高阶像差对白内障人工晶状体植入术后视觉质量的影响

doi:10.6040/j.issn.1673-3770.0.2021.551

摘要/Abstract

摘要： 在白内障患者日益增长的视觉期望和人工晶状体设计进步的推动下,白内障手术现在已经发展成为一种屈光手术,眼的高阶像差是影响视觉质量的重要因素,球差、彗差、三叶草差等高阶像差反映不同的光学特性,可从多方面影响视觉质量,进行屈光性白内障手术需尽可能减少高阶像差。非球面人工晶状体通过补偿球差、降低总高阶像差较球面人工晶状体改善了视觉质量。多焦点与单焦点人工晶状体的选择需结合患者使用需求及术前评估,多焦点人工晶状体植入术后并发症的解决手段也在探究中;回顾人眼高阶像差的作用机制,就人眼高阶像差与视觉质量的关系及影响、不同类型人工晶状体对高阶像差的影响进行综述,以期为白内障患者个性化选择人工晶状体提供新的参考,改善患者术后视觉质量。

关键词: 白内障, 视觉质量, 人工晶状体, 高阶像差

Abstract: With the development of cataract surgery technology and continuous improvement in people's requirements for a better quality of life, traditional cataract surgery has been changed to refractive surgery. High-order aberrations, including spherical aberrations, comas, and trefoil aberrations, are important factors affecting visual quality—they represent different optical characteristics that could be affected by various aspects. The use of an aspheric intraocular lens improves visual quality by compensating for the spherical aberration and reducing total higher-order aberrations. To that end, the choice regarding the use of multifocal or monofocal intraocular lenses should consider the patients' demands and the preoperative evaluation. Moreover, treatments for complications regarding multifocal intraocular lenses should also be explored. We reviewed the mechanisms of higher-order aberrations, the relationship between higher-order aberrations and visual quality, and the effects of different types of intraocular lenses on high-order aberrations. This paper aimed to provide a new reference for individualized intraocular lens selection in patients with cataract in order to provide better visual quality to the patients.

Key words: Cataract, Visual quality, Intraocular lens, High-order aberration

中图分类号:

R776.1

黄子彦综述段国平审校. 高阶像差对白内障人工晶状体植入术后视觉质量的影响[J]. 山东大学耳鼻喉眼学报, 2022, 36(6): 13-18.

HUANG ZiyanOverview,DUAN GuopingGuidance. Effect of higher-order aberrations on visual quality after cataract intraocular lens implantation[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(6): 13-18.

参考文献

[1] Du W, Lou W, Wu Q. Personalized aspheric intraocular lens implantation based on corneal spherical aberration: a review[J]. Int J Ophthalmol, 2019, 12(11): 1788-1792. doi:10.18240/ijo.2019.11.19.
[2] Hughes RP, Vincent SJ, Read SA, et al. Higher order aberrations, refractive error development and myopia control: a review[J]. Clin Exp Optom, 2020, 103(1): 68-85. doi:10.1111/cxo.12960.
[3] 毕宏生. 精准屈光性白内障手术规划[J]. 山东大学耳鼻喉眼学报, 2017, 31(4): 1-4. doi: 10.6040/j.issn.1673-3770.1.2017.026. BI Hongsheng. Design of treatment protocol in refractive cataract surgery is important for postoperative visual outcomes[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2017, 31(4): 1-4. doi: 10.6040/j.issn.1673-3770.1.2017.026.
[4] 黄秀旗, 兰长骏, 廖萱, 等. 双通道视觉质量分析系统在球面和非球面人工晶状体眼视觉质量评价中的应用[J]. 眼科新进展, 2019, 39(10): 964-968. doi:10.13389/j.cnki.rao.2019.0220. HUANG Xiuqi, LAN Changjun, LIAO Xuan, et al. Evaluation of visual quality of spherical and aspheric intraocular lenses by dual channel optical quality analysis system[J]. Recent Advances in Ophthalmology, 2019, 39(10): 964-968. doi:10.13389/j.cnki.rao.2019.0220.
[5] Chang DH, Rocha KM. Intraocular lens optics and aberrations[J]. Curr Opin Ophthalmol, 2016, 27(4): 298-303. doi:10.1097/ICU.0000000000000279.
[6] 李史序, 王静, 赵江月, 等. 应用iTrace视觉功能分析仪测量双眼角膜像差的一致性[J]. 眼科新进展, 2019, 39(1): 63-67. doi:10.13389/j.cnki.rao.2019.0014. LI Shixu, WANG Jing, ZHAO Jiangyue, et al. Consistency analysis on the corneal aberration expressed by iTrace visual function analyzer[J]. Recent Advances in Ophthalmology, 2019, 39(1): 63-67. doi:10.13389/j.cnki.rao.2019.0014.
[7] 任雁琳, 史春生, 姜波. FS-LASIK矫正不同程度近视术后角膜高阶像差的早期变化[J]. 国际眼科杂志, 2021, 21(5): 796-799. doi:10.3980/j.issn.1672-5123.2021.5.09. REN Yanlin, SHI Chunsheng, JIANG Bo. Early changes of the corneal higher-order aberrations after femtosecond laser-assisted in situ keratomileusis for different degrees of myopia[J]. International Eye Science, 2021, 21(5): 796-799. doi:10.3980/j.issn.1672-5123.2021.5.09.
[8] 王飞, 卢奕, 蒋永祥, 等. 白内障超声乳化术切口对角膜高阶像差的影响[J]. 中国眼耳鼻喉科杂志, 2008, 8(3): 154-156. doi:10.3969/j.issn.1671-2420.2008.03.006. WANG Fei, LU Yi, JIANG Yongxiang, et al. Effects of small-incisions on corneal high-order aberrations after phacoemulsification[J]. Chinese Journal of Ophthalmology and Otorhinolaryngology, 2008, 8(3): 154-156. doi:10.3969/j.issn.1671-2420.2008.03.006.
[9] Ruan XT, Liu ZZ, Luo LX, et al. The structure of the lens and its associations with the visual quality[J]. BMJ Open Ophthalmol, 2020, 5(1): e000459. doi:10.1136/bmjophth-2020-000459.
[10] Li XJ, Wang Y, Dou R. Aberration compensation between anterior and posterior corneal surfaces after Small incision lenticule extraction and Femtosecond laser-assisted laser in situ keratomileusis[J]. Ophthalmic Physiol Opt, 2015, 35(5): 540-551. doi:10.1111/opo.12226.
[11] Zhang M, Jing QH, Chen JH, et al. Analysis of corneal higher-order aberrations in cataract patients with high myopia[J]. J Cataract Refract Surg, 2018, 44(12): 1482-1490. doi:10.1016/j.jcrs.2018.07.048.
[12] Oshika T, Klyce SD, Applegate RA, et al. Changes in corneal wavefront aberrations with aging[J]. Invest Ophthalmol Vis Sci, 1999, 40(7): 1351-1355.
[13] Pérez-Gracia J, Varea A, Ares J, et al. Evaluation of the optical performance for aspheric intraocular lenses in relation with tilt and decenter errors[J]. PLoS One, 2020, 15(5): e0232546. doi:10.1371/journal.pone.0232546.
[14] von Sonnleithner C, Bergholz R, Gonnermann J, et al. Clinical results and higher-order aberrations after 1.4-mm biaxial cataract surgery and implantation of a new aspheric intraocular lens[J]. Ophthalmic Res, 2015, 53(1): 8-14. doi:10.1159/000364808.
[15] Tan QQ, Lin J, Tian J, et al. Objective optical quality in eyes with customized selection of aspheric intraocular lens implantation[J]. BMC Ophthalmol, 2019, 19(1): 152. doi:10.1186/s12886-019-1162-6.
[16] 刘彧琦, 王静, 张劲松. 非恒定像差非球面人工晶状体的研究现状与进展[J]. 国际眼科杂志, 2019, 19(2): 248-251. doi:10.3980/j.issn.1672-5123.2019.2.14. LIU Yuqi, WANG Jing, ZHANG Jinsong. Research status and progress of non-constant aberration aspherical IOL[J]. International Eye Science, 2019, 19(2): 248-251. doi:10.3980/j.issn.1672-5123.2019.2.14.
[17] Steinwender G, Strini S, Glatz W, et al. Depth of focus after implantation of spherical or aspheric intraocular lenses in hyperopic and emmetropic patients[J]. J Cataract Refract Surg, 2017, 43(11): 1413-1419. doi:10.1016/j.jcrs.2017.08.012.
[18] 蔡芳菲, 郑广瑛, 王华君, 等. 角膜Q值引导下个体化人工晶状体植入术后视觉质量的临床观察[J]. 中华眼科杂志, 2017, 53(11): 814-820. doi:10.3760/cma.j.issn.0412-4081.2017.11.004. CAI Fangfei, ZHENG Guangying, WANG Huajun, et al. Clinical observation of visual quality after the individual implantation of intraocular lens guided by corneal Q value[J]. Chinese Journal of Ophthalmology, 2017, 53(11): 814-820. doi:10.3760/cma.j.issn.0412-4081.2017.11.004.
[19] Poyales F, Garzón N, Rico L, et al. Comparison of visual performance between two aspheric monofocal intraocular lens models[J]. Clin Exp Optom, 2021: 1-7. doi:10.1080/08164622.2021.2009737.
[20] Ferreira TB, Almeida A. Comparison of the visual outcomes and OPD-scan results of AMO tecnis toric and alcon acrysof IQ toric intraocular lenses[J]. J Refract Surg, 2012, 28(8): 551-556. doi:10.3928/1081597x-20120703-03.
[21] Montés-Micó R, Ferrer-Blasco T, Cervño A. Analysis of the possible benefits of aspheric intraocular lenses: review of the literature[J]. J Cataract Refract Surg, 2009, 35(1): 172-181. doi:10.1016/j.jcrs.2008.09.017.
[22] Pérez-Vives C, Ferrer-Blasco T, García-Lázaro S, et al. Optical quality comparison between spherical and aspheric toric intraocular lenses[J]. Eur J Ophthalmol, 2014, 24(5): 699-706. doi:10.5301/ejo.5000440.
[23] Eom Y, Yoo E, Kang SY, et al. Change in efficiency of aspheric intraocular lenses based on pupil diameter.[J]. American Journal of Ophthalmology, 2013, 155(3):492-498. doi:10.1016/j.ajo.2012.09.024.
[24] Yamaguchi T, Negishi K, Ono T, et al. Feasibility of spherical aberration correction with aspheric intraocular lenses in cataract surgery based on individual pupil diameter[J]. J Cataract Refract Surg, 2009, 35(10):1725-1733. doi:10.1016/j.jcrs.2009.05.031.
[25] Miháltz K, Vécsei-Marlovits PV. The impact of visual axis position on the optical quality after implantation of multifocal intraocular lenses with different asphericity values[J]. Graefes Arch Clin Exp Ophthalmol, 2021, 259(3): 673-683. doi:10.1007/s00417-020-05052-5.
[26] Ashena Z, Maqsood S, Ahmed SN, et al. Effect of intraocular lens tilt and decentration on visual acuity, Dysphotopsia and wavefront aberrations[J]. Vision(Basel), 2020, 4(3): 41. doi:10.3390/vision4030041.
[27] 单玉琴, 郑广瑛, 李莉, 等. 区域折射型多焦点人工晶状体植入术与单焦点人工晶状体植入术中长期视觉质量比较[J]. 中华实验眼科杂志, 2020, 38(4): 348-354. doi:10.3760/cma.j.cn115985-20190902-00379. SHAN Yuqin, ZHENG Guangying, LI Li, et al. Comparison of medium and long term visual quality between regional refractive multifocal intraocular lens implantation and unifocal intraocular lens implantation[J]. Chinese Journal of Experimental Ophthalmology, 2020, 38(4): 348-354. doi:10.3760/cma.j.cn115985-20190902-00379.
[28] 王文莹, 王军, 张晶, 等. 多焦点与单焦点非球面人工晶状体植入后视觉质量的临床观察[J]. 中华眼科杂志, 2010, 46(8): 686-690. doi:10.3760/cma.j.issn.0412-4081.2010.08.004. WANG Wenying, WANG Jun, ZHANG Jing, et al. Clinical observation on visual quality in patients implanted with monofocal and multifocal aspheric intraocular lenses[J]. Chinese Journal of Ophthalmology, 2010, 46(8): 686-690. doi:10.3760/cma.j.issn.0412-4081.2010.08.004.
[29] Liao X, Lin J, Tian J, et al. Evaluation of optical quality: ocular scattering and aberrations in eyes implanted with diffractive multifocal or monofocal intraocular lenses[J]. Curr Eye Res, 2018, 43(6): 696-701. doi:10.1080/02713683.2018.1449220.
[30] Peng C, Zhao JY, Ma LW, et al. Optical performance after bilateral implantation of apodized aspheric diffractive multifocal intraocular lenses with +3.00-D addition power[J]. Acta Ophthalmol, 2012, 90(8): e586-e593. doi:10.1111/j.1755-3768.2012.02497.x.
[31] 计菁, 罗敏, 范先群, 等. 衍射型多焦点人工晶体与单焦点人工晶体植入术后的临床观察[J]. 上海交通大学学报(医学版), 2011, 31(8): 1073-1077. doi:10.3969/j.issn.1674-8115.2011.08.005. JI Jing, LUO Min, FAN Xianqun, et al. Clinical observations of monofocal intraocular lens and multifocal intraocular lens implantation in cataract surgery[J]. Journal of Shanghai Jiao Tong University(Medical Science), 2011, 31(8): 1073-1077. doi:10.3969/j.issn.1674-8115.2011.08.005.
[32] Wang SY, Stem MS, Oren G, et al. Patient-centered and visual quality outcomes of premium cataract surgery: a systematic review[J]. Eur J Ophthalmol, 2017, 27(4): 387-401. doi:10.5301/ejo.5000978.
[33] Liu XM, Xie LX, Huang YS. Effects of decentration and tilt at different orientations on the optical performance of a rotationally asymmetric multifocal intraocular lens[J]. J Cataract Refract Surg, 2019, 45(4): 507-514. doi:10.1016/j.jcrs.2018.10.045.
[34] Pilger D, Homburg D, Brockmann T, et al. Clinical outcome and higher order aberrations after bilateral implantation of an extended depth of focus intraocular lens[J]. Eur J Ophthalmol, 2018, 28(4): 425-432. doi:10.1177/1120672118766809.
[35] Yeu E, Cuozzo S. Matching the patient to the intraocular lens: preoperative considerations to optimize surgical outcomes[J]. Ophthalmology, 2021, 128(11): e132-e141. doi:10.1016/j.ophtha.2020.08.025.
[36] 魏佩佩. 多焦点人工晶体植入术后的视觉质量及并发症[J]. 山东大学耳鼻喉眼学报, 2021, 35(2): 141-146. doi:10.6040/j.issn.1673-3770.0.2020.164. WEI Peipei. Visual quality and complications after implantation of multifocal intraocular lens[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(2): 141-146. doi:10.6040/j.issn.1673-3770.0.2020.164.
[37] He WW, Qiu XD, Zhang SH, et al. Comparison of long-term decentration and tilt in two types of multifocal intraocular lenses with OPD-Scan Ⅲ aberrometer[J]. Eye(Lond), 2018, 32(7): 1237-1243. doi:10.1038/s41433-018-0068-5.
[38] Shin E, Yoo YS, Choi SH, et al. Clinical outcomes of topography-guided femtosecond laser-assisted in situ keratomileusis after multifocal intraocular lens implantation[J]. Sci Rep, 2020, 10(1): 10666. doi:10.1038/s41598-020-67726-8.
[39] Zhong YY, Zhu YN, Wang W, et al. Femtosecond laser-assisted cataract surgery versus conventional phacoemulsification: comparison of internal aberrations and visual quality[J]. Graefe's Arch Clin Exp Ophthalmol, 2022, 260(3): 901-911. doi:10.1007/s00417-021-05441-4.

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