非球面和球面人工晶状体植入术后远期对比敏感度和眩光敏感度的对比研究

目的 比较年龄相关性白内障患者植入非球面人工晶状体术后远期视力及对比敏感度和眩光敏感度的改变,以评价非球面人工晶状体的有效性和安全性.方法 将120例(161只眼)拟行超声乳化白内障摘除联合人工晶状体植入术的年龄相关性白内障患者随机分为3组,分别植入AerySof IQ非球面人工晶状体(47例54只眼),KS-3Ai预装式非球面人工晶状体(46例52只眼)和AerySof Natural蓝光滤过型球面人工晶状体(42例55只眼),随访时间均超过6个月.观察患者术后最佳矫正远视力、对比敏感度和眩光敏感度以及并发症情况.统计学分析采用方差分析、配对t检验和检验.结果 三组患者术后1周、1个月和≥6个月最佳矫正远视力差异无统计学意义(P=0.874,P=0.243,P=0.160).术后≥6个月,非球面组在夜(1.5c/d、3.0 c/d、6.0 c/d)及夜 周边眩光(1.5e/d、3.0 c/d、6.0 c/d)条件下对比敏感度均优于球面组,差异有统计学意义(P=0.004,P=0.040,P=0.050;P=0.009,P=0.031,P=0.036),非球面组之间差异无统计学意义(P>0.05).结论 植入非球面人工晶状体术后患者视力有较好的趋势,对比敏感度在暗视环境(低、中空间频率)下明显优于传统的球面人工晶状体,能较全面地改善白内障患者术后的视觉质量.     

非球面与球面人工晶状体植入术后对比敏感度的比较

目的观察非球面人工晶状体（IOL）和球面IOL植入术后在视力相同的情况下其对比敏感度的差异。方法收集行超声乳化联合IOL植入术的年龄相关性白内障患者49例（60眼）,其中植入非球面IOL Tecnis ZA9003者24例30眼,植入球面IOL Sensar AR40e者25例30眼,所有病例术后裸眼LogMAR视力均〉0．1。术后3个月时采用CSV-1000对比敏感度测试仪分别测量明视、暗视和眩光状态下的对比敏感度,用F．A．C．T对比敏感度表测量近距离对比敏感度。结果在明视和暗视状态下的对比敏感度,非球面IOL组均高于球面IOL组,两组在空间频率6、12、18周／度时的差异均有统计学意义（P〈0．05）;暗视眩光状态下的对比敏感度,非球面IOL组高于球面10L组,两组在各空间频率的差异均有统计学意义（P〈0．05）。F．A．C．T对比敏感度测试卡测得的对比敏感度,非球面IOL组高于球面IOL组,两组在各空间频率的差异均有统计学意义（P〈0．05）。结论在传统的视力表检查视力正常和相同的情况下,非球面IOL植入术后较球面IOL植入术后患眼具有较好的对比敏感度,提示非球面IOL可以提高功能视力。     

不同设计的非球面人工晶状体植入术后的对比敏感度比较

目的 比较两种不同设计的非球面人工晶状体植入术后患者对比敏感度的改变.方法 选择连续入院并拟由同一临床经验丰富的医师完成白内障超声乳化联合人工晶状体植入手术的患者63例(90只眼),随机分为三组,每组30只眼.组A患者植入前表面非球面修饰的人工晶状体( AMO Tecnis ZA 9003型),组B植入后表面非球面修饰的人工晶状体(Alcon IQ SN60WF型),对照组植入单焦球面人工晶状体( AMO AR40e).术后6个月对三组患者进行不同照明条件下(3 cd/m2,85 cd/m2),四种不同空间频率下(3c/d,6 c/d,12 c/d,18 c/d)的对比敏感度(CS)测定并进行比较.结果 两组非球面晶状体植入的患者术后对比敏感度较球面晶状体植入术的患者更好,其中在低空间频率下( 3c/d 、6c/d)差异有统计学意义(P＜0.05).在眩光条件下,球面晶体植入患者在高空间频率( 18c/d)下的对比敏感度下降(P＜0.05),而非球面晶状体组患者则耐受良好.结论 两种非球面人工晶状体都能获得良好地视功能,相比传统的球面型人工晶状体,新的非球面设计理念可以带来更好地视觉质量.     

非球面人工晶状体植入术后对比敏感度观察

目的:评价白内障超声乳化吸除联合非球面人工晶状体(intraocularlens,IOL)植入术后对比敏感度(contrast sensitivity,CS)的变化。方法:对45例(48眼)老年性白内障患者实施超声乳化吸除联合IOL植入术,24例(25眼)植入Z9001非球面IOL(AIOL);21例(23眼)植入AR40e单焦球面IOL(SI-OL)。术后3mo应用美国Stereo Optical公司产的OPTEC 6500P视功能测试系统的对比敏感度测试包分别在空间频率为1.5,3,6,12,18cpd的昼及夜照明条件下对手术眼进行有眩光和无眩光的对比敏感度检查。所得数据进行t检验。结果:术后3mo,AIOL组在大部分空间频率下CS普遍优于SIOL组,差异有统计学意义(P<0.05),在1.5cpd有眩光昼及夜照明条件,AIOL组的CS与SIOL组无统计学差异。结论:植入Z9001非球面IOL后,提高了患者的对比敏感度,明显改善患者的视觉质量.     

Aurium变色人工晶状体植入术后对比敏感度和眩光对比敏感度的研究

目的 研究Aurium变色人工晶状体对术后对比敏感度和眩光对比敏感度的影响.方法 临床病例系列对比研究.选取2010年8月至2011年4月在南昌大学第二附属医院眼科就诊的白内障超声乳化联合人工晶状体植入术后患者,且随访资料完整的病例70例(眼),其中37例为Aurium (model400)变色人工晶状体组,33例为黄色蓝光滤过型IQ (SN60WF)人工晶状体组.观察患者术后3个月时的裸眼视力(UCVA),最佳矫正视力(BCVA),对比敏感度(CS)和眩光对比敏感度(GS).结果 二组患者术后3个月时的裸眼视力和最佳矫正视力差异均无统计学意义(P＞0.05).Aurium组和IQ组在明适应、明适应眩光、暗适应条件下,两组之间的对比敏感度和眩光对比敏感度差异无统计学意义(P＞0.05),在暗适应眩光条件下Aurium组的眩光对比敏感度(空间频率3 cpd、6 cpd)要优于黄色蓝光滤过型IQ组,差异有统计学意义(P＜0.05).结论 植入Aurium变色人工晶状体术后患者的视力与黄色蓝光滤过型IQ人工晶状体的视力差异无统计学意义.Aurium变色人工晶状体在暗适应眩光条件下,空间频率(3 cpd、6 cpd)的眩光对比敏感度要优于黄色蓝光滤过型IQ人工晶状体.     

零球差非球面人工晶状体和球面人工晶状体植入术后视觉质量的对比研究

背景零球差非球面人工晶状体（IOL）本身不会增加IOL植入眼的球差,理论上能够改善术眼的视觉质量。目的比较零球差非球面IOL植入眼与球面IOL植入眼的视觉功能及波前像差,分析零球差设计对IOL植入眼视觉质量的影响。方法采用前瞻性病例对照研究设计。收集2008年12月至2009年3月在温州医学院附属眼视光医院诊断的年龄相关性白内障的患者52例80眼,按照随机数字表法将患者随机分为零球差非球面IOL组和球面IOL组,每组40眼,分别在常规白内障超声乳化术术中植入零球差非球面IOL（AkreosAO）或球面IOL。所有患者均在术前1d,术后1d、1周、1个月及3个月时进行眼科常规检查,在裂隙灯显微镜下观察术眼眼前后节情况,测量眼压,记录裸眼视力,应用Tracey波前像差仪在术前Id检查角膜前表面波前像差,术后3个月随访时检查最佳矫正远视力（LogMAR视力）,行对比敏感度、焦点深度及波前像差检查,并对2组结果进行比较。结果2组患者术前的人口基线特征比较差异均无统计学意义（P〉0．05）。术后3个月零球差非球面IOL组的最佳矫正LogMAR远视力为-0．03±0．08,球面IOL组为-0．02±0．10,2组比较差异无统计学意义（t=-0．50,P=0．61）;零球差非球面IOL组术眼在暗视（12．0c／d）及暗视＋周边眩光（3．0、6．0、18．0c／d）条件下的对比敏感度分别为12．42±13．16、42．58±24．96、30．19±25．64和3．03±5．49,球面IOL组分别为5．59±8．11、28．74±18．69、17．07±19．35和0．22±1．15,相同条件下2组比较差异均有统计学意义（P〈0．05）;零球差非球面IOL组术眼的平均焦点深度（3．48±1．07）D,球面IOL组为（3．20±0．77）D,差异无统计学意义（t=1．15,P=0．25）。术后3个月在5．0mm瞳孔分析直径下,零球差非球面IOL组的全眼球差为（0．13±0．07）μm,球面IOL组为（0．21±0．07）μm,差异有统计学意义（t=-4．19,P=0．00）,术后3个组间术眼的全眼总高阶像差、彗差及三叶草像差比较,差异均无统计学意义（P〈0．05）。结论零球差非球面IOL植入眼视觉质量明显优于球面IOL植入眼。     

非球面人工晶状体植入术后早期视功能的临床研究

目的：初步评估非球面人工晶状体植入术后早期视功能情况。 方法：将88例（91只眼）白内障患者随机分为AcrySof IQ（SN60WF）、KS-3Ai和AcrySof Natural（SN60AT）人工晶状体组。观察患者术后1d、1周和1月最佳矫正视力和术后1月对比敏感度及主观视觉等视功能情况。 结果：术后第1天KS-3Ai组最佳矫正视力明显优于其余两组（P〈0．05），术后1周、1月三组最佳矫正视力差异均无显著性意义（P〉0．05）。AcrySof IQ和KS-3Ai组中、低频区对比敏感度在瞳孔直径2.5mm～4．0mm及5.0mm～6.0mm时均优于AcrySof Natural组（P〈0．05），而AcrySof IQ和KS-3Ai两组比较无显著性意义（P〉0．05）。采用VF／QOL问卷调查显示AcrySof IQ和KS-3Ai组患者的总体满意度好。 结论：非球面人工晶状体能明显提高白内障患者术后对比敏感度，改善患者术后视觉质量。     

非球面散光矫正型多焦点人工晶状体植入术对白内障患者视力和对比敏感度的影响

目的：观察非球面散光矫正型多焦点人工晶状体植入术对白内障患者视力和对比敏感度的影响。
　　方法：将我院2014-05/2015-05期间行超声乳化人工晶状体植入术的合并有角膜规则散光的白内障患者58例72眼,随机分为两组：观察组植入散光矫正型多焦点人工晶状体29例36眼;对照组植入散光型单焦点人工晶状体29例36眼。术后随访1、6mo,观察术后患者的裸眼远视力(UCDVA)、裸眼近视力(UCNVA)、最佳矫正远视力(BCDVA)、最佳矫正近视力(BCNVA)、残余散光、暗光下对比敏感度。
　　结果：两组术后1、6mo UCDVA、BCNVA、BCDVA 以及残余散光的比较差异无统计学意义(P>0.05);观察组术后1、6mo 的 UCNVA 优于对照组(P<0.05);术后6mo 两组对比敏感度在高空间频率比较上差异有统计学意义(P<0.05)。
　　结论：非球面散光矫正型多焦点人工晶状体植入术治疗合并有角膜规则散光的白内障患者疗效确切,与散光型单焦点人工晶状体植入术比较均可改善患眼视力,且采用非球面散光矫正型多焦点人工晶状体植入术治疗后可获得更好的裸眼近视力和对比敏感度。     

球面与非球面IOL在不同瞳孔直径时的对比敏感度与眩光对比敏感度

目的比较球面与非球面人工晶状体（intraocularlens,IOL）在环境照度为85cd.m-2时在3种瞳孔直径：2.0-2.5mm、4-5mm、8mm下的对比敏感度（contrast sensitivi-ty,CS）和眩光对比敏感度（glare contrast sensitivity,GS）的差异。方法收集年龄相关性白内障患者48例（60眼）,行白内障超声乳化吸除或小切口手法摘出联合后房型IOL植入术。根据植入IOL的不同将患者分为2组：球面组和非球面组。30例（35眼）植入球面IOL,18例（25眼）植入非球面IOL。术后1个月检查2组患者在3种瞳孔直径下分别在低频3cycle/degree（cpd）、中频（6cpd）、高频（12cpd、18cpd）时的CS和GS。结果球面IOL组：瞳孔2.0-2.5mm时,各个空间频率的CS与GS之间的差异均无统计学意义;瞳孔4-5mm时,在6cpd、12cpd的CS与GS之间的差异有统计学意义;瞳孔8mm时,全部频率的CS与GS之间的差异均具有统计学意义。非球面IOL组：3个瞳孔直径下各个空间频率的CS与GS之间的差异均无显著性意义。球面与非球面IOL的比较：瞳孔直径2.0-2.5mm及5mm时,在高频段球面与非球面IOL的CS之间的差异有统计学意义;瞳孔8mm时,在低频段两者之间的GS差异有统计学意义,在中频段两者的CS及GS之间差异均具有统计学意义。结论在球面IOL组,随着瞳孔直径的增大,CS及GS均下降,且瞳孔越大,附加眩光时引起CS的下降效应越明显。在非球面IOL组,在各个瞳孔直径时附加眩光均不引起CS的明显下降。瞳孔直径越大,非球面IOL补偿正性球差、减少球面像差的作用越明显。     

Acri．Smart非球面人工晶状体与球面人工晶状体临床应用的对比研究

目的比较白内障超声乳化吸除植入前表面光学改良的非球面人工晶状体与传统球面人工晶状体对植入眼对比敏感度和视觉质量的影响。方法选择我院2006年4月至2007年8月年龄相关性白内障患者117例（117只眼），随机分为2组，行白内障超声乳化摘除术后，分别植入非球面人工晶状体（Acri．smart 36A）和球面人工晶状体（Aeri．smart 46S）。术后3个月分别检测最佳矫正视力、眩光和无眩光条件下的对比敏感度以及不同瞳孔直径条件下的全眼球像差。结果两组的最佳矫正视力比较，差异无统计学意义（P〉0．05）。植入Acri．smart 36A型人工晶状体眼的对比敏感度在空间频率3、6、12、18c／d时无眩光、有眩光条件下均明显大于植入Acri．smart 46S型人工晶状体眼（P〈0．01）。在全眼球像差方面植入Acri．smart 36A型人工晶状体眼在不同瞳孔直径条件下均明显低于植入Acri．smart 46S型人工晶状体眼（P〈0．01）。结论与球面人工晶状体比较，非球面人工晶状体可降低像差，提高视觉对比敏感度，改善白内障患者术后的视觉质量。     

Contrast visual acuity after multifocal intraocular lens implantation:aspheric versus spherical design

AIM: To evaluate contrast visual acuity (CVA) after implantation of an aspheric apodized diffractive intraocular lens (IOL) or a spherical apodized diffractive IOL in cataract surgery. METHOD: This prospective randomized controlled study with a 12-month follow-up compared the results of cataract surgery with implantation of an aspheric AcrySof ReSTOR SN6AD3 IOL (30 eyes) and a spherical AcrySof ReSTOR SN60D3 IOL (30 eyes). CVA with best distance correction was measured at 4 contrast levels (100%, 25%, 10% and 5%) under 3 levels of chart luminance [250, 85 and 25 candelas per square meter (cd/m²)] using a multi-functional visual acuity tester (MFVA-100)． RESULTS:At 12 months after surgery, there were no statistically significant differences in 100% CVA and 25% CVA under 250cd/m² (P100%=0.875 and P25%=0.057) and 85cd/m² (P100%=0.198 and P25%=0.193) between the aspheric group and the spherical group. However, the 10% CVA and 5% CVA were significant better in aspheric group than spherical group under 250cd/m² (P10%=0.042 and P5%=0.007) and 85cd/m² (P10%=0.002 and P5%=0.039). Under the luminance level of 25cd/m², no significant differences was found in the 100% CVA between the 2 group (P100%=0.245), while aspheric group had better visual acuity in the remaining 3 contracts (P25%=0.023, P10%=0.026 and P5%=0.002, respectively). CONCULSION:The aspheric AcrySof ReSTOR SN6AD3 IOL provided patients with better low-contrast visual acuity than the spherical AcrySof ReSTOR SN60D3 IOL.     

年龄相关性白内障患者超声乳化手术前后对比敏感度分析

目的研究年龄相关性白内障患者行超声乳化+球面人工晶状体植入术前后对比敏感度的变化。方法选取46～84岁的年龄相关性白内障患者22例(30眼),术前矫正视力为0.5～0.8,行白内障超声乳化+可折叠球面人工晶状体植入术。利用美国Stereo Optec6500视功能测试仪在术前及术后1个月测试患者,分析对比敏感度的变化。用SPSS15.0软件对数据进行统计学分析。结果除了在18.0c·d-1昏暗及昏暗+眩光条件下外,患者术后对比敏感度较术前在低、中、高空间频率均有提高,且与术前的差异均具有统计学意义(均为P<0.01)。明亮条件下,术前眩光对比敏感度在中、低空间频率(1.5c·d-1、3.0c·d-1、6.0c·d-1)低于无眩光状态(均为P<0.01),术后眩光对比敏感度在中、低空间频率高于无眩光状态(均为P<0.01)。昏暗条件下,术前和术后中、低空间频率眩光对比敏感度低于无眩光状态(均为P<0.05)。结论中、低空间频率眩光对比敏感度检查较传统视力检查能更有效评估未熟期年龄相关性白内障患者手术前后的视功能。     

Visual and optical performance of eyes with different corneal spherical aberration implanted with aspheric intraocular lens

AIM: To compare the visual and optical performance of eyes with different corneal spherical aberration (SA) implanted with spherical aberration-free intraocular lens (IOLs). METHODS: Thirty-six patients with different corneal SA had phacoemulsification with implantation of spherical aberration-free IOLs. Patients were divided into 3 groups according to the value of preoperative corneal SA. Eyes with corneal SA <0.10μm were assigned to group A, those with 0.10 ≤corneal SA <0.20μm to Group B, and those with 0.20≤ corneal SA <0.35μm to Group C. Best-corrected visual acuity (BCVA), contrast sensitivity, corneal SA, total ocular aberrations, and depth of focus were recorded 3 months postoperatively. Distance-corrected near and intermediate visual acuity was studied to measure depth of focus. RESULTS: BCVA and contrast sensitivity were similar between groups. There were no significant differences in distance-corrected near or intermediate visual acuity. Corneal SA was similar before and 3 months after surgery in the 3 groups. With a 5.0mm pupil diameter, root mean square values for total ocular higher-order aberrations (HOAs) were lower in groups A and B than in group C. Total ocular SA was lower in group A than in groups B and C. SA was also lower in group B than in group C. Coma and trefoil were similar between the groups. CONCLUSION: Implantation of spherical aberration-free IOLs in eyes with different corneal SA results in similar visual performance at BCVA, contrast sensitivity and depth of focus.     

Visual and optical performance of eyes with different corneal spherical aberration implanted with aspheric intraocular lens

AIM: To compare the visual and optical performance of eyes with different corneal spherical aberration (SA) implanted with spherical aberration-free intraocular lens (IOLs). METHODS: Thirty-six patients with different corneal SA had phacoemulsification with implantation of spherical aberration-free IOLs. Patients were divided into 3 groups according to the value of preoperative corneal SA. Eyes with corneal SA <0.10μm were assigned to group A, those with 0.10 ≤corneal SA <0.20μm to Group B, and those with 0.20≤ corneal SA <0.35μm to Group C. Best-corrected visual acuity (BCVA), contrast sensitivity, corneal SA, total ocular aberrations, and depth of focus were recorded 3 months postoperatively. Distance-corrected near and intermediate visual acuity was studied to measure depth of focus. RESULTS: BCVA and contrast sensitivity were similar between groups. There were no significant differences in distance-corrected near or intermediate visual acuity. Corneal SA was similar before and 3 months after surgery in the 3 groups. With a 5.0mm pupil diameter, root mean square values for total ocular higher-order aberrations (HOAs) were lower in groups A and B than in group C. Total ocular SA was lower in group A than in groups B and C. SA was also lower in group B than in group C. Coma and trefoil were similar between the groups. CONCLUSION: Implantation of spherical aberration-free IOLs in eyes with different corneal SA results in similar visual performance at BCVA, contrast sensitivity and depth of focus.     

非球面人工晶状体与球面人工晶状体的比较

随着波前像差技术的发展,人们对影响白内障术后视功能的因素有了更深刻的认识,设计出旨在降低人工晶状体眼球面像差从而提高视功能的非球面人工晶状体。现就非球面人工晶状体眼与球面人工晶状体眼相比,在视功能、波前像差等方面有何差异,非球面晶状体的优越性,以及影响优越性表现的因素综述如下。     

白内障超声乳化联合人工晶状体植入术后低视力分析

目的:了解白内障超声乳化吸除联合人工晶状体植入术后低视力的相关因素。方法:收集资料完整的白内障超声乳化吸除联合人工晶状体植入术患眼,术后最佳矫正视力低于0.3者,对发生原因进行回顾分析。结果:追踪超过0.5a的261眼(217例)中32眼发生低视力(12.26%),其中术前存在的眼底病引起低视力的22眼(68.75%),弱视引起低视力的患眼4眼(12.50%),术中和术后并发症引起的低视力6眼(18.75%)。结论:白内障超声乳化吸除联合人工晶状体植入术后发生低视力的主要原因为术前存在的眼底病变。     

个性化植入非球面人工晶状体术后视觉质量的临床观察

目的 观察根据患者角膜球差植入不同球差的非球面人工晶状体术后患者的视觉质量.方法 选择年龄相关性白内障患者62例(62眼)行白内障超声乳化吸出联合人工晶状体植入术,随机分为试验组及对照组,其中试验组32例(32眼)术前根据角膜球差植入非球面人工晶状体,对照组30例(30眼)随机植入非球面人工晶状体.术后3个月进行两组患者的视力、角膜球差、对比敏感度检查和生活问卷调查.结果 术后3个月,患者裸眼视力为4.89±0.57,与术前的4.00±0.31相比,差异有统计学意义(P=0.00),其中试验组裸眼视力为4.91±0.02,对照组为4.89±0.37,差异无统计学意义(P=0.48);最佳矫正视力试验组和对照组分别为4.97±0.21和4.97±0.18,差异亦无统计学意义(P=0.91);两组总角膜球差术后为(0.271±0.222) μm,与术前的(0.262±0.213) μm相比差异无统计学意义(P=0.47);对比敏感度检查在暗光及暗眩光状态下1.5c·d-1、3.0c·d-1、6.0c·d-1、12.0 c·d-、18.0c·d-1 15个不同空间频率下试验组均显著高于对照组(均为P＜0.05),在明光及明眩光状态5个空间频率下对比敏感度两组间差异均无统计学意义(均为P＞0.05);术后不良视觉症状发生率试验组少于对照组,患者满意度好于对照组(均为P＜0.05).结论 根据角膜球差植入非球面人工晶状体,术后均能够获得较满意的视觉质量,为个性化植入非球面人工晶状体这一方法的可行性提供了临床依据.     

Contrast sensitivity after extracapsular and intracapsular cataract extraction

Contrast sensitivity function after cataract extraction and intraocular lens implantation has been mainly correlated to the type or the material of the intraocular lens. Our purpose was to identify other possible factors, like posterior capsule, to contrast sensitivity alterations after cataract surgery, comparing patients operated for cataract by techniques that mainly differed on the posterior capsule's integrity. The intraocular lens implanted was either a posterior or an anterior chamber one, always monofocal and made of PMMA. We measured contrast sensitivity function at four spatial frequencies in two groups of operated individuals (group A and B) and in one group of healthy control individuals. Each group consisted of 42 eyes. Group A comprised eyes with intact, clear posterior capsule and posterior chamber monofocal intraocular lens. Group B comprised eyes with ruptured or removed posterior capsule and anterior chamber monofocal intraocular lens. Control group comprised healthy control eyes. A pair matched design was used to compare contrast sensitivity values among the individuals of the three groups. No statistically significant differences in contrast sensitivity values were found when group B patients were compared to healthy controls (p>0.05). Patients of group A exhibited contrast sensitivity function impairment at intermediate and high spatial frequencies when compared to patients of group B (p <0.05) and to controls (p <0.01). It seems that intact posterior capsule provides inferior visual function, in spite of relatively good visual acuity and apparently satisfactory results. This revised version was published online in July 2006 with corrections to the Cover Date.