【摘要】  　　目的：超声乳化术后植入非球面人工晶状体（Tecnis Z9001）或球面人工晶状体（Acrysof Nature），临床疗效的比较。方法：年龄相关性白内障患者59例60眼，随机分为2组，每组30眼。在超声乳化术后，一组植入非球面人工晶状体（Tecnis Z9001），另一组植入球面人工晶状体（Acrysof Nature）。在术后1/4，1及3mo检查术眼最佳矫正视力（BCVA）；在术后1及3mo检查明视及暗视对比敏感度、眼波前像差等。结果：术后1/4，1及3mo，两组BCVA均无显著性差异（P >0.05）。在术后1及3mo，Tecnis组在明视1.5cpd，3.0 cpd，6.0cpd，12cpd，18cpd及暗视1.5cpd，3.0cpd，6.0 cpd，12cpd，18cpd的对比敏感度均明显优于Acrysof组，差别有统计学意义（P <0.05）。在术后1及3mo，两组四阶球差（SA）及高阶像差（HOA）比较，Tecnis组均低于Acrysof组，两组差别有统计学意义（P <0.05）。 结论：非球面人工晶状体（Tecnis Z9001）与球面人工晶状体（Acrysof Nature）均可明显提高患者术后视力，但非球面人工晶状体（Tecnis Z9001）可以减少术眼的高阶像差尤其是球差，提高某些频率的对比敏感度，提高视觉质量。

【关键词】  白内障　超声乳化术　非球面人工晶状体

　　 Implantation of a modified prolate anterior surface intraocular lens after phacoemulsification for cataract extraction and the clinical observation

    Xuan Chen, Song-Bo Jia, Luo-Sheng Tang

    Department of Ophthalmology, the Second Affiliated Hospital of Xiangya Medical College, Central South University, Changsha 410011, Hunan Province, China

        Received: 2006-11-16 Accepted: 2007-01-19

    Abstract

    · AIM: The implantation of a modified prolate anterior surface intraocular lens(Tecnis Z9001) or a spherical intraocular lens（Acrysof Nature）after phacoemulsification for cataract extract and compare the clinical effect of the two IOLs.

    · METHODS: A total of 59 cases（60 eyes） with age related cataract were randomized to two groups, 30 eyes in each group. These patients had been implanted Tecnis Z9001 IOLs or Acrysof Nature IOLs after phacoemulsification for cataract surgery. One week, one month and three months after surgery, the best corrected visual acuity (BCVA) was examined. After 1 and 3 months the following investigations were performed: assessment of photopic and mesopic contrast sensitivities, wavefront aberration of the eyes and so on.

    · RESULTS: After 1 week, 1 month and 3 months, there was no significant difference in the BCVA between two IOLs after surgery(P>0.05). After 1 month and 3 months, the Tecnis IOL provided significantly better contrast sensitivity at almost all spatial frequencies under photopic conditions and mesopic conditions in comparison with the Acrysof IOL. In the two groups, the spherical aberration and total high order aberrations showed the significant difference between two IOLs(P<0.05) after 1 month and 3 months.

    · CONCLUSION: The modified prolate anterior surface IOLs (Tecnis Z9001) can improve the total high order aberrations, especially the spherical aberration and increase the contrast sensitivity at some spatial frequencies than the spherical IOL. The Tecnis can improve the visual quality.

    · KEYWORDS: cataract; phacoemulsification; modified prolate anterior surface IOL

    Chen X, Jia SB, Tang LS. Implantation of a modified prolate anterior surface intraocular lens after phacoemulsification for cataract extraction and the clinical observation.Int J Ophthalmol(Guoji Yanke Zazhi) , 2007;7(1):105-108

　　0引言

    现代白内障的治疗以手术治疗为主，其中白内障超声乳化吸出术配合折叠式人工晶状体的植入，是白内障手术的主要方法[1]。随着人们生活水平的提高，人们对于视觉质量的要求越来越高。我们常常会听到一些白内障术后的患者关于视觉质量下降的抱怨：如夜视力差、视物模糊、眩光与光晕、复视等，而这些患者的客观视力检查很好，甚至达1.0以上。引起这种现象的原因很多，其中像差是造成这种情况的主要因素之一，尤其以球面像差的作用为明显[2-4]。此外，人工晶状体的形状又是影响术后人工晶状体眼球面像差的最重要因素，甚至可以影响夜视功能[5]。

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