Study of the wavefront aberrations in children with amblyopia

Background Amblyopia is a common ophthalmological condition and the wavefront aberrometer is a relatively new diagnostic tool used globally to measure optical characteristics of human eyes as well as to study refractive errors in amblyopic eyes. We studied the wavefront aberration of the amblyopic children＇s eyes and analyzed the mechanism of the wavefront aberration in the formation of the amblyopia, try to investigate the new evidence of the treatment of the amblyopia, especially in the refractory amblyopia. Methods The WaveScan Wavefront System （VISX, USA） aberrometer was used to investigate four groups of children under dark accommodation and cilliary muscle paralysis. There were 45 cases in the metropic group, 87 in the amblyopic group, 92 in the corrected-amblyopic group and 38 in the refractory amblyopic group. One-way analysis of variance （ANOVA）, t-test and multivariate linear regression were used to analyze all the data. Results Third order to 6th order aberrations showed a decreasing trend whereas in the higher order aberrations the main ones were 3rd order coma （Z3LZ31）, trefoil （Z33-Z33） and 4th order aberration （Z4^0）; and 3rd order coma represented the highest percentage of all three main aberrations. Within 3rd order coma, vertical coma （Z3-1） accounted for a greater percentage than horizontal coma （Z3-1）. Significant differences of vertical coma were found among all clinical groups of children： vertical coma in the amblyopic group （0.17±0.15） was significantly higher than in the metropic group （0.11±0.13, P 〈0.05）. In addition, the vertical coma in the refractory amblyopic group （0.19±0.15） was higher compared with the metropic group （P 〈0.05）, the 5th order aberration （0.11±0.08） was also significantly higher than in the metropic group （0.07±0.04, P 〈0.05）. No significant difference was found in vertical coma and 5th order aberration between the corrected-amblyopic group （0.13±0.11） and metropic group （0.07±0.04） （P 〉0.05）. Conclusions Although lower order aberrations such as defocus （myopia and hyperopia） and astigmatism are major factors determining the quality of the retinal image, higher order aberrations also need to be considered in amblyopic eyes as their effects are significant.     

Comparison of higher-order aberrations and contrast sensitivity between Tecnis Z9001 and CeeOn 911A intraocular lenses: a prospective randomized study

Background The advent of wavefront technology in the past five years has provided some insight into the optical outcomes of cataract surgery. The Tecnis Z9001 intraocular lens （Tecnis IOL, AMO） with a modified prolate anterior surface was claimed to reduce or even eliminate ocular spherical aberration to improve the visual quality. The purpose of this study was to determine whether Tecnis IOLs can improve the quality of vision as evaluated by measuring visual acuity, wavefront aberration, and contrast sensitivity. Methods In an intraindividual prospective study, 20 patients with bilateral cataract were randomly assigned to receive a modified prolate anterior surface IOL （Tecnis Z9001, AMO） in one eye and a biconvex spherical surface IOL （CeeOn 911A, AMO） in the other. After 3 months, the following were investigated： best corrected visual acuity, pupil diameter, photopic and mesopic contrast sensitivity, and wavefront aberration of the whole eye （ocular）, cornea, and internal plane. Results The differences in the best corrected visual acuity and pupil diameter between the two groups were not statistically significant. Negative 4th-order spherical aberration （Z4^0） was found in the Tecnis group, whereas positive Z4^0 found in the CeeOn group for the internal and ocular plane. Statistically significant differences were found at the ocular higher-aberrations between the two IOLs. Contrast sensitivity testing showed significantly better results in the Tecnis group at visual angles higher than 1.0 degree under photopic conditions and at visual angles higher than 1.6 degree under mesopic conditions both without glare and with glare in comparison with the CeeOn group. Conclusions The Tecnis Z9001 IOL with a modified prolate anterior surface produces negative spherical aberration and consequently reduces the higher-order aberrations in pseudophakic eyes. This leads to enhanced contrast sensitivity and improved functional vision compared to conventional spherical IOLs.     

Changes in anterior chamber depth following vitrectomy

Background Anterior segment morphometry is crucial for ophthalmologists to understand the visual outcomes of cataract surgery,keratorefractive surgery,as well as some other anterior segment disorders.Previous reports in literature have shown that anterior chamber depth （ACD） may shift slightly after vitrectomy.This study aimed to characterize the shortterm changes in ACD in eyes after vitrectomy by means of A-scan ultrasound.Methods A prospective case series study was carried out on 29 eyes of 29 patients who underwent vitrectomy as the sole procedure.ACD was measured using A-scan ultrasound biometry shortly before vitrectomy and 1 week,1 month,and 3 months after the surgery.Postoperative ACDs were compared with baseline.Results Twenty-nine patients （16 males and 13 females） were enrolled in the study,with mean age of （50±11） （25-65） years.Twenty-three eyes of 23 patients were vitrectomized for vitreous hemorrhage （VH） and the other six were operated for idiopathic epiretinal membrane （ERM）.The mean preoperative ACD of the VH eyes was （2.98±0.38） mm.No significant difference was found between the ACD of the VH eyes and their fellow eyes （P=0.058）.The average preoperative ACD in the ERM eyes was （2.94±0.31） mm,which was statistically deeper than that of their fellow eyes （（2.85±0.28） mm,P=0.008）.No statistical difference was found in the postoperative average ACD of the VH eyes compared with baseline.In the ERM group,the postoperative ACD in the surgical eyes was still statistically deeper than the fellow eyes 1 week after surgery （P=0.034）.However,such statistical difference disappeared at 1 or 3 months postoperative （P=0.186 and 0.682）.Conclusions ERM may induce deepening of the ACD,which can be recovered by uneventful vitrectomy.VH does not cause shift of ACD,neither does vitrectomy.     

Analysis of clinical features of painless aortic dissection

The clinical characteristics of painless aortic dissection were investigated in order to improve the awareness of diagnosis and treatment of atypical aortic dissection. The 482 cases of aortic dissection were divided into painless group and pain group, and the data of the two groups were retrospectively analyzed. The major clinical symptom was pain in 447 cases（92.74%）, while 35 patients（7.26%） had no typical pain. The gender, age, hypertension, hyperlipidemia, diabetes, smoking and drinking history had no statistically significant differences between the two groups（P〉0.05）. The proportion of Stanford type A in painless group was significantly higher than that in pain group（48.57% vs. 21.03%, P=0.006）. The incidence of unconsciousness in the painless group was significantly higher than that in the pain group（14.29% vs. 3.58%, P=0.011）. The incidence of hypotension in painless group was significantly higher than that in pain group for 4.26 folds（P=0.01）. Computed tomography angiography（CTA） examination revealed that the incidence of aortic arch involved in the painless group was signifi-cantly higher than that in the pain group（19.23% vs. 5.52%, P=0.019）. It was concluded that the incidence of painless aortic dissection was higher in Stanford A type patients, commonly seen in the patients complicated with hypotension and unconsciousness. CTA examination revealed higher incidence of aor-tic arch involvement.     

Intravitreal ranibizumab therapy versus photodynamic therapy for idiopathic choroidal neovascularization: a comparative study on visual acuity, retinal and choroidal thickness

Background Photodynamic therapy （PDT） has been recommended as a main treatment for idiopathic choroidal neovascularization （I-CNV）.But the visual results of PDT were inconsistent and variable,and PDT may bring severe damage to the retinal pigment epithelium and choriocapillaries.In recent years,intravitreal ranibizumab therapy,showing favorable visual outcomes,has developed as an advanced treatment for choroidal neovascularization （CNV）.Although both methods have been reported to be effective in treating I-CNV,there is no detailed comparative report between the two methods.This study aimed to compare visual outcomes,retinal and choroidal thickness between intravitreal ranibizumab therapy and PDT in the treatment of I-CNV,and investigate the correlation of visual outcomes with retinal and choroidal thickness in each of the two groups.Methods Thirty-seven eyes of 37 patients with I-CNV were involved in this study; 19 eyes were treated with intravitreal ranibizumab therapy and 18 eyes were treated with PDT.The best corrected visual acuity （BCVA） was recorded before and at each follow-up visit after treatments （IogMAR）.Enhanced-depth imaging optical coherence tomography （EDI-OCT） was used to evaluate the retinal structural changes,and to measure central retinal thickness （CRT） and central choroidal thickness （CCT）.Results Mean BCVA was 0.64±0.27 in PDT group and 0.69±0.22 in ranibizumab group at baseline （P=0.55）.When compared with the baseline,mean BCVA in PDT group was improved significantly at 3-month after PDT （0.41±0.16,P=0.002）,then changed little （0.42±0.25 at 12-month,P=0.88）.Whereas mean BCVA in Ranibizumab group was improved significantly at each follow-up visit.It improved much more obviously in the first month and then remained stable.The mean BCVA in the ranibizumab group was significantly better at each follow-up visit than that in PDT （P ＜0.05）.When compared with the baseline,mean CRT in PDT group decreased significantly since 3-month visit,whereas     

Effect of Methyl-CpG Binding Domain Protein 2 （MBD2） on AMD-like Lesions in ApoE-Deficient Mice

Summary： The role of methyl-CpG binding domain protein 2 （MBD2） in an ApoE-deficient mouse model of age-related macular degeneration （AMD） was investigated. Eight-week-old Mbd2/ApoE double deficient （Mbd2^-/- ApoE^-/-） mice （n=12, 24 eyes, experimental group） and MBD2 （wt） ApoE^-/- mice （n=12, 24 eyes, control group） were fed on Western-type diet for 4 months. The mice were sacrificed, and total serum cholesterol levels were analyzed and Bruch＇s membrane （BM） of the eyes was removed for ultrastructural observation by transmission electron microscopy. Moreover, intercellular adhesion molecule 1 （ICAM-1） immunoreactivities were evaluated by fluorescence microscopy in sections of the eyes in both groups for further understanding the function mechanism of MBD2. There was no significant difference in the total serum cholesterol levels between control group and experimental group （P〉0.05）. Transmission electron microscopy revealed that AMD-like lesions, various vacuoles accumulated on BM, notable outer collagenous layer deposits and dilated basal infoldings of retinal pigment epithelium （RPE） were seen in both groups, and the BM in control group was significantly thickened as compared with experimental group （P〈0.05）. Fluorescence micrographs exhibited the expression of ICAM-1 in choroid was higher in control group than in experimental group. We are led to conclude that MBD2 gene knockout may lead to accumulation of more deposits on the BM and influence the pathogenesis of AMD via triggering endothelial activation and inflammatory response in choroid, improving microcirculation, and reducing lipid deposition so as to inhibit the development of AMD-like lesions. Our study helps to provide a new therapeutic approach for the clinical treatment of AMD.     

Effects of lptakalim on intracellular free calcium concentration of cultured rabbit pulmonary arterial smooth muscle cells

Objective：To explore the effects of Iptakalim on intracellular free calcium concentration and on the proliferation of cultured rabbit pulmonary arterial smooth muscle cells induced by endothelin-1 （ET-1） in vitro. Methods：A cell culture model, [^3H]-thymidine（[^3H]-TdR） incorporation test and confocal microscope were used to observe proliferation and intracellular free calcium concentration（[Ca^2±]） of rabbit PASMC induced by ET-1 in vitro. Results：The value of [^3H]-TdR incorporation in ET-1 group was increased 1.468 times higher than that in control group. Iptakalim at the concentration of 10^-7mol/L, 10^-6mol/L ,10^-5 mol/L lowered [^3H]-TdR incorporation by （19.8 ± 4.6）%, （41.2 ± 9.5）%, （54.7 ± 10.1）%, respectively, compared with the value of the cells treated with ET-1（P〈 0.01）; The intracellular fluorescence intensity of PASMC in ET-1 group was increased from 73.70 ± 10.12 to 143.84 ± 28.23, significantly higher than that in control group（P 〈 0.01）; whereas with Iptakalim,the fluorescence intensity（FI） was only increased from 74.30 ± 10.20 to 86.03 ± 9.82, significantly lower than that in ET-1 group（P 〈 0.01）. Conclusion：Iptakalim inhibited proliferation of PASMC and decreased intracellular free calcium concentration of cultured rabbit PASMC induced by ET-1.     

Levels of soluble adhesion molecules in patients with various clinical presentations of coronary atherosclerosis

Background Adhesion molecules play an important role in the development and progression of coronary atherosclerosis. The aim of this study was to compare concentrations of soluble forms of adhesion molecules in patients with different clinical presentations of coronary artery disease （CAD）.Methods One hundred and twenty-eight patients with CAD were divided into three groups; the first group was acute myocardial infarction group （AMI group, n=45）, the second group was unstable angina pectoris group （UAP group, n=48）,the third group was stable angina pectoris group （SAP group, n=35）. We compared them with patients with normal coronary arteries （control group, n=31）. The serum levels of vascular cell adhesion molecule （VCAM-1）, intercellular adhesion molecule-1 （ICAM-1）, E-selectin and P-selectin were measured in all subjects.Results The serum level of VCAM-1 in the AMI group was significantly higher than in the UAP, SAP and control groups （P 〈0.01）. The level in the UAP group was significantly higher than the SAP group and control group （P 〈0.01） and the level in the SAP group was significantly higher than in the control group （P 〈0.01）. The serum ICAM-1 level was significantly elevated in the AMI, UAP and SAP groups as compared to the control group （P 〈0.01）. The levels of serum E-selectin and P-selectin in the AMI and UAP groups were significantly higher than in the SAP and control groups （P〈0.01）.Conclusions Increased levels of VCAM-1 and ICAM-1, E-selectin and P-selectin, as markers of inflammation, showed the importance of inflammatory processes in the development of atherosclerosis and clinical expression of CAD. Soluble ICAM-1, VCAM-1, E-selectin and P-selectin concentrations are useful indicators of the presence of atherosclerosis and the severity of CAD clinical presentation.     

Effects of Rosiglitazone on Adiponectin Expression in 3T3- L1 Adipocytes at High Levels of Both Testosterone and Insulin In Vitro Culture

Objective To evaluate effects of rosiglitazone （RSG） on the expression of adiponectin in mature adipocytes at high levels of both testosterone （T） and insulin in vitro culture. Methods Mouse 3T3-L1 preadipocytes were induced to be mature adipocytes and used in this study. According to RSG concentrations, the cells added with T （10^-5 mol/L） and insulin （10^-4 mol/L） were divided into 4 groups： free-RSG group （0 mol/L RSG, FR-TI）, low-dose group （10^-9 mol/L RSG, LR-TI）, middle-dose group （lO-7mol/L RSG, MR-T1） and high-dose group （10^-6 mol/L RSG, HR-TI）. Besides, the cells added with RSG without T and insulin were also divided into 4 groups： FR, LR, MR, and HR. These 8 groups were incubated for 42 h. Cell viability was determined by MTT assay. Expression of adiponectin was detected by Western blotting. Results The maximum viability in FR-TI group was observed at point of 42 h. The growth of the adipocytes was significantly inhibited in MR-TI group compared with FR-TI （P〈0.01）. The level of adiponectin in MR-TI group was higher than that in LR- TI group （P〈0.01）. However, with RSG increasing; HR-TI group showed the lowest level of adiponectin among three treatment groups （P〈0.01）. In addition, adiponectin expression in MR-TI group was significantly higher than that in MR group （P〈0.01）. Conclusion RSG could increase the expression of adiponectin in 3T3-L1 adipocytes under high levels of both T and insulin, but it acts in a narrow concentration range.     

虹膜定位波前像差引导的LASIK治疗近视散光术后视觉质量的研究

[目的]评估虹膜定位联合波前像差引导的LASIK治疗近视散光的临床疗效及视觉质量。[方法]选取柱镜≥-1.0D的近视散光患者随机分为两组,分别接受虹膜定位联合波前像差引导的LASIK（82例,130眼）和常规LASIK（77例,118眼）治疗,比较术后3月、6月及1年裸眼视力、残余散光度、高阶像差和对比敏感度。[结果]术后各时期,虹膜定位组裸眼视力均优于常规组（P〈0.05）;虹膜定位组残余散光度均低于常规组（P〈0.05）;虹膜定位组高阶像差各项均低于常规组,其中术后3月两组RMSh、Coma及RMS6差异有统计学意义（P〈0.05）,术后6月两组RMSh、Coma、Trefoil、RMS3及RMS6差异有统计学意义（P〈0.05）,术后1年两组RMSh、Coma及RMS3差异有统计学意义（P〈0.05）。术后1年,虹膜定位组（除Trefoil）和常规组高阶像差各项均较术前明显增加（P〈0.05）。术后1年,虹膜定位组对比敏感度在暗光及暗光＋眩光状态下所有频段均明显好于常规组（P〈0.05）。[结论]虹膜定位联合波前像差引导的LASIK能有效治疗近视散光,提高术后视觉质量。     

虹膜定位波前像差引导的LASIK术像差的改变与视觉质量的关系

目的：通过Wavescan波前像差分析仪检查和分析虹膜定位波前像差引导的LASIK手术前后波前像差的改变与视觉质量的关系。方法：随机抽取66例（130眼）行虹膜定位波前像差手术的病人。分别于术后1d、1周和1、3、6个月检查裸眼视力（uncorrected visual acuity,UCVA）及满意度调查,术后3个月行波前像差检查。结果：术前平均最佳矫正视力（best corrected visual acuity,BCVA）为1．02±0．13,术后6个月平均UCVA为1．06±0．14,术后6个月平均UCVA较术前平均BCVA高（P〈0．05）,视觉质量满意度为96．92％。术后总体像差均方根值（root of mean square of general aberration,RMSg）明显减小（P〈0．01）,高阶像差均方根值（root of mean square of higher aberration,RMSh）增大（P〈0．01）,高阶像差所占的百分比（Hiorder）增大（P〈0．01）。C4减小（P〈0．01）,C7增大（P〈0．05）,C12增大（P〈0．01）,三叶草差Z33减小,C8增大。结论：虹膜定位波前像差引导的LASIK手术有助于提高患者的视觉质量,Zernike函数C7、C12增大与术后视觉质量有一定关系。     

波前像差引导的个体化切削术后高阶像差

目的观察采用波前像差引导的个体化切削准分子激光角膜原位磨镶术治疗中、低度近视的疗效。方法对24例48眼中低度近视患者行波前像差引导的个体化准分子激光角膜原位磨镶术,观察术后视力、屈光度和高阶像差,并与同期42眼的标准手术进行对比。结果个体化准分子激光手术后30 d裸眼视力3眼UCVA超过术前BCVA 2行,16眼超过1行;24眼与术前相等,3眼低于术前1行,优于对照组;术后慧差减小;且术前垂直慧差与术后波前像差均方根和呈负相关。结论波前像差引导的个体化准分子激光近视矫正手术可以减小患者术后高阶像差,提高患者术后视觉质量。正确选择适应证可以提高个体化手术的效果。     

EFFECTS OF PREOPERATIVE SOFT CONTACT LENS WEAR ON HIGHER-ORDER ABERRATIONS AFTER LASER IN SITU KERATOMILEUSIS

Objective To evaluate the effects of preoperative soft contact lens (SCL) wear on higher-order aberrations(HOAs)correction after wavefront-guided and conventional laser in situ keratomileusis (LASIK).Methods A prospective randomized double-masked comparative study was conducted in 180 eyes of 90 patients scheduled for LASIK, including 92 eyes of 46 patients with previous SCL wear. The patients were divided into four groups: no SCL-conventional group, SCL-conventional group, no SCL-wavefront group and SCL-wavefront group. Preoperative and postoperative examinations included uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), contrast sensitivity and HOAs.Results The UCVA and BSCVA were 20/20 in all patients at 6 months postoperatively. And 36.3%, 22.7%, 18.1% and 35.4% gained one line or more of BSCVA in no SCL-wavefront group, SCL-wavefront group, no SCL-conventional group and SCL-conventional group, respectively. Both the safety index and efficacy index surpassed one in 4 groups and were highest in no SCL-wavefront group. The increase in root-mean-square (RMS) values of HOAs was significantly lower in no SCL-wavefront group and higher in SCL-wavefront group. At 6 months postoperatively, the increase in RMS of HOAs (RMSh) were 0.67, 1.58, 1.17 and 1.28 in no SCL-wavefront group, SCL-wavefront group, no SCL-conventional group and SCL-conventional group, respectively.Conclusion Preoperative contact lens wear has significant influence on the efficacy of HOAs correction in wavefront-guided LASIK. Patients with contact lens wear preoperatively should be cautious when scheduled for wavefront-guided LASIK.     

虹膜定位波前像差引导的LASIK与传统LASIK治疗高度近视像差的变化与对比敏感度、眩光敏感度关系

目的：比较虹膜定位波前像差引导的准分子激光原位角膜磨镶术（LASIK）和传统LASIK矫正高度近视术后3个月时波前像差的变化与对比敏感度、眩光敏感度的关系,探讨像差对视觉质量的影响。方法：将行虹膜定位波前像差引导的LASIK的高度近视患者9例（17眼）作为试验组,行传统LASIK的近视患者8例（14眼）作为对照组。对试验组和对照组术后3个月的视力、波前像差、对比敏感度和眩光敏感度进行统计学分析。结果：（1）试验组、对照组术后3个月的视力无统计学意义（P〉0．05）,波前像差Zernike函数c4（离焦）、C7（垂直彗差）、C8（水平彗差）、三叶草差（C6、C9）、C12（球差）、RMSg（总体像差均方根值）、RMSh（高阶像差均方根值）无统计学意义（P〉0．05）。（2）术后3个月比较对比敏感度,白天在低频区3．0c／d、中频区6．0c／d空间频率下,有统计学意义（P〈0．05）;晚上在低频区3．0c／d空间频率下,有统计学意义（P〈0．05）。白天＋眩光在低频区3．0c／d空间频率下,有统计学意义（P〈0．05）。结论：虹膜定位波前像差引导的LASIK较传统LASIK矫正高度近视无更好的视觉质量。     

Ocular higher-order aberrations features analysis after corneal refractive surgery

Background  The recent studies have shown that visual performance might be affected by the ocular aberration after the corneal refractive surgery, and try to minimize it. This study was to investigate the effects of photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) on the higher order of wavefront aberration and analysis of their characteristics.
Method  This prospective study involved 32 eyes with similar refractive powers (-5.0 D to -6.0 D preoperatively). LASIK and PRK were performed with the same parameters of 6 mm diameter optical zone and 7 mm diameter transition zone ablation. Wavefront aberrations were tested using a ray tracing technique preoperatively and 3 months postoperatively. Three measurements were obtained for each condition; the root mean squared wavefront error (RMS), values for overall wavefront aberrations and each order of the Zernike aberrations were analyzed using the Matlab software. The 2-tailed t test was used for statistical analysis.
Results  Overall higher order aberrations were increased from (0.550.26) µm preoperatively to (0.930.37) µm for PRK and (0.790.38) µm for LASIK postoperatively. This was a 1.69 fold increase in the PRK group (t=3.95, P<0.001) and a 1.43 fold increase in the LASIK group (t=2.60, P<0.05). At 3 months, the mean RMS value for higher-order (3rd to 6th) were significantly increased compared with the corresponding preoperative values (P<0.05). The fourth order aberrations, spherical like aberration, were dominant by a 2.64 fold in PRK and a 2.31 fold in LASIK. Different influences of the PRK group and LASIK group were shown in the various zernike components. The statistically significant differences were seen in C₄⁰, C₄⁺⁴, C₅⁺¹, C₅⁺³, C₅⁺⁵ and C₆⁺² of the PRK group and C₃^-3, C₄⁰, C₅^-5, C₅⁺⁵, C₆^-2 of the LASIK group, which represents a 7.42, 3.58, 9.21, 2.72 and 5.3 fold increases in PRK group, and 6.40, 10.80, 11.06, 3.47 and 6.09 fold increases in LASIK group, respectively. C₃^-3 in LASIK was higher and C₅⁺¹ and C₅⁺³ were lower than those in the PRK group. C₄⁰ (spherical aberration) values were similar between PRK and LASIK, however, C₃^-1 and C₃¹ (coma) in LASIK were higher than those in PRK, but these differences are of no statistical significance.
Conclusions  PRK and LASIK may increase ocular higher-order aberrations, but they both have their own features. The difference between the two types of surgery may be correlated with the change of the corneal shape, the conversion of biodynamics, the healing of the corneal cut, and re-structured corneal epithelium and/or the stroma.

     

波前像差引导的LASIK手术与传统LASIK手术的疗效对比研究

目的：比较常规准分子激光原位角膜磨镶术（1aserinsitukeratomileusis,LASIK）和波前像差引导的LASIK手术后（wavefrontandirislocatingguided—LASIK,WG—LASIK）近视患者的疗效以及角膜前表面像差的变化。方法：随机选取2011年10月～2011年12月在我院行手术治疗的患者100例200眼,排除手术禁忌证后,按球镜屈光度分成低度（≤-3．00D）和中度（-3．00D～-6．00D）。每组患者随机分成2组,一组行波前像差LASIK,另一组行常规LASIK。分别在术后1个月、3个月随访患者的裸眼视力、波前像差检查。结果：在低度和中度患者中,LASIK组和wG—LASIK组术后视力在1个月和3个月均达到术前水平,两组间差异无统计学意义（P〉0．05）。在低、中度近视组,LASIK组和WG—LASIK组在术后1个月时彗差、球差及总的高阶像差均较术前有所增加。至术后3个月时彗差、球差及总的高阶像差均未恢复至术前水平。在中度近视组,LASIK组和WG—LASIK组间彗差、球差及总的高阶像差的差异有统计学意义（P〈0．05）。结论：波前像差引导的LASIK手术能有效的矫正近视和散光。并且其视觉质量优于传统的LASIK手术。     

人工晶状体眼波阵面像差变化

目的研究超声乳化联合人工晶状体植入术对术眼波前像差及成像质量的影响。方法选择白内障患者96人(104眼),随机分为两组进行手术(植入不同类型直径的人工晶状体)。术后分别于1W与4W及12W观察术眼波阵面像差及其他相关变化。结果不同光学结构的人工晶状体均存在单色光像差,其中球差的影响最明显。Z4、Z9、Z12和Z24值在手术前后有显著性差异(P<0.05);RMS1~6、RMSg、RMSh值术后较术前均呈显著性下降(P<0.001)。折叠人工晶状体的类型(三片、一片)与术后RMS 3(r=-0.319)、RMS 4(r=-0.475)、RMS 5(r=-0.304)和RMSh(r=-0.408)值呈显著相关性(P均<0.05)。结论波前像差技术可以帮助揭示术后出现相关视觉问题的原因。白内障术后各阶像差较术前均显著性减小,光学成像质量提高,具特征性的改变是三叶草形的像差和四阶球差;三片式折叠人工晶状体眼的高阶像差小于一片式折叠人工晶状体眼。*     

非球面(Z9001)和标准(911a和AR40e)人工晶状体对视觉功能和生活质量的影响

目的 比较校正波前像差的非球面人工晶状体(IOL)和对于行白内障超声乳化人工晶状体植入术的患者植入标准球面IOL的视觉质量.方法 受试者随机分配到接受非球面Tecnis Z9001、球状硅CeeOnEdge 911或球状丙烯酸Sensar AR40e球面人工晶体植入(所有产品均为美国加州圣安娜雅培医疗光学提供).WFA1000主观波前像差仪用于分析主观像差.Allegretto波前像差分析仪用于分析客观波前像差.采用FACT测试卡分析对比敏感度.对VF-14问卷加以少许修改以适应中国人群的需要,例如,采用骑自行车代替驾车,用放风筝和门球代替高尔夫球和网球.在第1周、第1个月、第3个月和第6个月进行检查 结果 球面波前像差与年龄呈正相关(r=0.582,P＜0.05).Z9001 IOL(37倒)组与911(19例)和AR40e( 16例)组相比,Z40 Zernike系数、RMS4和RMSh均较低(P＜0.05),5级空间频率上对比敏感度更高 Z9001 IOL的视觉功能分数高于其他两种球面IOL(P＜0.05) 结论 白内障手术时在晶状体平面校正波前像差能改善视觉功能.     

白内障患者不同人工晶状体植入术后视觉质量比较

目的检测白内障三种单焦球面人工晶状体植入术后所获得视觉质量的差异。方法选取行超声乳化联合折叠式人工晶状体植入术的单纯老年性白内障患者120人(120眼),分别植入肝素表面处理亲水性丙烯酸酯人工晶状体(HQ-201HEP组,n=40)、疏水性丙烯酸酯人工晶状体(Sensar AR40 e组,n=40)或蓝光滤过人工晶状体(AcrySof Natural SN60AT组,n=40);另选取年龄相近的正常人40眼作为对照组。应用CSV-1000E对比敏感度仪测量对比敏感度及眩光对比敏感度,鹰视波前像差仪测定高阶像差,比较各组对比敏感度和眩光敏感度以及各级高阶像差之间的差异。结果三组患者对比敏感度及眩光对比敏感度在各空间频率的差异均无统计学意义(P>0.05),但均低于对照组(P<0.05或P<0.01)。三组患者间总高阶像差(RMSh)、三阶(RMS3)、四阶(RMS4)、五阶(RMS5)、六阶(RMS6)像差差异均无统计学意义(P>0.05);在球差(C12)、次级球差(C24)、RMSh、RMS3、RMS4、RMS5和RMS6均显著高于对照组(P<0.01)。结论白内障三种单焦球面人工晶状体植入术后对比敏感度功能和各级高阶像差无显著差异,视网膜成像质量无明显区别。植入单焦球面人工晶状体可部分恢复白内障患者的对比敏感度功能,但尚未达到正常同龄人水平。