非球面人工晶状体植入术后偏心和倾斜与视觉质量的相关性研究

目的：探讨新型眼前节扫频光相干断层扫描仪CASIA2测量年龄相关性白内障患者植入非球面人工晶状体(IOL)术后的偏心和倾斜与视觉质量的关系。

方法：观察性研究。纳入年龄相关性白内障术后1mo随访的患者62例90眼。应用CASIA2于散瞳后测量IOL偏心和倾斜的大小和方向，进行3次测量，取其矢量平均值。再使用KR-1W波前像差仪和双通道视觉质量分析系统(OQAS)进行测量，获取4、6mm瞳孔直径下全眼总高阶像差(tHOA)、球面像差(SA)、彗差(Coma)、客观散射指数(OSI)、调制传递函数截止频率(MTF cut off)和斯特列尔比(SR)等参数。

结果：IOL偏心与4mm瞳孔直径下SA(r=0.347，P=0.001)和OSI(r=0.343，P=0.002)成正相关，与MTF cut off(r=-0.244，P=0.032)呈负相关，与tHOA、Coma和SR无相关。IOL倾斜与4mm瞳孔直径下MTF cut off(r=-0.345，P=0.002)和SR(r=-0.256，P=0.023)呈负相关，与tHOA、SA、Coma、OSI均无相关性。IOL的偏心和倾斜与6mm瞳孔直径下的tHOA、SA、Coma、MTF cut off、SR均无相关性。

结论：年龄相关性白内障患者植入非球面IOL后，除IOL偏心与4mm瞳孔直径下SA呈弱相关性，偏心和倾斜与其余各项高阶像差均无明显相关性，与视觉质量参数OSI值及MTF cut off值弱相关，提示临床医生在精准白内障手术中关注高阶像差及视觉质量。

Correlation between postoperative decentration and tilt of aspherical intraocular lens implantation and visual quality

AIM: To investigate the correlation between postoperative lens decentration and tilt and visual quality in eyes implanted with aspherical intraocular lens(IOL)by using a new anterior segment swept-source optical coherence tomography(OCT)CASIA2.

METHODS: An observational study. A total of 90 eyes of 62 participants who underwent age-related cataract surgery at 1mo were included. Using CASIA2 by an experienced examiner, IOL tilt and decentration were obtained three consecutive times after mydriasis and the vector mean values were calculated. Double-pass optical quality analysis system(OQAS)and wavefront aberration instrument KR-1W were used for the visual quality measurements, including the total high-order aberration(tHOA), spherical aberration(SA), Coma, objective scatter index(OSI), modulation transfer function cut off frequency(MTF cut off)and Strehl ratio(SR)at 4 and 6mm pupil diameter.

RESULTS: IOL decentration was positively correlated with SA(r=0.347, P=0.001)and OSI(r=0.343, P=0.002)at 4mm pupil diameter, and it was negatively correlated with MTF cut off(r=-0.244, P=0.032). There was no significant correlation between IOL decentration and tHOA, Coma and SR. IOL tilt was negatively correlated with MTF cut off(r=0.-345, P=0.002)and SR(r=-0.256, P=0.023)at 4mm pupil diameter, but it was not correlated with tHOA, SA, Coma and OSI. There were no significant correlations between the IOL decentration and tilt and tHOA, SA, Coma, MTF cut off and SR at 6mm pupil diameter.

CONCLUSION: After aspherical IOL implantation in age-related cataract patients, IOL decentration was weakly correlated with SA at 4mm pupil diameter, while decentration and tilt were not significantly correlated with other higher-order aberrations. The decentration and tilt were weakly correlated with OSI value and MTF cut off value of the visual quality parameters. The results suggest that clinicians should pay more attention to higher-order aberrations and visual quality during precise cataract surgery.