【摘要】 目的：评价Canon Staar KS—3Ai非球面人工晶状体（IOL）对提高年龄相关性白内障患者术后视功能的作用。方法：年龄相关性白内障患者98例（126眼）随机分成两组。在白内障超声乳化吸除术后，观察组52例（65眼）植入非球面IOL（Canon Staar KS—3Ai），对照组46例（61眼）植入球面IOL（Allergan Sensor AR40e）。观察患者术后的裸眼视力（uncorrected visual activity, UCVA）、最佳矫正视力（best corrected visual activity, BCVA）、屈光状态、对比敏感度（contrast sensitivity,CS）、波前像差的均方根（root mean square,RMS）值。随访时间为术后6mo。结果：术后6mo两组UCVA、BCVA、屈光状态差异无统计学意义。无眩光环境下12,18c/d空间频率和眩光环境下6,12,18c/d空间频率上观察组CS明显优于对照组。在瞳孔直径6mm时，观察组4阶像差、4阶球差、总高阶像差RMS值低于对照组。在瞳孔直径6mm时3阶像差、5阶像差RMS值及瞳孔直径3mm时两组高阶像差RMS值差异无统计学意义。结论：非球面IOL眼视觉质量明显优于球面IOL眼。
【关键词】 人工晶状体；非球面；对比敏感度；波前像差
Clinical study of visual function after implantation of aspheric intraocular lens
Jing Chen, XianNa Zheng，JinYin Deng
Department of Ophthalmology，Guangzhou General Hospital of Guangzhou Military Command of Chinese PLA, Guangzhou 510010, Guangdong Province, China
Abstract
AIM: To evaluate the visual function after implantation of aspheric intraocular lens ( IOL) in patients eyes with agerelated cataract.
METHODS: Ninetyeight cases (126 eyes) with age related cataract were classified randomly into two groups. Observation group (52 cases, 65 eyes) was implanted with aspheric IOL(Canon Staar KS3Ai), control group (46 cases, 61 eyes) with natural spherical IOL (Allergan Sensor AR40e). Uncorrected visual activity (UCVA), best corrected visual activity (BCVA), refraction, contrast sensitivity (CS), and the root mean square (RMS) values of wavefront aberrations were examined six months postoperatively.
RESULTS: Six months after surgery, there were no significant differences in UCVA, BCVA and refraction between two groups. Without glare the observation group showed significantly higher spatial CS than the control group in 12c/d and 18c/d frequencies, with glare the observation group showed higher in 6c/d, 12c/d and 18c/d frequencies. The RMS values of 4thorder aberration, 4thorder spherical aberration and total high order aberration in the observation group were lower than those in the control group at 6mm pupil diameter six months postoperatively. RMS values of 3rd and 5thorder at 6mm pupil diameter and RMS values at 3mm pupil diameter, no significant differences were found in both groups.
CONCLUSION: Our study shows the optical quality of eyes implanted with aspheric IOLs was significantly better than spherical IOLs.
KEYWORDS: intraocular lens; aspheric; contrast sensitivity; wavefront aberration
0引言
随着超声乳化白内障吸除术联合折叠式人工晶状体（intraolular lens，IOL）植入术的迅猛发展，白内障手术日趋成熟，目前已从单纯的复明手术进入屈光性眼内手术时代。IOL的功能也由单纯的屈光作用向同时恢复屈光、调节等晶状体生理功能的方向发展。随着波前像差技术应用到IOL设计与白内障手术中，为非球面IOL研制以及临床结果的验证提供了新的思路和方法。我们对白内障超声乳化吸除术联合Canon Staar KS—3Ai非球面IOL植入术后的患者进行随访，观察其成像质量。
1对象和方法
1.1对象 收集2007 01/12在我院行白内障超声乳化手术治疗的年龄相关性白内障患者98例（126眼）。病例选择标准：无高度近视和高度远视；排除眼部外伤、手术史；排除眼病和可能影响研究结果的系统性疾病；术眼无不规则散光，规则散光度数绝对值<1.50D。入选患者随机分为两组，观察组52例（65眼）植入Canon Staar KS—3Ai非球面IOL，对照组46例（61眼）植入 Allergan Sensor AR40e球面IOL。
1.2方法 手术采用美国Allergan公司的Sovereign compact超声乳化机。表面麻醉满意后，做11∶00位3.2mm×1.75mm透明角膜隧道切口和2∶00～2∶30位1.4mm×1.0mm的穿刺辅助切口，前房注入透明质酸钠后行居中直径5.5mm连续环形撕囊，水分离后囊袋内超声乳化晶状体核，自动灌注系统吸除残余皮质，囊袋内植入IOL。观察术后并发症、IOL位置、眼压以及裸眼视力（uncorrected visual activity，UCVA）、最佳矫正视力（best corrected visual activity，BCVA）、屈光状态。并采用美国Vertor Vision公司CSV1000对比敏感度测试仪行术眼无眩光及眩光状态下对比敏感度（contrast sensitivity，CS）检查；采用美国VISX公司Custom VueTM波前像差仪行术眼波前像差检查。随访时间为术后6mo。
统计学分析：数据使用SPSS 10.0软件包，采用独立样本t检验对计量资料进行统计学分析。以P＜0.05为差异有统计学意义。
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