CAJ | 학술논문

目的比较非球面或球面Toric IOL植入术后年龄相关性白内障患者的视觉质量.方法前瞻性研究.选择2012年5月至2013年6月在天津医科大学眼科医院就诊的术前角膜散光为1.00～3.00D的年龄相关性白内障患者89例(100只眼),分为非球面(IQ Toric)组和球面(Toric)组.其中非球面(IQ Toric)组44例(50只眼)患者超声乳化白内障吸除术后植入Acrysof IQ Toric IOL(SN6AT),球面(Toric)组45例(50只眼)患者植入Acrysof Toric IOL (SN60TT).患者平均年龄为(73.7±6.6)岁,术前平均散光为(1.68±0.51)D.术后3个月评估两组的裸眼视力、矫正视力、残余眼散光和轴位旋转,并采用CSV-1000E对比敏感测试仪分别进行明视状态、暗视状态及暗视眩光状态下的对比敏感度检查,采用iTrace波前像差仪进行波前像差检查,选取3.0 mm和5.0 mm瞳孔下的全眼的总高阶像差和总球差的均方根进行分析,运用视觉质量分析系统测量两组间的客观散射指数、MTF截止频率、斯特列尔比和3种不同对比度(OV100％、OV20％和OV9％)的模拟视力.使用Studentt检验分析正态分布数据;使用Mann-Whitney U检验分析非正态分布数据.结果术后3个月非球面组和球面组的裸眼视力分别为LogMAR 0.19±0.11和LogMAR 0.21±0.11;矫正视力分别为LogMAR 0.08±0.09和LogMAR 0.10±0.10;残余眼散光分别为(0.50±0.30)D和(0.59±0.32)D;轴位旋转分别为3.74°±1.88°和3.84°±1.68°,两组间相比较差异均无统计学意义(U=1135.50,P=0.414;U=1118.52,P=0.342;U=1035.00,P=0.128,t=0.28,P=0.780).非球面组在暗视及暗视眩光状态下中高空间频率的对比敏感度明显高于球面组,两组间差异有统计学意义.非球面组在瞳孔直径3.0 mm的球差均方根值及瞳孔直径5.0 mm的总高阶像差和球差均方根值明显小于球面组,两组间差异有统计学意义(t=3.49,P=0.003;t=6.46,P＜0.01;U=0.00,P＜0.01).非球面组和球面组视觉质量分析系统中的客观散射指数分别是1.69±0.7和1.65±0.77,MTF截止频率分别是(23.21±5.41) cpd和(25.01±5.46) cpd,斯特列尔比分别是0.14±0.04和0.16±0.04,OV100％分别是0.77±0.18和0.83±0.18,OV20％分别是0.77±0.18和0.79±0.21,OV9％分别是0.75±0.20和0.78±0.17,但两组间相比较差异均无统计学意义(t=0.26,P=0.795;t=1.66,P=0.100;t=1.92,P=0.057;t=1.72,P=0.089;t=0.39,P=0.693;t=0.98,P=0.328).结论 IQ Toric IOL和Toric IOL均可有效及安全地矫正白内障患者的术前角膜散光,IQ ToricIOL植入术后的视觉质量更优于ToricIOL. 目的比較非毬麵或毬麵Toric IOL植入術後年齡相關性白內障患者的視覺質量.方法前瞻性研究.選擇2012年5月至2013年6月在天津醫科大學眼科醫院就診的術前角膜散光為1.00～3.00D的年齡相關性白內障患者89例(100隻眼),分為非毬麵(IQ Toric)組和毬麵(Toric)組.其中非毬麵(IQ Toric)組44例(50隻眼)患者超聲乳化白內障吸除術後植入Acrysof IQ Toric IOL(SN6AT),毬麵(Toric)組45例(50隻眼)患者植入Acrysof Toric IOL (SN60TT).患者平均年齡為(73.7±6.6)歲,術前平均散光為(1.68±0.51)D.術後3箇月評估兩組的裸眼視力、矯正視力、殘餘眼散光和軸位鏇轉,併採用CSV-1000E對比敏感測試儀分彆進行明視狀態、暗視狀態及暗視眩光狀態下的對比敏感度檢查,採用iTrace波前像差儀進行波前像差檢查,選取3.0 mm和5.0 mm瞳孔下的全眼的總高階像差和總毬差的均方根進行分析,運用視覺質量分析繫統測量兩組間的客觀散射指數、MTF截止頻率、斯特列爾比和3種不同對比度(OV100％、OV20％和OV9％)的模擬視力.使用Studentt檢驗分析正態分佈數據;使用Mann-Whitney U檢驗分析非正態分佈數據.結果術後3箇月非毬麵組和毬麵組的裸眼視力分彆為LogMAR 0.19±0.11和LogMAR 0.21±0.11;矯正視力分彆為LogMAR 0.08±0.09和LogMAR 0.10±0.10;殘餘眼散光分彆為(0.50±0.30)D和(0.59±0.32)D;軸位鏇轉分彆為3.74°±1.88°和3.84°±1.68°,兩組間相比較差異均無統計學意義(U=1135.50,P=0.414;U=1118.52,P=0.342;U=1035.00,P=0.128,t=0.28,P=0.780).非毬麵組在暗視及暗視眩光狀態下中高空間頻率的對比敏感度明顯高于毬麵組,兩組間差異有統計學意義.非毬麵組在瞳孔直徑3.0 mm的毬差均方根值及瞳孔直徑5.0 mm的總高階像差和毬差均方根值明顯小于毬麵組,兩組間差異有統計學意義(t=3.49,P=0.003;t=6.46,P＜0.01;U=0.00,P＜0.01).非毬麵組和毬麵組視覺質量分析繫統中的客觀散射指數分彆是1.69±0.7和1.65±0.77,MTF截止頻率分彆是(23.21±5.41) cpd和(25.01±5.46) cpd,斯特列爾比分彆是0.14±0.04和0.16±0.04,OV100％分彆是0.77±0.18和0.83±0.18,OV20％分彆是0.77±0.18和0.79±0.21,OV9％分彆是0.75±0.20和0.78±0.17,但兩組間相比較差異均無統計學意義(t=0.26,P=0.795;t=1.66,P=0.100;t=1.92,P=0.057;t=1.72,P=0.089;t=0.39,P=0.693;t=0.98,P=0.328).結論 IQ Toric IOL和Toric IOL均可有效及安全地矯正白內障患者的術前角膜散光,IQ ToricIOL植入術後的視覺質量更優于ToricIOL.
목적 비교비구면혹구면Toric IOL식입술후년령상관성백내장환자적시각질량.방법 전첨성연구.선택2012년5월지2013년6월재천진의과대학안과의원취진적술전각막산광위1.00～3.00D적년령상관성백내장환자89례(100지안),분위비구면(IQ Toric)조화구면(Toric)조.기중비구면(IQ Toric)조44례(50지안)환자초성유화백내장흡제술후식입Acrysof IQ Toric IOL(SN6AT),구면(Toric)조45례(50지안)환자식입Acrysof Toric IOL (SN60TT).환자평균년령위(73.7±6.6)세,술전평균산광위(1.68±0.51)D.술후3개월평고량조적라안시력、교정시력、잔여안산광화축위선전,병채용CSV-1000E대비민감측시의분별진행명시상태、암시상태급암시현광상태하적대비민감도검사,채용iTrace파전상차의진행파전상차검사,선취3.0 mm화5.0 mm동공하적전안적총고계상차화총구차적균방근진행분석,운용시각질량분석계통측량량조간적객관산사지수、MTF절지빈솔、사특렬이비화3충불동대비도(OV100％、OV20％화OV9％)적모의시력.사용Studentt검험분석정태분포수거;사용Mann-Whitney U검험분석비정태분포수거.결과 술후3개월비구면조화구면조적라안시력분별위LogMAR 0.19±0.11화LogMAR 0.21±0.11;교정시력분별위LogMAR 0.08±0.09화LogMAR 0.10±0.10;잔여안산광분별위(0.50±0.30)D화(0.59±0.32)D;축위선전분별위3.74°±1.88°화3.84°±1.68°,량조간상비교차이균무통계학의의(U=1135.50,P=0.414;U=1118.52,P=0.342;U=1035.00,P=0.128,t=0.28,P=0.780).비구면조재암시급암시현광상태하중고공간빈솔적대비민감도명현고우구면조,량조간차이유통계학의의.비구면조재동공직경3.0 mm적구차균방근치급동공직경5.0 mm적총고계상차화구차균방근치명현소우구면조,량조간차이유통계학의의(t=3.49,P=0.003;t=6.46,P＜0.01;U=0.00,P＜0.01).비구면조화구면조시각질량분석계통중적객관산사지수분별시1.69±0.7화1.65±0.77,MTF절지빈솔분별시(23.21±5.41) cpd화(25.01±5.46) cpd,사특렬이비분별시0.14±0.04화0.16±0.04,OV100％분별시0.77±0.18화0.83±0.18,OV20％분별시0.77±0.18화0.79±0.21,OV9％분별시0.75±0.20화0.78±0.17,단량조간상비교차이균무통계학의의(t=0.26,P=0.795;t=1.66,P=0.100;t=1.92,P=0.057;t=1.72,P=0.089;t=0.39,P=0.693;t=0.98,P=0.328).결론 IQ Toric IOL화Toric IOL균가유효급안전지교정백내장환자적술전각막산광,IQ ToricIOL식입술후적시각질량경우우ToricIOL.
Objective To compare the optical quality after two different types (aspheric and spheric) of toric intraocular lens implantation.Methods The study was a prospective study.One hundred eyes of 89 patients with regular corneal astigmatism (range 1.00 D to 3.00 D) underwent implantation of toric intraocular lens in the Tianjin Medical University Eye Hospital from May 2012 to June 2013,including 50 eyes of 44 patients implanted Acrysof IQ Toric IOL(SN6AT) (aspheric group) and 50 eyes of 45 patients implanted Acrysof Toric IOL(SN60TT) (spheric group).Mean age was 73.7 years ±6.6 and mean astigmatism was 1.68±0.51D.Main outcomes of two groups evaluated at 3-months of follow-up,included uncorrected distance visual acuity (UDVA),corrected distance visual acuity (CDVA),residual refractive cylinder and IOL rotation.Contrast sensitivity testing was performed under photopic,mesopic and mesopic with glare conditions using the CSV-1000E charts.Ocular higher order aberrations,including total higher order aberrations and spherical aberration,were measured at optical zone of 3.0 and 5.0 mm using iTrace aberrometer.Objective optical quality was measured using optical quality analysis system(OQAS),included MTF cutoff,OSI,Strehl ratio,OV100％,OV20％ and OV9％.The Student t test was performed for data with normal distribution.The Mann-Whitney U test was performed for data with no normal distribution.Results Postoperatively,the mean UDVA of aspheric and spheric group were 0.19 ±0.11 and 0.21±0.11 LogMAR respectively;the mean CDVA were 0.08±0.09 and 0.10±0.10 LogMAR respectively;the mean residual refractive cylinder were 0.50± 0.30D and 0.59± 0.32D respectively;the mean absolute misalignment were 3.74± 1.88 degrees and 3.84± 1.68 degrees respectively.No statistically significant differences were noted between groups in mean UDVA,CDVA,residual refractive cylinder and absolute misalignment(U=1135.50,P=0.414;U=1118.52,P=0.342;U=1035,P=0.128 and t=0.28,P=0.780,respectively).Aspheric group performed better than spheric group under mesopic and mesopic glare conditions at moderate and high spatial frequency.Mean ocular spherical aberration of aspheric group at 3.0 mm pupil was significantly less than spheric group and mean total higher order aberrations and spherical aberration of aspheric group at 5.0 mm pupil were less than spheric group (t=3.49,P=0.003;t=6.46,P＜0.001 and U=0.00,P＜0.001,respectively).The mean MTFcutoff of aspheric and spheric group were(23.207±5.409) cpd and (25.01±5.46) cpd,the mean OSI were 1.69±0.7 and 1.65±0.77,the mean Strehl ratio were 0.14±0.04 and 0.16±0.04,the mean OV100％ were 0.77±0.18 and 0.83±0.18,the mean OV20％were 0.77±0.18 and 0.79±0.21,and the mean OV9％ were 0.75±0.20 and 0.78±0.17.No statistically significant differences were noted between groups in mean MTFcutoff,OSI,Strehl ratio,OV100％,OV20％ and OV9％(t=0.26,P=0.795;t=1.66,P=0.100;t=1.92,P=0.057;t=1.72,P=0.089;t=0.39,P=0.693 and t=0.98,P=0.328,respectively).Conclusions Both aspheric and spheric toric IOL implantation were an effective and safe method to correct corneal astigmatism during cataract surgery.Moreover,aspheric toric IOL performed better optical quality than spheric toric IOL.