不同非球面人工晶状体植入术后调节幅度的比较

目的 研究不同非球面单焦可折叠后房型人工晶状体（IOL）植入术后调节幅度的比较。方法 前瞻性病例对照研究。选取2010年8月至2011年8月在天津医科大学眼科医院行白内障超声乳化联合IOL植入术的年龄相关性白内障患者102例（102眼），将其分为3组：Rayner组植入Rayner Superflex 920H型IOL（Rayner），SN60WF组植入Acrysof IQ SN60WF型IOL（Alcon），SN60AT组植入Acrysof NATURAL SN60AT型IOL（Alcon）。术后6个月检测患者裸眼远视力、最佳矫正远视力、最佳矫正远视力后的近视力；使用Hartmann-Shack波前像差仪（Wavefront）测量患者球差；使用综合验光仪调节尺测量患者主观调节幅度；使用WR-5100型全自动电脑验光仪（Grand Seiko）测量患者客观调节幅度。采用卡方检验和方差分析分别对计数资料和计量资料行统计学分析，采用Pearson相关分析检验参数相关性。结果 Rayner组、SN60WF组和SN60AT组患者主观调节幅度分别为（2.00±0.58）D、（2.26±0.60）D、（2.29±0.48）D，3组患者客观调节幅度分别为（0.87±0.37）D、（1.01±0.38）D、（1.04±0.37）D，3组患者比较差异均无统计学意义（F主观=2.662，P主观>0.05；F客观=1.925，P客观>0.05）。3组患者球差在瞳孔直径为3 mm时分别为（0.08±0.04）μm、（0.05±0.04）μm、（0.14±0.05）μm，3组比较差异有统计学意义（F=45.780，P<0.01）。球差与主、客观调节幅度均无相关性（r主观=0.056，P主观>0.05；r客观=0.095，P客观>0.05）。结论 植入Acrysof SN60WF型非球面IOL和Rayner Superflex 920H型非球面IOL与植入Acrysof SN60AT型球面IOL相比，对调节幅度没有明显影响。球面像差与人工晶状体眼调节幅度不相关。

Contrast studies on the accommodation amplitude after different aspheric intraocular lenses implantation

Objective To compare the accommodation amplitude after different aspheric monofocal posterior chamber intraocular lenses （IOLs） implantation. Methods A prospective clinical study comprised 102 eyes of 102 patients who underwent phacoemulsification and intraocular lens implantation in Tianjin Medical University Eye Hospital from August 2010 to August 2011. Patients were divided into 3 groups according to the type of IOLs that implanted： Group Rayner were implanted with Rayner Superflex 920H IOL （Rayner）； Group SN60WF were implanted with Acrysof IQ SN60WF IOL （Alcon）； Group SN60AT were implanted with Acrysof NATURAL SN60AT IOL （Alcon）. At 6 months postoperatively， uncorrected visual acuity， best corrected visual acuity， distance corrected near visual acuity were evaluated. Spherical aberration was measured by Hartmann-Shack wavefront sensor. Patients′ subjective amplitude of accommodation was measured by integrated refractometer adjustment feet； while the objective amplitude of accommodation was measured by WR-5100 automatic computer Refractometer （GrandSeiko）. Statistical analysis of count data and measurement data were done separately by the chi-square test and variance analysis. Pearson correlation was performed to analyze the association between parameters. Results The subjective amplitude of accommodation in the 3 groups were 2.00±0.58 D， 2.26±0.60 D， 2.29±0.48 D， respectively， while the objective amplitude of accommodation in the three groups were 0.87±0.37 D， 1.01±0.38 D， 1.04±0.37 D， respectively. There was no statistically significant difference between the subjective and objective amplitude of accommodation in the 3 groups （Fsub=2.662， Psub=0.075； Fob=1.925， Pob=0.151）. When the pupil diameter was 3 mm， the spherical aberrations of the three groups were 0.08±0.04 μm， 0.05±0.04 μm， 0.14±0.05 μm， respectively. The difference of spherical aberration among the three groups was statistically significant （F=45.780， P<0.01）. No correlation was found in the spherical aberration with subjective or objective amplitude of accommodation （rsub=0.056， Psub=0.576； rob=0.095， Pob=0.343）. Conclusion Compared with the implantation of Acrysof SN60AT spherical intraocular lens， the implantation of the Acrysof SN60WF aspheric intraocular lens and Rayner Superflex 920H aspheric intraocular lens do not affect the amplitude of accommodation significantly. No correlation is found between spherical aberration and subjective or objective amplitude of accommodation.