人工晶状体Alpha角对连续视程人工晶状体眼视觉质量的影响

doi:10.6040/j.issn.1673-3770.0.2024.322

摘要/Abstract

摘要： 目的探讨IOL Alpha角对连续视程人工晶体(extended depth-of-field intraocular lens, EDOF IOL)植入术后视觉质量的影响。方法选取行白内障超声乳化联合EDOF IOLs植入术的年龄相关性白内障患者50例(50只眼)。采用OPD-Scan Ⅲ像差分析仪的日-夜瞳孔测量系统,得到人工晶状体(intraocular len, IOL)植入术后Alpha角,根据光学路径差扫描仪Ⅲ(Optical Path Difference Scan Ⅲ, OPD Scan Ⅲ)测量术后IOL Alpha角大小分为3组:A组19只眼(0 mm< Alpha角≤0.2 mm),B组19只眼(0.2 mm< Alpha角≤0.4 mm),C组12只眼(Alpha角>0.4 mm)。采用 OPD-Scan Ⅲ像差分析仪检测术前Alpha角;术后 3 个月检测裸眼远视力(uncorrected distance visual acuity, UDVA),OPD-Scan Ⅲ测量EDOF IOLs植入眼的客观视觉质量,包括眼内高阶像差(higher-order aberrations, HOA)、斯特列尔比(strehl ratio, SR)、全眼HOA、彗差(Coma)、三叶草像差(Trefoil)并进行比较分析。采用视功能指数量表-14(visual function index, VF-14)评估患者的视功能。结果术前Alpha角与IOL Alpha角差异不具有统计学意义(t=0.11,P=0.915)。经Pearson相关性分析,术前Alpha角与IOL Alpha角之间呈正相关(r=0.983,P<0.001)。IOL Alpha角三组间UDVA、眼内HOA、SR、全眼HOA、Coma、Trefoil差异都具有统计学意义(P均<0.05)。眼内HOA、SR值及Coma值组间两两比较均有统计学差异(P均<0.05);Trefoil值及全眼HOA值仅在A组与C组之间差异具有统计学意义(P=0.030,P=0.001)。VF-14问卷调查显示A、B、C组眩光或光晕的发病率分别为47.4%(9/19)、68.4%(13/19)和100%(12/12),差异具有统计学意义(χ2=9.365,P=0.009)。结论 IOL Alpha角可反映IOL居中性及在眼内的实际状态,其不仅影响术后患者视觉质量、反映其术后实际视觉效果,较大的IOL Alpha角还会增加术后眩光、光晕发生率,进而影响患者生活质量。

关键词: Alpha角, 光学路径差扫描仪Ⅲ, 连续视程人工晶体, 视觉质量

Abstract: Objective To study the effect of the IOL Alpha angle on visual quality following the implantation of the EDOF IOL(ZXR00). Methods A total of 50 cases(50 eyes)that underwent phacoemulsification combined with EDOF IOL implantation were included in the study. Preoperative and IOL Alpha angle assessments were conducted using the OPD Scan Ⅲ wavefront aberrometer. The study eyes were then categorized into three distinct groups based on the IOL Alpha angle values ascertained: Group A(19 eyes, 0 mm < Alpha angle ≤0.2 mm), Group B(19 eyes, 0.2 mm < Alpha angle≤0.4 mm), and Group C(12 eyes, Alpha angle >0.4 mm). UDVA was recorded three months postoperatively. The OPD Scan Ⅲ was employed to evaluate intraocular aberrations, including SR, total HOA, Coma and Trefoil. The assessment of photic phenomena were conducted utilising the Visual Functioning Index-14. Results The preoperative and IOL Alpha angle were no statistically significant difference(t=0.11, P=0.915). Pearson correlation analysis revealed a significant positive correlation between the preoperative and the IOL Alpha angle(r=0.983, P<0.001). The differences in UDVA, intraocular aberration, SR, total HOA, Coma and Trefoil values among the three groups were statistically significant(all P<0.05). Statistically significant differences in intraocular aberrations were observed in pairwise comparisons among groups(all P<0.05). A statistically significant difference in Trefoil values was found between Group A and Group C(P=0.030), as well as in total HOA values between these two groups(P=0.001). The results of the questionnaire survey indicated that the prevalence of glare/halos among patients in the three groups was 47.4%(9/19), 68.4%(13/19)and 100%(12/12), respectively, with these differences being statistically significant(χ2=9.365, P=0.009). Conclusion The IOL Alpha angle may reflect the decentration and actual position of the IOL within the eye. The IOL Alpha angle may affect the postoperative visual acuity and reflect the actual visual quality after surgery. Larger IOL Alpha angle will increase the incidence of postoperative glare/halos, which may affect the patient's quality of life.

Key words: Alpha angle, Cataract, OPD-Scan Ⅲ, Extended depth-of-field intraocular lens, Visual quality

中图分类号:

R776.1

刘振,周维维,刘涵婧,张艺,朱玉广,朱艳. 人工晶状体Alpha角对连续视程人工晶状体眼视觉质量的影响[J]. 山东大学耳鼻喉眼学报, 2026, 40(1): 47-53.

LIU Zhen, ZHOU Weiwei, LIU Hanjing, ZHANG Yi, ZHU Yuguang, ZHU Yan. Influence of Alpha angle of intraocular lens on visual quality after the implantation of extended depth-of-field intraocular lens[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2026, 40(1): 47-53.

参考文献 25

[1]	Rampat R, Gatinel D. Multifocal and extended depth-of-focus intraocular lenses in 2020[J]. Ophthalmology, 2021, 128(11): e164-e185. doi:10.1016/j.ophtha.2020.09.026
[2]	Halkiadakis I, Ntravalias T, Kollia E, et al. Screening for multifocal intraocular lens implantation in cataract patients in a public hospital[J]. Int Ophthalmol, 2024, 44(1): 151. doi:10.1007/s10792-024-03088-8
[3]	Zamora-de La Cruz D, Bartlett J, Gutierrez M, et al. Trifocal intraocular lenses versus bifocal intraocular lenses after cataract extraction among participants with presbyopia[J]. Cochrane Database Syst Rev, 2023, 1(1): CD012648. doi:10.1002/14651858.CD012648.pub3
[4]	Ukai Y, Okemoto H, Seki Y, et al. Quantitative assessment of photic phenomena in the presbyopia-correcting intraocular lens[J]. PLoS One, 2021, 16(12): e0260406. doi:10.1371/journal.pone.0260406
[5]	Mori Y, Miyata K, Suzuki H, et al. Clinical performance of a hydrophobic acrylic diffractive trifocal intraocular lens in a Japanese population[J]. Ophthalmol Ther, 2023, 12(2): 867-878. doi:10.1007/s40123-022-00634-4
[6]	于腾飞, 李彦松, 刘振, 等. 0.2%酒石酸溴莫尼定对连续视程人工晶体植入术后伴有光学干扰患者夜间视觉质量的影响[J]. 山东大学耳鼻喉眼学报, 2022, 36(6): 45-50. doi:10.6040/j.issn.1673-3770.0.2022.220 YU Tengfei, LI Yansong, LIU Zhen, et al. Effect of brimonidine tartrate 0.2% on visual quality after phaco and extended depth of focus intraocular lens implantation with Dysphotopsia under mesopic condition[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(6): 45-50. doi:10.6040/j.issn.1673-3770.0.2022.220
[7]	李彦松, 朱玉广. 泪膜稳定性对超声乳化术后视觉质量影响的研究进展[J]. 山东大学耳鼻喉眼学报, 2022, 36(6): 19-25. doi:10.6040/j.issn.1673-3770.0.2022.157 LI Yansong, ZHU Yuguang. Research progress on the effects of tear film stability on visual quality after phacoemulsification[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(6): 19-25. doi:10.6040/j.issn.1673-3770.0.2022.157
[8]	Kim DR, Yoon YC, Whang WJ, et al. Ocular parameters associated with visual performance of enhanced monofocal intraocular lens[J]. BMC Ophthalmol, 2024, 24(1): 74. doi:10.1186/s12886-024-03316-w
[9]	Mamalis N. Complications of multifocal intraocular lenses: what have we learned [J]. J Cataract Refract Surg, 2021, 47(10): 1256-1257. doi:10.1097/j.jcrs.0000000000000777
[10]	De la Paz M, Tsai LM. Outcomes and predictive factors in multifocal and extended depth of focus intraocular lens implantation[J]. Curr Opin Ophthalmol, 2024, 35(1): 28-33. doi:10.1097/ICU.000000000000101
[11]	Holladay JT, Piers PA, Koranyi G, et al. A new intraocular lens design to reduce spherical aberration of pseudophakic eyes[J]. J Refract Surg, 2002, 18(6): 683-691. doi:10.3928/1081-597X-20021101-04
[12]	McKelvie J, McArdle B, McGhee C. The influence of tilt, decentration, and pupil size on the higher-order aberration profile of aspheric intraocular lenses[J]. Ophthalmology, 2011, 118(9): 1724-1731. doi:10.1016/j.ophtha.2011.02.025
[13]	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
[14]	Qin MM, Ji M, Zhou TQ, et al. Influence of angle alpha on visual quality after implantation of extended depth of focus intraocular lenses[J]. BMC Ophthalmol, 2022, 22(1): 82. doi:10.1186/s12886-022-02302-4
[15]	孙雅慧. Alpha角对人工晶状体植入术后视觉质量的影响[D]. 长春: 吉林大学, 2023
[16]	Cervantes-Coste G, Tapia A, Corredor-Ortega C, et al. The influence of angle alpha, angle kappa, and optical aberrations on visual outcomes after the implantation of a high-addition trifocal IOL[J]. J Clin Med, 2022, 11(3): 896. doi:10.3390/jcm11030896
[17]	Montrimas A, Žemaitien(·overe)R, Yao K, et al. Chord mu and chord alpha as postoperative predictors in multifocal intraocular lens implantation[J]. Graefes Arch Clin Exp Ophthalmol, 2024, 262(2): 367-380. doi:10.1007/s00417-023-06098-x
[18]	Fu YN, Kou JJ, Chen DJ, et al. Influence of angle kappa and angle alpha on visual quality after implantation of multifocal intraocular lenses[J]. J Cataract Refract Surg, 2019, 45(9): 1258-1264. doi:10.1016/j.jcrs.2019.04.003
[19]	Mahr MA, Simpson MJ, Erie JC. Angle alpha orientation and magnitude distribution in a cataract surgery population[J]. J Cataract Refract Surg, 2020, 46(3): 372-377. doi:10.1097/j.jcrs.0000000000000066
[20]	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
[21]	Grzybowski A, Eppig T. Angle alpha as predictor for improving patient satisfaction with multifocal intraocular lenses?[J]. Graefes Arch Clin Exp Ophthalmol, 2021, 259(3): 563-565. doi:10.1007/s00417-020-05053-4
[22]	Xu J, Lin PM, Zhang SH, et al. Risk factors associated with intraocular lens decentration after cataract surgery[J]. Am J Ophthalmol, 2022, 242: 88-95. doi:10.1016/j.ajo.2022.05.005
[23]	Lawu T, Mukai K, Matsushima H, et al. Effects of decentration and tilt on the optical performance of 6 aspheric intraocular lens designs in a model eye[J]. J Cataract Refract Surg, 2019, 45(5): 662-668. doi:10.1016/j.jcrs.2018.10.049
[24]	Thananjeyan AL, Siu A, Jennings A, et al. Extended depth-of-focus intraocular lens implantation in patients with age-related macular degeneration: a pilot study[J]. Clin Ophthalmol, 2024, 18: 451-458. doi:10.2147/OPTH.S442931
[25]	Melki SA, Harissi-Dagher M. Coaxially sighted intraocular lens light reflex for centration of the multifocal single piece intraocular lens[J]. Can J Ophthalmol, 2011, 46(4): 319-321. doi:10.1016/j.jcjo.2011.06.007

多维度评价

Viewed

Full text

Abstract

Cited

Shared

Discussed