山东大学耳鼻喉眼学报 ›› 2019, Vol. 33 ›› Issue (4): 109-114.doi: 10.6040/j.issn.1673-3770.0.2018.357

• 论著 • 上一篇    下一篇

球面与非球面人工晶状体植入术后视觉质量的对比研究

林佳,廖萱,兰长骏,谭青青,文佰伟,田靖   

  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
  • 出版日期:2019-07-20 发布日期:2019-07-22

Visual quality research on a custom selection of aspheric intraocular lenses in cataract patients

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

  1. Department of Ophthalmology, Affiliated Hospital of North Sichuan Medical College, Department of Ophthalmology & Optometry of North Sichuan Medical College, Nanchong 637000, Sichuan, China
  • Online:2019-07-20 Published:2019-07-22

摘要: 目的 通过比较不同球差设计的非球面及球面人工晶状体(IOL)植入术后视觉质量,为白内障患者合理选择IOL提供依据。 方法 59例(91眼)白内障超声乳化术后患者分为A、B两组,分别植入非球面和球面IOL,术后3个月测量4 mm和6 mm瞳孔直径下角膜、眼内及全眼的总高阶像差(tHOA)、球差(SA)、慧差(coma)及三叶草像差(trefoil)、客观散射指数(OSI)、调制传递函数截止频率(MTF cut off)以及斯特列尔比(SR)、OV100%、OV20%、OV9%模拟对比度视力以及对比敏感度(CS)的变化。 结果 术后3个月两组间裸眼视力(UCVA)和最佳矫正视力(BCVA)差异无统计学意义。术后4 mm及6 mm瞳孔直径下两组间角膜tHOA、SA、coma、trefoil均无统计学差异,眼内SA有统计学差异,tHOA、coma、trefoil均无统计学差异;4 mm瞳孔直径下两组间全眼SA有统计学差异,tHOA、coma、trefoil均无统计学差异,6 mm瞳孔直径下两组间全眼tHOA、SA有统计学差异,coma、trefoil均无统计学差异。两组OSI、MTF cut off、SR、VA100%、VA20%、VA9%均有统计学差异。两组3cpd空间频率CS变化无统计学意义,6cpd、12cpd、18cpd CS空间频率差异均有统计学意义。 结论 非球面IOL组全眼SA、tHOA以及眼内SA小于球面IOL组;OQAS相关视觉质量指标及中高空间频率下CS均优于球面IOL组。非球面IOL植入术后视觉质量优于球面IOL植入术。

关键词: 白内障, 球面人工晶状体, 非球面人工晶状体

Abstract: ObjectiveTo compare the visual quality after implanting aspheric and spherical intraocular lenses(IOLs)in cataract patients, to influence selectability of the better lens. Methods A prospective, non-random, controlled study was conducted on 59 age-related cataract patients(91 eyes)after phacoemulsification and IOL implantation. They were sorted into two groups; group A received aspheric IOLs and group B received spherical IOLs. Corneal, internal, and ocular high order aberrations(HOAs)including spherical aberration(SA), coma and trefoil, and total high order aberration(tHOA), were measured at 3 months postoperatively at pupil diameters(PD)of 4 mm and 6 mm using Topcon KR-1W. Objective scatter index(OSI), strehl ratio(SR), modulation transfer function(MTF)cut off, contrast visual acuity OV100%, OV20%, and OV9% were measured by OQASTMⅡ and the CSV-1 000. The independent samples t-test was used to analyze the data. Results There were no statistically significant differences between group A and B in uncorrected visual acuity and best corrected visual acuity. There was no statistically significant difference between the two groups in corneal tHOA, SA, coma, and trefoil at 4 mm and 6 mm PD. There was a statistically significant difference between the two groups in internal SA, but no significant difference in internal tHOA, coma, or trefoil at 4 mm and 6 mm PD. There was a statistically significant difference between the two groups in ocular SA but no significant difference in coma and trefoil at 4 mm PD. There was a statistically significant difference between the two groups in ocular tHOA, SA, but no significant difference in ocular tHOA, coma, and trefoil at 6 mm PD. There was a statistically significant difference between the two groups in OSI, MTF cut off, SR, OV100%, OV20%, and OV9%. With respect to CS, no significant difference was found at a spatial frequency of 3 cpd, but significant differences at 6 cpd, 12 cpd, and 18 cpd were observed between aspheric and spherical IOL groups. Conclusion The ocular tHOA, SA and internal SA in aspheric IOL group were lower than the spherical group at 4 mm and 6 mm PD; which demontrates that the visual quality parameters from the Optical Quality Analysis System and the middle and high frequency(6 cpd, 12 cpd, 18 cpd)in the aspheric IOL group were better than those of the spherical IOL group. Visual quality in aspheric IOL groups was better than spherical IOL groups.

Key words: Cataract, Spherical intraocular lenses, Aspheric intraocular lenses

中图分类号: 

  • R776
[1] Schuster AK, 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]. Ophthalmology,2013,120(11):2166-2175. doi: 10.1016/j.ophtha.2013.04.011.
[2] Chang DH, Rocha KM. Intraocular lens optics and aberrations[J]. Curr Opin Ophthalmol, 2016, 27(4): 298-303. doi:10.1097/ICU.0000000000000279.
[3] 田靖, 廖萱, 兰长骏, 等. 不同球差非球面人工晶状体眼高阶像差比较[J]. 山东大学耳鼻喉眼学报, 2017, 31(4): 13-17. doi:10.6040/j.issn.1673-3770.1.2017.031. TIAN Jing, LIAO Xuan, LAN Changjun, et al. Comparison of high order aberrations in pseudophakia with spherical intraocular lens and aspheric intraocular lens implantation[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2017, 31(4): 13-17. doi:10.6040/j.issn.1673-3770.1.2017.031.
[4] Wei YH, Chen WL, Su PY, et al. The influence of corneal wound size on surgically induced corneal astigmatism after phacoemulsification[J]. J Formos Med Assoc, 2012, 111(5): 284-289. doi:10.1016/j.jfma.2011.03.002.
[5] 王春红, 曹茜, 杨丽萍, 等. 年龄相关性白内障人群角膜球面像差的分布及影响因素[J]. 国际眼科杂志, 2015, 15(3): 531-533. doi:10.3980/j.issn.1672-5123.2015.3.41. WANG Chunhong, CAO Xi, YANG Liping, et al. Distribution and reIated factors of corneaI sphericaI aberration in age-reIated cataract patients[J]. International Eye Science, 2015, 15(3): 531-533. doi:10.3980/j.issn.1672-5123.2015.3.41.
[6] 王李松, 赵军民. 不同类型人工晶状体植入术后视觉质量的比较[J]. 中华眼外伤职业眼病杂志, 2016, 38(3): 203-206. WANG Lisong, ZHAO Junmin. Comparison of visual quality after the implantation of different types of intraocular lens[J]. Chin J Ocul Traum Occupat Eye Dis, 2016, 38(3): 203-206.
[7] Jia LX, Li ZH. Clinical study of customized aspherical intraocular lens implants[J]. Int J Ophthalmol, 2014, 7(5): 816-821. doi:10.3980/j.issn.2222-3959.2014.05.14.
[8] 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. doi:10.1016/j.ajo.2009.09.019.
[9] 马立威, 仝真真, 周文凯, 等. 年龄相关性白内障患者高阶像差的研究[J]. 中国实用眼科杂志, 2017, 35(3): 261-266. doi:10.3760/cma.j.issn.1006-4443.2017.03.009. MA Liwei, TONG Zhenzhen, ZHOU Wenkai, et al. Study of higher-order aberrations induced by age-related cataract[J]. Chinese Journal of Practical Ophthalmology, 2017, 35(3): 261-266. doi:10.3760/cma.j.issn.1006-4443.2017.03.009.
[10] 文佰伟, 兰长骏, 廖萱, 等. 视觉质量评价方法的研究进展[J]. 眼科新进展, 2017, 37(8): 793-796. doi:10.13389/j.cnki.rao.2017.0201. WEN Baiwei, LAN Changjun, LIAO Xuan, et al. Research progress on visual quality assessment methods[J]. Recent Advances in Ophthalmology, 2017, 37(8): 793-796. doi:10.13389/j.cnki.rao.2017.0201.
[11] 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. doi:10.5301/ejo.5000452.
[12] 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. doi:10.1016/j.jcrs.2015.04.005.
[13] Luo M, Ji J, Zhao C, et al. Clinical study of Acrysof IQ aspheric intraocular lenses[J]. Clin Experiment Ophthalmol, 2010, 38(4): 358-362.
[14] 丁晓霞, 张劲松. C-quant及OQAS对早期年龄相关性白内障散射光测量结果重复性和相关性[J]. 中国实用眼科杂志, 2016, 34(3): 241-245. doi:10.3760/cma.j.issn.1006-4443.2016.03.009. DING Xiaoxia, ZHANG Jinsong. The repeatability and correlation of scatter light measured by C-quant and OQAS in early age-related cataract[J]. Chinese Journal of Practical Ophthalmology, 2016, 34(3): 241-245. doi:10.3760/cma.j.issn.1006-4443.2016.03.009.
[15] 乔利亚, 蔡啸谷, 万修华, 等. 应用双通道客观视觉质量分析系统与光线追踪波阵面像差系统分析正常人眼调制传递函数[J]. 中华眼科杂志, 2015, 51(1): 20-25. doi:10.3760/cma.j.issn.0412-4081.2015.01.006. QIAO Liya, CAI Xiaogu, WAN Xiuhua, et al. Comparison of ocular modulation transfer function measurements by ray tracing wavefront technology and double-pass system[J]. Chinese Journal of Ophthalmology, 2015, 51(1): 20-25. doi:10.3760/cma.j.issn.0412-4081.2015.01.006.
[16] 王新, 马忠旭, 巩晨, 等. OQAS视觉质量分析系统比较不同材料人工晶状体眼内散射光及视觉质量[J]. 中国实用眼科杂志, 2014, 32(2): 130-134. doi:10.3760/cma.j.issn.1006-4443.2014.02.010. WANG Xin, MA Zhongxu, GONG Chen, et al. OQAS Double-pass system analysis of the Objective Scatter Index and optical performance of intraocular lens[J]. Chinese Journal of Practical Ophthalmology, 2014, 32(2): 130-134. doi:10.3760/cma.j.issn.1006-4443.2014.02.010.
[17] 肖显文, 张红, 田芳, 等. 双通道视觉质量分析系统在眼科的应用[J]. 国际眼科纵览, 2013, 37(2): 77-82. doi:10.3760/cma.j.issn.1673-5803.2013.02.002. XIAO Xianwen, ZHANG Hong, TIAN Fang, et al. Development of the double-pass Optical Quality Analysis System in ophthalmology[J]. International Review of Ophthalmology, 2013, 37(2): 77-82. doi:10.3760/cma.j.issn.1673-5803.2013.02.002.
[18] 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.
[19] Lee H, Lee K, Ahn JM, et al. Double-pass system assessing the optical quality of pseudophakic eyes[J]. Optom Vis Sci, 2014, 91(4): 437-443. doi:10.1097/OPX.0000000000000190.
[20] 邢晓杰, 宋慧, 汤欣, 等. 应用OQAS双通道系统对人工晶状体眼视觉质量评估可重复性研究[J]. 中国实用眼科杂志, 2014, 32(10): 1163-1168. doi:10.3760/cma.j.issn.1006-4443.2014.010.008. XING Xiaojie, SONG Hui, TANG Xin, et al. Repeatability of measurements with a double-pass OQAS system after 3 IOLs implantations[J]. Chinese Journal of Practical Ophthalmology, 2014, 32(10): 1163-1168. doi:10.3760/cma.j.issn.1006-4443.2014.010.008.
[21] 肖显文, 田芳, 张红, 等. 非球面Toric人工晶状体植入术后视觉质量的临床研究[J]. 中华眼科杂志, 2015, 51(4): 263-269. doi:10.3760/cma.j.issn.0412-4081.2015.04.007. XIAO Xianwen, TIAN Fang, ZHANG Hong, et al. Clinical study of optical quality after implantation of aspheric toric intraocular lens in cataract surgery[J]. Chinese Journal of Ophthalmology, 2015, 51(4): 263-269. doi:10.3760/cma.j.issn.0412-4081.2015.04.007.
[1] 刘建波,张环. 超声乳化联合玻璃体腔药物注射治疗白内障合并糖尿病性黄斑水肿[J]. 山东大学耳鼻喉眼学报, 2019, 33(2): 99-104.
[2] 陈莹,李元彬. 先天性白内障治疗新进展[J]. 山东大学耳鼻喉眼学报, 2019, 33(2): 143-148.
[3] 唐唯,李元彬. 屈光性白内障手术新进展[J]. 山东大学耳鼻喉眼学报, 2019, 33(2): 149-158.
[4] 涂雪峰. 重组牛碱性成纤维细胞生长因子联合玻璃酸钠治疗干眼症的疗效分析[J]. 山东大学耳鼻喉眼学报, 2018, 32(6): 84-87.
[5] 王道光,刘冬梅,毕宏生. 三焦点人工晶体植入超长眼轴白内障患者一例报告[J]. 山东大学耳鼻喉眼学报, 2018, 32(6): 117-118.
[6] 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.
[7] 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.
[8] 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.
[9] 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.
[10] 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.
[11] 田靖,廖萱,兰长骏,谭青青,林佳,文佰伟. 不同球差非球面人工晶状体眼高阶像差比较[J]. 山东大学耳鼻喉眼学报, 2017, 31(4): 13-17.
[12] 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.
[13] 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.
[14] 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.
[15] 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.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] 杨长亮,黄治物,姚行齐,诸勇,孙艺 . 正常气骨导听性脑干反应及其应用[J]. 山东大学耳鼻喉眼学报, 2006, 20(1): 9 -13 .
[2] 曹忠良 . 颌面复合伤155例临床分析[J]. 山东大学耳鼻喉眼学报, 2006, 20(1): 89 -89 .
[3] 毕景云 . 鼻中隔矫正术后血肿的处理[J]. 山东大学耳鼻喉眼学报, 2006, 20(1): 90 -91 .
[4] 刘大昱,潘新良,雷大鹏,许风雷,张立强,栾信庸 . 梨状窝内侧壁癌的手术治疗[J]. 山东大学耳鼻喉眼学报, 2007, 21(1): 8 -11 .
[5] 刘 艳,刘新义,王金平,李大健 . 后鼓室解剖结构测量观察及临床意义[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 218 -221 .
[6] 赵 敏,王守森,甄泽年,陈贤明,王茂鑫 . 鼻内镜联合显微镜行蝶窦及经蝶鞍区微创手术[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 244 -245 .
[7] 伦 杰,吕心红 . 鼻部脂溢性角化病1例[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 252 -252 .
[8] 黄 方,黄海琼,黄建强,何荷蕃 . 支气管内镜视频监视系统在小儿气管-支气管异物诊治中的应用[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 276 -277 .
[9] 于志良,王卫卫,王明华 . 耳鼻喉综合动力系统切除会厌囊肿23例[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 278 -279 .
[10] 张剑利,王跃建,陈伟雄,胡维维,李广民 . 免疫组化和连续切片在检测头颈鳞癌颈淋巴结微转移中的意义[J]. 山东大学耳鼻喉眼学报, 2008, 22(4): 299 -303 .