【摘要】  目的 利用波前像差检测仪检测行超声乳化并植入同种材料不同直径的折叠式人工晶状体白内障患者术后患眼波前像差的变化，以讨论其相关性。方法 随机选取自愿接受超声乳化合并人工晶状体植入手术的白内障患者（排除眼科其他疾病及相关全身疾病）共47例（50眼），随机分为两组：A组35例（35眼）植入光学直径为5.75 mm亲水性丙烯酸酯（Rayner）人工晶状体；B组15例（15眼）植入光学直径为6.0 mm亲水性丙烯酸酯（Isotechnics）人工晶状体,其中3例双眼分别植入这两种人工晶状体。术后第3个月观察患眼波前像差及其他相关的变化。结果 瞳孔直径4.0 mm时，两组的高阶像差均方根值(root mean square high,RMSh)分别为(0.36±0.11)?滋m和(0.30±0.15)?滋m；瞳孔直径5.0 mm时，两组RMSh分别为(0.57±0.12)?滋m和(0.61±0.17)?滋m；瞳孔直径6.0 mm时，两组RMSh分别为(0.84±0.15)?滋m和（0.89±0.20)?滋m；瞳孔直径7.0 mm时，两组RMSh分别为(1.49±0.19)?滋m和 (1.42±0.22)?滋m。经统计学分析，瞳孔直径为4.0 mm、5.0 mm、6.0 mm及7.0 mm时，两组的RMSh差异均无显著性（P>0.05）。结论 ?譹?訛人工晶状体眼的高阶像差随瞳孔直径增大而增大；?譺?訛在瞳孔直径4.0 mm、5.0 mm、6.0 mm及7.0 mm时，植入同种材料的光学直径5.75 mm人工晶状体的患眼的高阶像差均方根值与植入直径6.0 mm人工晶状体的患眼的高阶像差均方根值的差异无显著性。

    【关键词】  波前像差；白内障；人工晶体

    ［Abstract］   Objective   To compare higher-order aberrations in cataract eyes with different intraocular lens (IOL) implants and to improve the optical designs of IOLs for better retinal image quality. Methods  Forty-seven patients (50 eyes) who had agreed to undergo phacoemulsification and accept IOL implants were randomly selected for the study. Any other eye disease or systemic disease was criteria for exclusion. The patients were divided into two groups based on the diameters of the IOLs. In group A, a 5.75 mm optical diameter Hydrophilic Acrylic IOL（Rayner） was implanted into 35 eyes of 35 patients; in group B, a 6.0mm optical diameter Hydrophilic Acrylic IOL（Isotechnics） was implanted into 15 eyes of 15 patients. Three patients in group A were implanted with a 6.0mm optical diameter Hydrophilic Acrylic IOL in their consenual eyes. Wavefront aberrations were measured at 3 months postoperatively. Results  ?譹?訛For a 4.0 mm pupil, the average higher-order root mean square (RMSh)  values of the two groups were (0.36±0.11)μm (group A) and (0.30±.15)μm (group B). For a 5.0 mm pupil, the average RMSh values were (0.57±0.12)μm (group A) and (0.61±0.17)μm (group B). For a 6.0 mm pupil, the average RMSh values were (0.84±0.15)μm (group A) and (0.89±0.20)μm (group B). For a 7.0 mm pupil, the average RMSh values were (1.49±0.19)μm (group A) and (1.42±0.22)μm (group B). ?譺?訛For 4.0 mm, 5.0 mm, 6.0 mm and 7.0 mm pupils, the average RMSh values were not significantly different between the two groups (P>0.05). Conclusion    ?譹?訛RMSh values are higher in the pseudophakic eye with larger pupils.  ?譺?訛For 4.0 mm，5.0 mm，6.0 mm and 7.0mm pupils, there were no significant differences between the average RMSh values of eyes implanted with a 5.75 mm optical diameter IOL and those with a 6.0 mm optical diameter IOL.

    [Key words]   aberration； cataract； intraocular lens 

     随着时代的发展，超声乳化白内障摘除（phacoemulsification）联合人工晶状体（intraocular lens）植入手术日趋完善和普遍，越来越多的学者已经将此项手术视为一种屈光手术。大部分患者术后虽然视力较好，但却存在着眩光、暗视力差、视物模糊及视物变色、失去调节力等问题。本研究通过对白内障术中植入同种材料不同直径人工晶状体的患眼进行波前像差的检测与分析，以期为临床合理地选择适合患眼的人工晶状体提供客观资料。

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