高度近视行虹膜固定型人工晶状体植入术的像差变化

目的：探讨有晶体眼虹膜固定型人工晶状体（ IOL）植入术矫正高度近视的安全性、有效性及手术前后像差变化规律。方法对高度近视26例（51眼）行有晶体眼虹膜固定型人工晶状体植入手术，观察术前、术后3个月裸眼视力（ UC-VA）、最佳矫正视力（BCVA）、角膜内皮细胞计数（CECd）、眼压（IOP）、角膜曲率（CC），利用视觉功能分析仪（iTrace）观察术前、术后1周、术后3个月5 mm瞳孔直径下的总像差、总高阶像差、总低阶像差、球差、慧差、三叶草差的均方根（ RMS）值。术前术后各指标变化比较采用配对t检验。结果①51眼均一次性成功植入虹膜固定型人工晶状体。术后UCVA与术前BC-VA比较差异有统计学意义（P＜0．05）。术后IOP、CECd、CC与术前相比差异无统计学意义（P＞0．05）。②术后1周时，总像差、总低阶像差RMS值与术前比较差异有统计学意义（P＜0．01），总高阶像差与术前比较差异无统计学意义（P＞0．05）。术后3个月时，总像差、总低阶像差的RMS值与术前比较差异有统计学意义（P＜0．01），总高阶像差与术前比较差异无统计学意义（ P＞0．05）。从术前至术后3个月，总像差、低阶像差RMS值呈持续降低趋势，高阶像差RMS值呈现先升高后降低的趋势。③术后1周时，球差、慧差的RMS值与术前比较差异有统计学意义（P＜0．05），三叶草差RMS值与术前比较差异无统计学意义（P＞0．05）。术后3个月时，慧差、球差、三叶草差RMS值与术前比较差异无统计学意义（P＞0．05）。从术前至术后3个月，慧差、球差、三叶草差RMS值呈现先升高后降低趋势。结论有晶体眼虹膜固定型人工晶状体植入术矫正高度近视具有安全、有效、可预测特点。术后3个月内总像差及低阶像差RMS值持续降低，高阶像差、球差、慧差、三叶草差RMS值均呈先增高后降低?

The change of aberration of before and after iris-fixated intraocular lens implantation for high myopia

Objective To evaluate the safety ,efficiency of phakic iris-fixated intraocular lens and change of aberration before and after operation for the correction of high myopia .Methods In this prospective study ,51 eyes of 26 patients with high myopia un-derwent implantation of Verisyse phakic intraocular lenses （PIOLs）.Uncorected visual acuity （UCVA）,best corrected visual acuity （BCVA）,cornea lend othelial cell density （CECd）,intraocular pressure （IOP）,corneal curvature （CC） were recorded preoperatively and 3 months after the operation ,as well as root mean square （ RMS） value of total aberration ,total high-order aberration ,total low-or-der aberration,spherical aberration,coma aberration,trefoil aberration with 5 mm pupil size spreoper atively and 1 week,3 months after the operation.Presurgery versus postsurgery changes within the group were analyzed using a paired t test.Results ①All the 51 eyes were implanted successfully with Verisyse PIOLs .UCVA of postoperation compared with preoperation BCVA was statistically significant （P〈0.05）.Postoperatively IOP,CECd,CC was no statistically significant compared with preoperation （P〉0.05）.②Between preop-eration and 1 week after operation and 3 months after operation ,RMS value of total a berration ,total low-order aberration was significant difference respectively （P〈0.05）.Between preoperation and 1 week after operation and 3 month after operation,RMS value of total high-order aberration was no statistically significant （P〉0.05）.RMS value of total aberration,total low-order aberration keep declining from preoperation to 3 months after operation ,the tedency of RMS value of total high-order aberration was ascend in first and descend at last.③Between preoperation and 1 week after operation ,RMS value of spherical aberration ,coma aberration was significant difference respectively （P〈0.05） and trefoil aberration was no statistically significant （P〉0.05）.Between preoperation and 3 months after op-eration,RMS