山东大学耳鼻喉眼学报 ›› 2017, Vol. 31 ›› Issue (4): 13-17.doi: 10.6040/j.issn.1673-3770.1.2017.031

• 屈光性白内障手术·论著 • 上一篇    下一篇

不同球差非球面人工晶状体眼高阶像差比较

田靖,廖萱,兰长骏,谭青青,林佳,文佰伟   

  1. 川北医学院附属医院眼科/川北医学院眼视光学系, 四川 南充 637000
  • 收稿日期:2017-07-12 出版日期:2017-08-16 发布日期:2017-08-16
  • 通讯作者: 兰长骏. E-mail:lanchangjun@sina.com

Comparison of high order aberrations in pseudophakia with spherical intraocular lens and aspheric intraocular lens implantation.

TIAN Jing, LIAO Xuan, LAN Changjun, TAN Qingqing, LIN Jia, WEN Baiwei   

  1. Department of Ophthalmology, Affiliated Hospital of North Sichuan Medical College, Department of Ophthalmology &Optometry of North Sichuan Medical College, Nanchong 637000, Sichuan, China
  • Received:2017-07-12 Online:2017-08-16 Published:2017-08-16

摘要: 目的 球面及不同球差非球面人工晶状体植入后,比较患者眼角膜、眼内及全眼球的高阶像差,为个性化选择人工晶状体(IOL)提供依据。 方法 年龄相关性白内障患者112例(160眼)分为4组,分别植入AMO Sensor AR40 IOL(AR40组,26例40眼)、AMO Tecnis ZA9003 IOL(ZA9003组,31例40眼)、Bausch & Lomb SofPort AO IOL(AO组,28例40眼)、Alcon SN60WF IQ IOL(IQ组,27例40眼)。测量术后3个月4 mm及6 mm瞳孔直径下的角膜、眼内和全眼的总高阶像差(tHOA)、球差(SA)、慧差及三叶草像差。 结果 术后3个月,各组间患者术后裸眼及最佳矫正视力差异无统计学意义。4 mm及6 mm瞳孔直径下各组间角膜tHOA、SA、coma及trefoil差异均无统计学意义。4 mm瞳孔直径下各组间眼内SA及coma差异有统计学意义,各组间眼内tHOA及trefoil差异无统计学意义;6 mm瞳孔直径下各组间眼内tHOA、SA及coma差异有统计学意义,各组间眼内trefoil差异无统计学意义。4 mm及6 mm瞳孔直径下各组间全眼tHOA及SA差异有统计学意义,各组间全眼coma及trefoil差异无统计学意义。 结论 超声乳化白内障吸除术后植入非球面IOL可以降低全眼SA,提高患者视觉质量。不同SA的非球面IOL,全眼SA的可预测性较好,为非球面IOL的个性化植入提供了临床依据。

关键词: 非球面, 人工晶状体, 高阶像差, 球差, 白内障

Abstract: Objective To compare the corneal, internal, and ocular high order aberrations(HOAs)in pseudophakia of spherical intraocular lens(IOL)with aspheric IOL implantation, and to provide evidence for individual selection of aspheric IOL. Methods A prospective, non-randomized, controlled clinical study was conducted on 112 age-matched cataract patients(160 eyes). Patients were divided into four groups, and implanted with AMO Sensor AR40 IOL(group AR40, 40 eyes of 26 patients), AMO Tecnis ZA9003 IOL(group ZA9003, 40 eyes of 31 patients), Bausch & Lomb SofPort AO IOL(group AO, 40 eyes of 28 patients), or Alcon SN60WF IQ IOL(group IQ, 40 eyes of 27 patients). The corneal, internal, and ocular HOAs including total HOA(tHOA), spherical aberration(SA), coma, and trefoil were measured at three months postoperatively with a pupil diameter(PD)of 4 mm or 6 mm. Result There were no statistically significant differences in postoperative uncorrected visual acuity and best corrected visual acuity, and in postoperative corneal tHOA, SA, coma, and trefoil at 4 mm or 6 mm PD among the four groups. At 4 mm PD, there were significant differences in internal SA and coma but no differences in tHOA and trefoil; at 6 mm PD, there were significant differences in internal tHOA, SA, and coma but no differences in trefoil. In addition, there were significant differences in ocular tHOA and SA but no differences in coma and trefoil at 4 mm or 6 mm PD among the four groups. Conclusion Phacoemulsification of the cataract and implantation of an aspheric IOL can reduce corneal SA, resulting in enhanced visual quality. For aspheric IOLs with other SAs, the predictability of corneal SA is exact, which provides a clinical basis for personalized implantation of aspheric IOLs.

Key words: Intraocular lenses, Aspheric, Spherical aberration, Cataract, High order aberration

中图分类号: 

  • R776
[1] Schuster AK, Tesarz J, Vossmerbaeumer U. Ocular wavefront analysis of aspheric compared with spherical monofocal intraocular lenses in cataract surgery: Systematic review with metaanalysis[J].J Cataract Refract Surg, 2015, 41(5):1088-1097.
[2] Chang DH, Rocha KM. Intraocular lens optics and aberrations[J]. Current Opinion Ophthalmol, 2016, 27(4):298-303.
[3] Levy Y, Segal O, Avni I, et al. Ocular higher-order aberrations in eyes with supernormal vision[J].Am J Ophthalmol, 2005, 139(2):225-228.
[4] Nochez Y, Majzoub S, Pisella PJ. Effect of residual ocular spherical aberration on objective and subjective quality of vision in pseudophakiceyes[J]. J Cataract Refract Surg, 2011, 37(6):1076-1081.
[5] Schuster A K, Tesarz J, Vossmerbaeumer U. The impact on vision of aspheric to spherical monofocal intraocular lenses in cataract surgery: a systematic review with meta-analysis[J]. Ophthalmol, 2013, 120(11): 2166-2175.
[6] Tandogan T, Auffarth GU, Choi CY, et al. In vitro comparative optical bench analysis of a spherical and aspheric optic design of the same IOL model[J]. BMC Ophthalmol, 2017, 17(1):9.
[7] Santhiago MR, Netto MV, Barreto J Jr, et al. Wavefront analysis, contrast sensitivity, and depth of focus after cataract surgery with aspherical intraocular lens implantation[J]. Am J Ophthalmol, 2010, 149(3):383-389.
[8] Ohtani S, Miyata K, Samejima T, et al. Intraindividual comparison of aspherical and spherical intraocular lenses of same material and platform[J].Ophthalmol, 2009, 116(5):896-901.
[9] Yagci R, Uzun F, Acer S, et al. Comparison of visual quality between aspheric and spherical IOLs [J]. Eur J Ophthalmol, 2014, 24(5):688-692.
[10] Mu(~overn)oz G, Albarrán-Diego C, Ferrer-Blasco T, et al. Long-term comparison of corneal aberration changes after laser in situ keratomileusis: mechanical microkeratome versus femtosecond laser flap creation[J]. J Cataract Refract Surg, 2010, 36(11):1934-1944.
[11] Keir NJ, Simpson T, Hutchings N, et al. Outcomes of wavefront-guided laser in situ keratomileusis for hyperopia[J]. J Cataract Refract Surg, 2011, 37(5):886-893.
[12] 王静, 张劲松, 赵江月. 角膜球面像差引导下个体化IOL植入术后视觉质量[J]. 中华眼视光学与视觉科学杂志, 2012, 14(10):617-621. WANG Jing, ZHANG Jinsong, ZHAO Jiangyue. Evaluation of the optical quality of corneal spherical aberration-guided customized intraocular lens implants[J]. Chin J Optometry Ophthalmol Visual Sci, 2012, 14(10):617-621.
[13] 连慧芳, 汤欣, 宋慧, 等. 超声乳化白内障吸除术前角膜球差对相对个性化非球面人工晶状体植入的影响[J]. 中华眼科杂志, 2010, 46(5):410-414. LIAN Huifang, TANG Xin, SONG Hui, et al. The influence of preoperative corneal spherical aberration on relatively personalized implantation of aspheric intraocular lens[J]. Chin J Ophthalmol, 2010, 46(5):410-414.
[14] Jia LX, Li ZH. Clinical study of customized aspherical intraocular lens implants[J]. Int J Ophthalmol, 2014, 7(5):816-821.
[15] 邢晓杰,汤欣,宋慧. KR-1W 波前像差仪测量人工晶状体眼像差可重复性研究[J]. 中国实用眼科杂志, 2011, 29(11):1127-1130. XING Xiaojie, TANG Xin, SONG Hui. Intrasubject repeatability of internal aberrometry obtained with KR-1W integrated aberrometer[J]. Chin J Pract Ophthalmol, 2011, 29(11):1127-1130.
[16] Fujikado T, Saika M. Evaluation of actual retinal images produced by misaligned aspheric intraocular lenses in a model eye [J]. Clin Ophthalmol, 2014, 28(8):2415-2423.
[17] Denoyer A, Denoyer L, Halfon J, et al. Comparative study of aspheric intraocular lenses with negative spherical aberration or no aberration[J]. J Cataract Refract Surg, 2009, 35(3):496-503.
[1] 李厚秀,刘中华,陈智. 白内障超声乳化术中后囊膜破裂风险因素分析[J]. 山东大学耳鼻喉眼学报, 2018, 32(2): 88-90.
[2] 高雪,郝琳琳,刘少华,张晗. 两种人工晶体计算公式预测闭角型青光眼合并白内障患者超声乳化手术后屈光度准确性的比较[J]. 山东大学耳鼻喉眼学报, 2018, 32(1): 68-71.
[3] 郑晚秋,万文娟,李灿. 前房维持器在白内障术中后囊破裂的应用[J]. 山东大学耳鼻喉眼学报, 2017, 31(4): 9-12.
[4] 魏超, 张晗. 多焦点人工晶状体的临床应用进展[J]. 山东大学耳鼻喉眼学报, 2017, 31(4): 29-35.
[5] 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.
[6] 杨玉焕,张婕,张锦鹏,严宏. Pentacam系统监测散瞳对白内障患者手术前后前节参数的影响[J]. 山东大学耳鼻喉眼学报, 2017, 31(4): 5-8.
[7] 冀帅飞,张婕,严宏. 年龄相关性黄斑变性患者人工晶状体的选择[J]. 山东大学耳鼻喉眼学报, 2017, 31(4): 36-39.
[8] 翁碧艳,柳灿. 巩膜隧道切口和透明角膜切口对白内障超声乳化摘除术患者术后泪膜的影响[J]. 山东大学耳鼻喉眼学报, 2017, 31(4): 80-83.
[9] 刘露,梁皓. 中老年白内障人群角膜散光的分布规律[J]. 山东大学耳鼻喉眼学报, 2016, 30(6): 75-77.
[10] 邓志峰. 改良白内障超声乳化术的临床研究[J]. 山东大学耳鼻喉眼学报, 2016, 30(3): 85-88.
[11] 林莉,杨旭. 白内障术后角膜上皮功能障碍治疗的疗效分析[J]. 山东大学耳鼻喉眼学报, 2016, 30(2): 84-86.
[12] 刘钊, 吴昌睿, 高宁. 白内障超声乳化摘除手术对睑板腺功能的影响[J]. 山东大学耳鼻喉眼学报, 2015, 29(6): 68-70.
[13] 王晶, 武芹, 吴昊, 刘春雷, 毕宏生. 客观视觉质量分析系统测量人工晶体伪调节力的临床研究[J]. 山东大学耳鼻喉眼学报, 2015, 29(3): 84-85.
[14] 刘志高, 颜世龙, 胡尊霞, 孙同鑫, 杨明, 王玉. 济南市农村白内障患者糖尿病及糖尿病视网膜眼底病变患病率调查分析[J]. 山东大学耳鼻喉眼学报, 2015, 29(1): 38-39.
[15] 朱子诚, 温跃春, 吴章友, 柯根杰. 高度近视合并白内障患者植入不同人工晶状体术后黄斑区视网膜厚度的变化[J]. 山东大学耳鼻喉眼学报, 2015, 29(1): 40-43.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!