Z4)、散光(Z5)、三阶彗差(Z8)、四阶散光(Z11)和四阶球差(Z12)均低于ZA9003组,差异具有统计学意义(t=2.372,P=0.021;t=2.801,P=0.007;t=3.269,P=0.002;t=3.230,P=0.002;t=3.468,P=0.001).ZA9003组90°方向上的倾斜与3.0 mm和5.0 mm瞳孔下的四阶散光(Z13)均呈正相关(r=0.396,P=0.023;r=0.378,P=0.030);其偏心值与3.0 mm瞳孔下的Z13呈负相关(r=-0.441,P=0.010).结论 一片式与三片式IOL均有良好囊袋内稳定性,前者更稳定且视觉质量略优;前者偏心和倾斜与眼内像差之间不存在显著相关性,后者偏心和倾斜与不同瞳孔直径下的眼内四阶散光之间存在显著相关性.
目的 比較白內障摘除術後一片式與三片式非毬麵人工晶狀體(IOL)的偏心量和傾斜度及其對眼內像差的影響.方法 前瞻性臨床病例對照研究.根據隨機數字錶法將49例(72隻眼)白內障患者隨機分成兩組,一組植入Tecnis ZCB00型IOL(美國AMO公司,一片式),即ZCB00組,另一組植入Tecnis ZA9003型IOL(美國AMO公司,三片式),即ZA9003組.術後3箇月利用Pentacam三維眼前節成像繫統測量IOL的偏心和45°、90°、135°及180°方嚮上的傾斜度;利用iTrace視覺功能分析儀採集眼內像差.兩組IOL的偏心量、傾斜度和眼內像差各指標行獨立樣本t檢驗,而傾斜度和偏心量對眼內像差的影響採用Pearson相關進行分析.結果 患者年齡在50～80歲之間.術後3箇月兩組最佳矯正視力(BCVA)≥0.5,其中ZA9003組的BCVA與3.0 mm和5.0 mm瞳孔直徑下眼內的Z3(散光)均呈正相關(r=0.504,P=0.003;r=0.637,P=0.000),而與Z13(四階散光)均呈負相關(r=-0.476,P=0.005;r=-0.531,P=0.001).ZCB00組在90°和135°方嚮上的傾斜分彆為(0.50±0.33)°、(0.69±0.41)°均較ZA9003組(0.90±0.78)°、(0.98±0.73)°小,差異具有統計學意義(t=2.899,P=0.005;t=2.120,P=0.038).5.0 mm瞳孔下,ZCB00的離焦(Z4)、散光(Z5)、三階彗差(Z8)、四階散光(Z11)和四階毬差(Z12)均低于ZA9003組,差異具有統計學意義(t=2.372,P=0.021;t=2.801,P=0.007;t=3.269,P=0.002;t=3.230,P=0.002;t=3.468,P=0.001).ZA9003組90°方嚮上的傾斜與3.0 mm和5.0 mm瞳孔下的四階散光(Z13)均呈正相關(r=0.396,P=0.023;r=0.378,P=0.030);其偏心值與3.0 mm瞳孔下的Z13呈負相關(r=-0.441,P=0.010).結論 一片式與三片式IOL均有良好囊袋內穩定性,前者更穩定且視覺質量略優;前者偏心和傾斜與眼內像差之間不存在顯著相關性,後者偏心和傾斜與不同瞳孔直徑下的眼內四階散光之間存在顯著相關性.
목적 비교백내장적제술후일편식여삼편식비구면인공정상체(IOL)적편심량화경사도급기대안내상차적영향.방법 전첨성림상병례대조연구.근거수궤수자표법장49례(72지안)백내장환자수궤분성량조,일조식입Tecnis ZCB00형IOL(미국AMO공사,일편식),즉ZCB00조,령일조식입Tecnis ZA9003형IOL(미국AMO공사,삼편식),즉ZA9003조.술후3개월이용Pentacam삼유안전절성상계통측량IOL적편심화45°、90°、135°급180°방향상적경사도;이용iTrace시각공능분석의채집안내상차.량조IOL적편심량、경사도화안내상차각지표행독립양본t검험,이경사도화편심량대안내상차적영향채용Pearson상관진행분석.결과 환자년령재50～80세지간.술후3개월량조최가교정시력(BCVA)≥0.5,기중ZA9003조적BCVA여3.0 mm화5.0 mm동공직경하안내적Z3(산광)균정정상관(r=0.504,P=0.003;r=0.637,P=0.000),이여Z13(사계산광)균정부상관(r=-0.476,P=0.005;r=-0.531,P=0.001).ZCB00조재90°화135°방향상적경사분별위(0.50±0.33)°、(0.69±0.41)°균교ZA9003조(0.90±0.78)°、(0.98±0.73)°소,차이구유통계학의의(t=2.899,P=0.005;t=2.120,P=0.038).5.0 mm동공하,ZCB00적리초(Z4)、산광(Z5)、삼계혜차(Z8)、사계산광(Z11)화사계구차(Z12)균저우ZA9003조,차이구유통계학의의(t=2.372,P=0.021;t=2.801,P=0.007;t=3.269,P=0.002;t=3.230,P=0.002;t=3.468,P=0.001).ZA9003조90°방향상적경사여3.0 mm화5.0 mm동공하적사계산광(Z13)균정정상관(r=0.396,P=0.023;r=0.378,P=0.030);기편심치여3.0 mm동공하적Z13정부상관(r=-0.441,P=0.010).결론 일편식여삼편식IOL균유량호낭대내은정성,전자경은정차시각질량략우;전자편심화경사여안내상차지간불존재현저상관성,후자편심화경사여불동동공직경하적안내사계산광지간존재현저상관성.
Purpose To compare the tilt and decentration between a single-piece and a 3-piece aspheric intraocular lens (IOL),and the impact of these factors on the HOAs after phacoemulsification and IOL implanted in capsular bag.Methods It is a prospective randomized clinical trial.According to the table of random number,72 eyes of 49 patients were divided into 2 groups.One group received a 1-piece aspheric IOL (Tecnis ZCBO0,AMO) and a 3-piece aspheric IOL (Tecnis ZA9003,AMO) in the other group.The tilt at 45°,90°,135° and180° and decentration of the IOL were obtained using Scheimphlug system (Pentacam,Oculus) and image-analysis 3 months after the surgery.The internal ocular HOA of the IOL were evaluated with iTrace examination.The tilt and decentration of the IOL and the variables of the internal ocular HOAs were compared by independent-samples t test.The effect of tilt and decentration on the HOAs was assessed by Pearson correlation analysis.Results Patients age ranged from 50 to 80 years.The best corrected visual acuity (BCVA) of both group were all not less than 0.5.In 3-piece IOLs group,there was a significant positive correlation between the BCVA and the astigmatism (Z3) (r=0.504,P=0.003;r=0.637,P=0.000) and a significant negative correlation between the BCVA and the fourth-order astigmatism (Z13) (r=-0.476,P=0.005;r=-0.531,P=0.001) at 3.0 mm and 5.0 mm pupil.The mean tilt at 90° (vertical) and 135°of the 3-piece aspheric IOL group [(0.90±0.78)° and (0.98±0.73)°,respectively] were higher than those in 1-piece aspheric IOL group [(0.50±0.33)° and (0.69±0.41)°,respectively],the differences were statistically significant (t=2.899,P=0.005;t=2.120,P=0.038).At 5.0 mm pupil,the defocus (Z4),astigmatism (Z5),third-order coma(Z8),fourth-order astigmatism (Z11) and fourth-order spherical (Z12) in 3-piece aspheric IOLs group were higher than those in 1-piece aspheric IOL group,the difference were statistically significant (t=2.372,P=0.021;t=2.801,P=0.007;t=3.269,P=0.002;t=3.230,P=0.002;t=3.468,P=0.001).In 3-piece IOL group,a significant positive correlation was found between the mean tilt and the fourth-order astigmatism (Z13) at 3.0 mm and 5.0 mm pupil (r=0.396,P=0.023;r=0.378,P=0.030),and a significant negative correlation was also found between the decentration and the fourth-order astigmatism (Z13) with at 3.0 mm pupil (r=-0.441,P =0.010).Conclusions Both 1-piece and 3-piece IOL designs showed well stability in capsular bag,the former was slightly more stable with better visual quality.There was no significant correlation between the internal ocular HOA and the degrees of IOL tilt and decentration in the 1-piece aspheric IOL group.At different pupil diameters,a significant correlation was found between the decentration and tilt of IOL and fourth-order astigmatism Z (13) in the 3-piece IOL group.
