应用静息态功能磁共振成像分数低频振幅技术研究中高度近视患者大脑活动的异常改变

目的 利用静息态功能磁共振成像中的分数低频振幅(fractional amplitude of low frequency fluctuation,fALFF)技术研究中高度近视患者的脑功能改变,探讨其与近视患者临床资料的相关性.方法 选择21例中高度近视患者为近视组,选择21名年龄、性别相匹配的健康志愿者为正常对照组,对入选者行静息态功能磁共振fALFF扫描.比较近视组与正常对照组大脑功能活动fALFF值的差异,并且分析fALFF改变的脑区与近视患者临床资料的相关性.结果 相比于正常对照组,近视组在左侧额下回、壳核与右侧额下回、壳核、岛叶等区域fALFF值显著减低(均为P＜0.05),然而双侧中扣带回、双侧前扣带回、左侧中央后回以及左侧顶上小叶等区域fALFF值显著增高(均为P＜0.05).在近视组中,患者大脑不同区域的平均fALFF值与其病程、屈光度及最佳矫正视力均无明显相关性(均为P ＞0.05).结论 近视患者伴随着多个脑区的神经元活动异常,这些脑区异常可能反映近视患者在语言理解和注意力控制方面可能存在功能障碍.     

基于V1区种子点应用静息态功能磁共振的功能连接技术分析正常眼压性青光眼患者脑部功能连接的变化

目的 基于V1区种子点(ROI)应用静息态功能磁共振的功能连接技术研究正常眼压性青光眼(NTG)患者和健康志愿者的脑部功能连接变化,旨在探究NTG患者的发病机制及早期诊断方法。方法 收集符合纳入标准的NTG患者14例(NTG组)及健康对照者14例(HCs组),收集受试者的临床数据信息后对两组受试者行静息态功能性磁共振成像扫描。通过软件对磁共振数据进行预处理,以双侧V1区作为ROI,分别计算其与全脑体素时间序列的相关性并比较组间静息态功能连接的差异得到V1区ROI和全脑的功能连接值。采用Pearson相关分析探讨NTG组患者与V1区功能连接显著差异脑区功能连接值与临床变量之间的相关性。结果 与HCs组受试者相比,NTG组患者年龄、性别、体重、杯盘比、24 h平均眼压差异均无统计学意义(均为P>0.05),两组患者间左、右眼最佳矫正视力(BCVA)及视盘周围视网膜神经纤维层厚度(RNFLT)差异均有统计学意义(均为P<0.05)。Pearson相关性分析结果显示,NTG组患者与V1区异常功能连接脑区功能连接值均与RNFLT具有相关性(P<0.05)。ROI1-左侧额上回、...     

虹膜睫状体炎患者的静息态脑功能不同频段低频振幅研究

目的　采用静息态功能磁共振成像（rs-fMRI）技术探究虹膜睫状体炎患者静息状态下不同频段低频振幅（ALFF）的变化。方法　选取武汉大学人民医院眼科中心收治的28例虹膜睫状体炎患者为患者组,纳入同期与患者组性别、年龄、受教育程度等相匹配的27名健康者为健康对照组。对受试者进行全脑rs-fMRI扫描,采集两组受试者不同频段下ALFF信号值,分别采用单样本t检验和双样本t检验对两组ALFF数据进行组内和组间比较。结果　与健康对照组比较,患者组受试者在右侧舌回、左侧舌回、右侧颞中回及左侧楔叶的分数ALFF显著降低;在slow-4频段下,患者组受试者在左侧距状沟、左侧枕中回、右侧枕上回及右侧角回的ALFF显著降低;在slow-5频段下,患者组受试者在右侧枕下回及左侧楔叶的ALFF显著降低。结论　虹膜睫状体炎患者存在多个脑区神经元的自发活动异常,主要涉及初、高级视皮层及情感认知调节相关脑区。     

薄角膜正常眼压性青光眼OCT检测与分析

目的 探讨薄角膜正常眼压性青光眼(NTG)患者视盘周围视网膜神经纤维层(RNFL)厚度及视盘结构的OCT特征.方法 采用OCT对21例(42只眼)中央角膜厚度(CCT)低于正常人群范围(＜500μm)的正常眼压性青光眼患者进行RNFL及视盘扫描,并根据其CCT值分为:组1(480μm≤CCT＜500μm)和组2(460μm≤CCT＜480μm),比较分析两组RNFL厚度、视盘参数及30.中心视野指数.结果 两组患者的OCT检测参数包括Avg.Thick、Savg、Iavg、Navg、Tavg差异无统计学意义(P＞0.05),Max-Min值差异有统计学意义(P＜0.05);视盘参数(垂直盘沿容积值等)、视野参数(MD、MS值)差异无统计学意义(P＞0.05).两组患者的RNFL平均厚度与视野平均缺损值MD呈强且负的直线关系(r=-0.602,P=0.000).结论 OCT能对NTG患者视盘及视网膜神经纤维层做出定量测量和分析,且与视野检测指标有良好的相关性,在NTG的早期诊断中有重要意义;薄角膜NTG患者的角膜厚度水平与视网膜神经纤维层缺损程度无明显相关.

Abstract：

Objective To investigate the thickness changes of peripapillary retinal nerve fiber layer (RNFL) in normal tension glaucoma (NTG) with thin cornea measured by optical coherence tomography (OCT).Methods Twenty-one NTG patients (42 eyes) with thin cornea were divided into two groups according to their central corneal thickness (CCT):group 1 (480μm≤CCT＜500μm) and group 2 (460μm≤CCT＜480μm),and analysis the different results of OCT scan and visual outcome in two groups.Results There were no significant differences in OCT parameters of Avg.,Thick,Savg,Iavg,Navg and Tavg among the two groups (P ＞0.05),while Max-Min was lower in group 2 (P ＜0.05);There were also no significant differences in the optic nerve head analysis results,visual field mean defect (MD) and mean sensitivity (MS) among two groups (P＞0.05).The average RNFL thickness and MD showed a strong and negative linear relationship(r =-0.602,P =0.000).Conclusions OCT can make quantitative measurement and analysis of optic disc and RNFL for NTG patients,and has a good correlation with vision field.It has important significance in the early diagnosis of NTG.For NTG patients with thin corneas,there is no significant correlation between the level of CCT and extent of retinal nerve fiber layer defect.     

视野缺损计分与OCT测量RNFL厚度的关系

目的:探讨视野缺损计分值与视网膜神经纤维层损害的关系。方法:收集开角型青光眼患者30例30眼,分别进行OCT视网膜神经纤维层厚度及视野检查。根据视野结果进行视野缺损计分并分组。组间分析各象限视网膜神经纤维层厚度值与视野缺损计分,平均缺损(MD)的关系和相关性。结果:根据视野缺损计分将患者分为四组,上侧、下侧,平均视网膜神经纤维层厚度在组间有显著性差异(P=0.010,P<0.01,P<0.01)。四组间随视野缺损程度加重,上侧、下侧,平均视网膜神经纤维层厚度变薄。在重度缺损组视网膜神经纤维层厚度最薄。视野缺损计分与上、下、鼻、颞侧及平均视网膜神经纤维层厚度均明显负相关(r=-0.610,P=0.001;r=-0.779,P<0.01;r=-0.463,P=0.015;r=-0.500,P=0.008;r=-0.782,P<0.01),视野指数MD与上侧,下侧及平均RNFL厚度明显正相关(r=0.557,P=0.003;r=0.431,P=0.025;r=0.532,P=0.004)。结论:视野缺损计分对视野缺损的客观评估,与OCT测得的视网膜神经纤维层厚度的结果负相关,是反应青光眼视神经损伤的可靠的观察指标。     

相干光断层扫描仪检测正常人及青光眼患者中央角膜厚度

目的探讨相干光断层扫描仪(OCT)测量正常人、原发性开角型青光眼(POAG)、正常眼压性青光眼(NTG)、高眼压症(OHT)患者的中央角膜厚度(CCT)。方法采用OCT3测量正常人143例(143只眼)、POAG患者36例(36只眼)、NTG患者39例(39只眼)及OHT患者40例(40只眼)的CCT,并进行单因素4水平设计定量资料的方差分析;用线性回归方法分析正常人CCT与Goldmann压平眼压测量值的相关关系;对OCT测量CCT观察者间和观察者内的一致性进行类内相关系数(ICC)分析。结果正常组、POAG组、NTG组及OHT组的平均CCT值分别为(523.66±32.13)μm、(530.92±27.32)μm、(506.92±21.49)μm及(573.13±27.39)μm。POAG组与正常人组的平均CCT值差异无统计学意义(P=0.099);OHT组的平均CCT值大于其他各组,均P<0.01;NTG组的平均CCT值小于其他各组,均P<0.01。正常组CCT与眼压值呈正相关(r=0.318,R2=0.101,P<0.01)。OCT测量CCT的测量者间和测量者内的ICC值分别为0.995和0.996。结论OCT可以准确地测量CCT;NTG患者平均CCT比正常人薄,而OHT患者比正常人厚;CCT可以影响Goldmann压平眼压计的测量值,但贡献率较小。(中华眼科杂志,2006,42:199-203)     

正常眼压性青光眼与睡眠呼吸事件的相关性研究

背景正常眼压性青光眼（NTG）是原发性开角型青光眼中的一个重要类型,非眼压依赖因素对本病的影响已受到广泛关注,而近期一些研究发现睡眠呼吸暂停综合征患者青光眼发病率较高,提示两者之间有一定的内在联系。目的探讨NTG患者睡眠呼吸事件的发生频率和强度及其与青光眼进展的关系。方法采用前瞻性病例对照研究设计,纳入2011—2012年于北京大学第三医院眼科就诊的NTG患者20例作为NTG组,纳入同期年龄和性别匹配的18名健康志愿者作为正常对照组,所有受试者进行视野、海德堡共焦激光眼底断层扫描仪（HRT）检查、OCT检查以及多导睡眠监测（PSG）,采用SPSS17．0统计学软件对两组之间受试者的各睡眠呼吸参数测量值的差异进行Mann—WhitneyU检验或独立样本t检验,对受试者睡眠呼吸事件参数测量值与平均视网膜神经纤维层（RNFL）厚度及视杯容积的关系进行Spearman秩相关分析和Pearson相关分析,确定NTG患者睡眠呼吸事件与青光眼相关指标的关系。结果两个组间受试者的临床基线特征,包括年龄、性别、身高、体质量及体质量指数（BMI）的差异均无统计学意义（P〉0．05）。NTG组受试者测量的呼吸暂停低通气指数（AHI）、低通气指数（HI）和呼吸暂停指数（AI）均明显高于正常对照组,差异均有统计学意义（U=89．000,P=0．007;U=91．000,P=0．008;U=89．000,P=0．007）,睡眠呼吸事件中关于时间的相关参数均明显长于正常对照组（P〈0．05）,而睡眠觉醒期和睡眠中动脉血氧饱和度均低于正常对照组,差异均有统计学意义（t=-3．480,P=0．001;t=-3．255,P=0．002）。两个组间受试者睡眠平均心率、睡眠最低心率、睡眠最高心率的差异均无统计学意义（t=-0．133,P=0．895;t=-0．906,P=0．371;t=-0．164,P=0．871）。HRT测量的NTG患者平均RNFL厚度为（188．16±98．29）μm,与最低睡眠动脉血氧饱和度[（85．55±6．58）％]呈中度正相关（r=0．552,P=0．022）,与AHI、AI均呈中度负相关（r=-0．530,P=0．019;r=-0．517,P=0．024）,但HI与RNFL厚度无明显相关性（r=-0．399,P=0．091）。OCT测量的NTG患者视杯容积为（0．580±0．215）μm^3,与AHI、AI、HI均呈中度正相关（r=0．584,P=0．018;r=0．670,P=0．005;r=0．544,P=0．034）,而与睡眠最低动脉血氧饱和度间无明显相关性（r=-0．493,P=0．052）。结论NTG患者睡眠呼吸事件发生的概率及强度均较正常人增加,可能在一定程度上与NTG的发病有关,同时对NTG患者的神经修复过程有不良影响。     

OCT检测原发性开角型青光眼视网膜神经纤维层厚度与视野平均缺损的相关性分析

目的探讨OCT检测原发性开角型青光眼(POAG)视网膜神经纤维层厚度(RNFL)与视野平均缺损(MD)的相关性。方法分别采用Ze iss-Humphrey,Stratus TM,Version3.0 OCT和OCTOPUS101全自动电脑视野分析仪对正常组25例(36只眼)和青光眼组52例(81只眼)进行检测,将各个青光眼组中心30°视野内全视网膜MD和OCT检测的RNFL厚度值进行比较,并做相关性分析。结果青光眼组MD均高于正常组(P<0.01),中期和晚期青光眼组RNFL值均低于正常组(P<0.05)。所有被检测者视野MD与RNFL厚度呈负的直线相关(相关系数为-0.626,P=0.000);青光眼组MD与RNFL厚度呈负的直线相关(相关系数为-0.615,P=0.000);正常组MD与RNFL厚度无直线相关性(相关系数为-0.022,P=0.910)。结论MD与RNFL厚度有很好的直线相关性,通过OCT对RNFL厚度的检测,有助于了解和监测POAG对RNFL的损伤,是一种很有价值和潜力的青光眼客观辅助诊断方法。     

频域OCT检测青光眼视网膜神经节细胞复合体厚度的研究

背景 青光眼以视网膜神经节细胞( RGCs)丢失为主要的病理特征,频域光学相干断层扫描(SD-OCT)可以检测黄斑区视网膜神经节细胞复合体(GCC)厚度. 目的 探讨黄斑区视网膜GCC厚度在原发性开角型青光眼(POAG)人群的分布特征. 方法 采用系列病例对照研究设计.利用SD-OCT( RTVue100)和时域OCT(TD-OCT)技术分别检测POAG患者101例101眼和年龄、屈光度相匹配的正常对照者41例41眼视网膜的黄斑区整体平均GCC厚度(GCC-Avg)、上方平均GCC厚度(GCC-Sup)和下方平均GCC厚度(GCC-Inf)及对应区域视盘旁视网膜神经纤维层(RNFL)厚度,按照POAG的程度分为视野损害前POAG组、早期POAG组、进展期POAG组和晚期POAG组,比较各POAG组与正常对照组间上述3个GCC参数的差异,分析GCC厚度和RNFL厚度的相关性以及青光眼患者视野平均缺损值(MD)与GCC厚度的相关性. 结果 视野损害前POAG组、早期POAG组GCC-Avg、GCC-Sup和GCC-Inf值均明显低于正常对照组,差异均有统计学意义( GCC-Avg:t=5.411、10.247,P＜0.01:GCC-Sup:t=6.171、9.484,P＜0.01; GCC-Inf:t=5.281、8.592,P＜0.01).进展期POAG组GCC-Avg、GCC-Sup和GCC-Inf值均明显低于早期POAG组,差异均有统计学意义(GCC-Avg:t =4.246,P＜0.01;GCC-Sup:t=2.419,P=0.019;GCC-Inf:t=4.636,P＜0.01),而晚期POAG组GCC-Avg、GCC-Sup和GCC-Inf值均明显低于进展期POAG组,差异均有统计学意义(GCC-Avg:t=2.095,P=0.040;GCC-Sup:t=2.756,P＜0.01;GCC-Inf:t=2.018,P=0.040).GCC-Sup、GCC-Inf和GCC-Avg值与对应区域平均RNFL厚度值均呈高度正相关(r=0.802、0.825、0.856,P＜0.01),青光眼患者的视野MD值与GCC-Avg值呈正相关( r=0.601,P＜0.01). 结论 SD-OCT能够定量测量并区分青光眼患者与正常人群的黄斑区GCC厚度,GCC厚度随青光眼病情的进展而逐渐变薄,并与RNFL和视野的损害有较好的相关性.     

动态轮廓眼压计在正常眼压性青光眼及原发性开角型青光眼的应用研究

目的:应用动态轮廓眼压计(dynamic contour tonometer,DCT)测量正常眼压性青光眼(normal tension glaucoma,NTG)及原发性开角型青光眼(primary open angle glaucoma,POAG)患者的眼压(intraocular pressure,IOP)及眼脉动幅度值(ocular pulse amplitude,OPA),并探讨影响OPA测量值的相关因素。方法:选取NTG患者20例,POAG患者21例及正常对照组各20例,应用Goldmann压平眼压(Goldmann applanation tonometer,GAT)及DCT测量IOP,同时测量了中央角膜厚度(central corneal thickness,CCT)、眼轴(axial length,AL)、心率(heart rate,HR)、收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP)等指标,并探讨GAT,DCT两种眼压计测量的相关性,进而分析OPA测量值的影响因素。结果:三组被检者的IOP,OPA,SBP及DBP差异均有统计学意义(P<0.05),而CCT,AL及HR差异无统计学意义(P>0.05)。其中OPA值NTG组为(1.7±0.9)mmHg,POAG组为(2.8±0.7)mmHg,正常对照组为(2.4±0.6)mmHg;NTG组与POAG组比较(P=0.001),与正常对照组比较(P=0.005)差异均有统计学意义,POAG组与正常对照组比较(P=0.502)差异无统计学意义;OPA值与IOP,HR及CCT无相关性(P>0.05),与AL,SBP及DBP具有一定的相关性(P<0.05)。结论:NTG患者与POAG患者及正常人的OPA值存在差异,同时OPA值受AL及SBP及DBP影响。     

Segmentation and accuracy in copying and drawing: Experts and beginners

As part of an ongoing investigation into real-world copying and drawing, I recorded the eye-hand drawing strategies of 16 subjects with drawing experiences ranging from expert to novice while they copied a line drawing of a standing nude. The experts produced accurate copies whereas all the beginners produced marked inaccuracies of overall scaling, proportion and shape. Analysis of eye and hand movements showed that the experts alone segmented the original drawing into simple line sections that were copied one at a time using a direct eye-hand strategy not requiring intermediary encoding to visual memory. The results suggest that segmentation into simple lines defines the task-specific process of accurate copying, and that this process is restricted to experts, i.e. acquired through training and practice. Additional preliminary tests also suggest that a similar process may apply to drawing a model from life.     

Paraneoplastic and non-paraneoplastic retinopathy and optic neuropathy: Evaluation and management

Paraneoplastic syndromes involving the visual system are a heterogeneous group of disorders occurring in the setting of systemic malignancy. Timely recognition of one of these entities can facilitate early detection and treatment of an unsuspected, underlying malignancy, sometimes months before it would have otherwise presented, and gives the patient an increased chance at survival. We outline the clinical features, pathogenesis, and treatment strategies for the retinal- and optic nerve–based paraneoplastic syndromes: cancer-associated retinopathy; melanoma-associated retinopathy; paraneoplastic vitelliform maculopathy; bilateral diffuse uveal melanocytic proliferation; paraneoplastic optic neuropathy; and polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes syndrome. Distinguishing these disorders from their non-paraneoplastic counterparts (e.g., autoimmune-related retinopathy and optic neuropathy, and acute zonal occult outer retinopathy) and determining appropriate systemic evaluation for the responsible tumor can be challenging. In addition, we discuss the utility and interpretation of autoantibody testing.     

Sensitivity to first- and second-order motion and form in children and adults

We compared the sensitivity of adults and children aged 3-10 years to first- and second-order motion and form. For first-order stimuli, at all ages sensitivity was better for motion than form, and motion thresholds were better at 6 Hz than at 1.5 Hz. For second-order stimuli, at all ages sensitivity was better for form than motion, and motion thresholds were better at 0.25 cyc/deg than at 1 cyc/deg. Thresholds became adult-like later for motion than for form and later for first-order than second-order stimuli. For first-order stimuli, the changes with age were larger and more protracted.     

Nodes and nodal points and lines in eyes and other optical systems

The typical stigmatic optical system has two nodal points: an incident nodal point and an emergent nodal point. A ray through the incident nodal point emerges from the system through the emergent nodal point with its direction unchanged. In the presence of astigmatism nodal points are not possible in most cases. Instead there are structures, called nodes in this paper, of which nodal points are special cases. Because of astigmatism most eyes do not have nodal points a fact with obvious implications for concepts, such as the visual axis, which are based on nodal points. In order to gain insight into the issues this paper develops a general theory of nodes which holds for optical systems in general, including eyes, and makes particular allowance for astigmatism and relative decentration of refracting elements in the system. Key concepts are the incident and emergent nodal characteristics of the optical system. They are represented by 2 × 2 matrices whose eigenstructures define the nature and longitudinal position of the nodes. If a system's nodal characteristic is a scalar matrix then the node is a nodal point. Otherwise there are several possibilities: Firstly, a node may take the form of a single nodal line. Second, a node may consist of two separated nodal lines reminiscent of the familiar interval of Sturm although the nodal lines are not necessarily orthogonal. Third, a node may have no obvious nodal line or point. In the second and third of these classes one can define mid-nodal ellipses. Astigmatic systems exist with nodal points and stigmatic systems exist with no nodal points. The nodal centre may serve as an approximation for a nodal point if the node is not a point. Examples in the Appendix , including a model eye, illustrate the several possibilities.     

Nutritional antioxidants and age-related cataract and maculopathy

Loss of vision is the second greatest, next to death, fear among the elderly. Age-related cataract (ARC) and maculopathy (ARM) are two major causes of blindness worldwide. There are several important reasons to study relationships between risk for ARC/ARM and nutrition: (1) because it is likely that the same nutritional practices that are associated with prolonged eye function will also be associated with delayed age-related compromises to other organs, and perhaps, aging in general, (2) surgical resources are insufficient to provide economic and safe surgeries for cataract and do not provide a cure for ARM, and (3) there will be considerable financial savings and improvements in quality of life if health rather than old age is extended, particularly given the rapidly growing elderly segment of our population. It is clear that oxidative stress is associated with compromises to the lens and retina. Recent literature indicates that antioxidants may ameliorate the risk for ARC and ARM. Given the association between oxidative damage and age-related eye debilities, it is not surprising that over 70 studies have attempted to relate antioxidant intake to risk for ARC and ARM. This article will review epidemiological literature about ARC and ARM with emphasis on roles for vitamins C and E and carotenoids. Since glycation and glycoxidation are major molecular insults which involve an oxidative stress component, we also review new literature that relates dietary carbohydrate intake to risk for ARC and ARM. To evaluate dietary effects as a whole, several studies have tried to relate dietary patterns to risk for ARC. We will also give some attention to this emerging research. While data from the observational studies generally support a protective role for antioxidants in foods or supplements, results from intervention trials are less encouraging with respect to limiting risk for ARC/ARM prevalence or progress through antioxidant supplementations, or maintaining higher levels of antioxidants either in diet or blood. Without more information it is difficult to parse these results. It would be worthwhile to determine why the various types of studies are not yielding similar results. However, there are many common insults and mechanistic compromises that are associated with aging, and proper nutrition early in life may address some of these compromises and provide for extended youthful function later in life. Indeed, proper nutrition, possibly including use of antioxidant supplements for the nutritionally impoverished, along with healthy life styles may provide the least costly and most practical means to delay ARC and ARM. Further studies should be devoted to identifying the most effective strategy to prevent or delay the development and progress of ARC/ARM. The efforts should include identifying the right nutrient(s), defining useful levels of the nutrient(s), and determining the age when the supplementation should begin.     

Ethics and optometry: concepts and applications

Ethics refers both to the study of behaviour, and moral principals. The related concepts of justice and law are also relevant to optometry. A profession typically claims specialist knowledge and ethical behaviour – putting the interests of clients above its own. However, professional codes fail as ethical directives, and their goals are questioned. Beginning with broad principles, institutional ethics and issues of general health care provision are considered, and applications to optometry are made. Ethical theory can guide us in interacting with our patients, utilising resources and ordering priorities. The conservative approach to consumerism and advertising is defended on the basis of protecting public and professional interests. Ethical behaviour can be fostered, and this process should begin in undergraduate education.     

Exogenous attention and color perception: performance and appearance of saturation and hue

Exogenous covert attention is an automatic, transient form of attention that can be triggered by sudden changes in the periphery. Here we test for the effects of attention on color perception. We used the methodology developed by Carrasco, Ling, and Read [Carrasco, M., Ling, S., & Read, S. (2004). Attention alters appearance. Nature Neuroscience, 7 (3) 308-313] to explore the effects of exogenous attention on appearance of saturation (Experiment 1) and of hue (Experiment 2). We also tested orientation discrimination performance for single stimuli defined by saturation or hue (Experiment 3). The results indicate that attention increases apparent saturation, but does not change apparent hue, notwithstanding the fact that it improves orientation discrimination for both saturation and hue stimuli.     

Aberration and contrast sensitivity comparison of aspherical and monofocal and multifocal intraocular lens eyes

BACKGROUND: Higher-order aberrations and contrast sensitivity were evaluated in patients who underwent phacoemulsification cataract extraction followed by implantation of aspherical, monofocal or multifocal intraocular lens (IOL) replacements. METHODS: In this comparative trial, 124 patients with an average age of 66.8+/-5.2 years and their 124 eyes were randomly divided into three surgical implantation groups to receive one of three types of IOLs in replacement of cataract lenses. The patients of group 1 were given an aspherical IOL Z9001 (AMO, Santa Ana, CA, USA) replacement, and group 2 was implanted a monofocal IOL SA60AT (Alcon, Fort Worth, TX, USA) and group 3 the multifocal IOL SA40N (AMO). Post-surgical best-corrected visual acuity, corneal aberrations, total ocular aberrations, pupil diameters, capsulorhexsis sizes and contrast sensitivity were measured and compared. RESULTS: There was no statistical difference for mean best-corrected visual acuity, pupil diameter, curvilinear capsulorhexis size and corneal aberration among the three groups. For the spherical aberration, fourth-order higher-order aberration and total ocular higher-order aberration, the SA40N group was higher than the SA60AT group and the SA60AT group was higher than the Z9001 group, and the differences between the three groups were statistically significant for these measurements. Contrast sensitivity was higher for the Z9001 group than the SA60AT group and the SA60AT group was higher than the SA40N group, and the difference was statistically significant in all the spatial frequencies of 3, 6, 12 and 18. CONCLUSIONS: Although the multifocal IOL can provide near vision, it can increase higher-order aberration and negatively influence contrast sensitivity. However, the aspherical IOL can reduce aberration and improve contrast sensitivity as compared with the monofocal IOL.