Optical quality of toric intraocular lens implantation in cataract surgery

AIM: To analyze the optical quality after implantation of toric intraocular lens with optical quality analysis system. METHODS: Fifty-two eyes of forty-four patients with regular corneal astigmatism of at least 1.00 D underwent implantation of AcrySof toric intraocular lens, including T3 group 19 eyes, T4 group 18 eyes, T5 group 10 eyes, T6 group 5 eyes. Main outcomes evaluated at 3mo of follow-up, included uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), residual refractive cylinder and intraocular lens (IOL) axis rotation. Objective optical quality were measured using optical quality analysis system (OQAS Ⅱ?, Visiometrics, Spain), included the cutoff frequency of modulation transfer function (MTFcutoff), objective scattering index (OSI), Strehl ratio, optical quality analysis system value (OV) 100%, OV 20% and OV 9% [the optical quality analysis system (OQAS) values at contrasts of 100%, 20%, and 9%]. RESULTS: At 3mo postoperative, the mean UDVA and CDVA was 0.18±0.11 and 0.07±0.08 logMAR; the mean residual refractive cylinder was 0.50±0.29 D; the mean toric IOL axis rotation was 3.62±1.76 degrees, the mean MTFcutoff, OSI, Strehl ratio, OV 100%, OV 20% and OV 9% were 22.862±5.584, 1.80±0.84, 0.155±0.038, 0.76±0.18, 0.77±0.19 and 0.78±0.21. The values of UDVA, CDVA, IOL axis rotation, MTFcutoff, OSI, Strehl ratio, OV100%, OV20% and OV9% depending on the power of the cylinder of the implantation were not significantly different (P>0.05), except the residual refractive cylinder (P<0.05). CONCLUSION: The optical quality analysis system was useful for characterizing the optical quality of AcrySof toric IOL implantation. Implantation of an AcrySof toric IOL is an effective and safe method to correct corneal astigmatism during cataract surgery.     

准分子激光角膜原位磨镶术后远期视觉质量的观察

目的:研究接受准分子激光角膜原位磨镶术(Laser in situ keratomileusis,LASIK)患者的视觉质量在术后数年内是否稳定,应用视觉质量分析系统(Optical Quality Analysis System,OQASⅡ)对LASIK术后远期视觉质量进行评价.方法:从第四军医大学学员中招募志愿者作为受试者,从中选择曾行LASIK手术者35例70眼作为观察组,未行LASIK手术者70例140眼作为对照组,应用OQASⅡ比较近期观察组(LASIK术后2~4a)和远期观察组(LASIK术后5~11 a)的视觉质量,通过设立近期对照组(<22岁)和远期对照组(≥23岁)探讨年龄、用眼习惯等混杂因素对视觉质量的影响,并分别与近期观察组和远期观察组相比较.观察指标为客观散射指数(OSI)、MTF截止空间频率(MTF cutoff)、斯特列尔比值(SR)、100%对比敏感度的OQAS分值(OV100%)、20%对比敏感度的OQAS分值(OV20%)和9%对比敏感度的OQAS分值(OV9%).结果:在术后数年内,观察组的OSI显著高于对照组,而MTF cutoff、SR以及OV100%、OV20%和OV9%显著低于对照组(P<0.05);随术后时间延长,视觉质量基本保持稳定,OSI有一定降低的趋势,而MTF cutoff、SR、OV100%、OV20%、OV9%有一定升高的趋势,但均没有统计学差异(P>0.05).结论:LASIK是矫正近视的常用手术方法,随术后时间延长,因手术一定程度降低的视觉质量有恢复的趋势,但在数年内不能完全恢复,基本保持稳定的状态.OQAS能够对LASIK术后的视觉质量进行定性和定量分析,有助于近视矫正术后视觉质量的分析和手术方案的改进.     

Objective visual quality one year after toric IOL implantation for correction of moderate and high corneal astigmatism

AIM:To compare the objective visual quality after implantation of a toric intraocular lens(IOL)in order to correct moderate or high corneal astigmatism at the one year postoperative follow-up.METHODS:From December 2017 to June 2018,66 patients(90 eyes)with simple age-related cataract with regular corneal astigmatism greater than 1.5 D were enrolled in this prospective self-control study.The patients were implanted with Proming?toric IOL(model:AT3 BH-AT6 BH).The subjects were divided into moderate astigmatism group(46 eyes,1.5-2.5 D)and high astigmatism group(44 eyes,>2.5 D).The uncorrected distance visual acuity,residual astigmatism and axial position of IOL were observed before operation,3,6 mo and 1 y after operation.Modulation transfer function cutoff(MTF cutoff),Strehl ratio(SR),object scatter index(OSI)were observed by OQAS II to evaluate the objective visual quality of patients.RESULTS:There was no significant difference in UCVA,residual astigmatism,axial deviation,MTF cutoff,SR and OSI between moderate and high astigmatism group(all P>0.05).After 3 mo,UCVA,MTF cutoff and SR were significantly increased(all P<0.05),residual astigmatism and OSI were significantly decreased(all P<0.05).After 3 mo,all the indexes remained stable.CONCLUSION:Proming toric IOL can effectively treat age-related cataract patients with moderate-to-high regular corneal astigmatism,correcting corneal astigmatism,improving UCVA,ensuring long-term stability in the capsule,and providing patients with better visual quality.     

双通道系统视觉质量分析仪评价正常人视觉质量的可重复性研究

目的 探讨双通道系统视觉质量分析仪（optical quality analysis system, OQAS）评价正常人客观视觉质量的可重复性。 设计 诊断技术评价。 研究对象 26例（48眼）除屈光不正外无其他眼病的正常成年人。方法 在相同的测试条件下,由同一测试者采用OQAS对研究对象进行视觉质量的检查,连续测量10次,检查视觉质量参数6种,包括调制传递函数的截止点（MTFcutoff）、斯特列尔比值（Strehl2D ratio）、对比度为100%、20%、9%时的OV值（OV100%、 OV20%、 OV9%）以及客观散射指数（OSI）。利用SAS软件计算重复性限（RL）值。主要指标 6种OQAS参数的重复性限值（RL）。 结果 受试者的平均MTFcutoff、Strehl2D ratio、OV100%、OV20%、OV9%和OSI 分别为39.55±10.99、0.23±0.07、1.32±0.37、1.36±0.46、1.38±0.52和0.70±0.43,其RL值（百分比数值）分别为17.74%、24.95%、17.74%、20.59%、23.31%和37.07%。结论 双通道系统视觉质量分析仪作为评价正常人客观视觉质量的检查方法具有良好的可重复性。     

Protective effects of human umbilical cord mesenchymal stem cells on retinal ganglion cells in mice with acute ocular hypertension

AIM:To observe the protective effect of human umbilical cord mesenchymal stem cells(huc MSCs)on retinal ganglion cel s(RGCs)injury in mice with acute ocular hypertension(AOH).METHODS:Fifty-six adult male C57 BL/6 mice were randomly divided into four groups:normal group,AOH group,huc MSCs group,normal saline(NS)group.Left eye of mice was induced by 90 mm Hg intraocular pressure for 1 h to establish AOH model.huc MSCs 1×105/μL,1μL or NS 1μL was injected into the vitreous body the next day.CMDil fluorescent dye was used to label the 3 rd generation of huc MSCs,for tracing the cells in the vitreous cavity of mice.Seven days after the model established,hematoxylin-eosin(HE)staining was used to observe the thickness of the inner retina layer in four groups.Numbers and loss rate of RGCs were evaluated by counting Brn-3 a positive cells stained by immunofluorescencein.RESULTS:On the 7 th day after AOH established,labeled huc MSCs were found in the vitreous cavity.HE staining showed that the thickness of retinal inner layer in AOH group was significantly lower than that in normal group and huc MSCs group(P<0.05),same as that in NS group(P>0.05).Compared with AOH group,the RGCs in normal group was significantly higher;RGCs number increased in huc MSCs group and the loss rate was lower(P<0.05).Injection of NS had no protective effect on RGCs.CONCLUSION:In AOH mouse model,vitreous injection of hucMSCs have shown a protection for RGCs.     

Early outcomes of vision and objective visual quality analysis after cataract surgery with trifocal intraocular lens implantation

AIM: To investigate the early outcomes of vision, objective visual quality and their correlation after cataract surgery with trifocal intraocular lens implantation. METHODS: The visual examination and objective visual quality analysis using Optical Quality Analysis System (OQAS) at 1mo and 3mo, and defocus curve examination at 3mo were performed in 20 patients (27 eyes) after phacoemulsification combined with trifocal intraocular lens implantation surgery. RESULTS: The uncorrected distant (UD), intermediate and near visual acuity (VA) were significantly improved after surgery (P<0.001). UDVA at 1mo after the surgery was slightly better than that after 3mo (P=0.026). The defocus curve after 3mo indicated that the peak of distant vision was close to 0 logMAR, and UDVA was lower than 0.3 logMAR in the range of -1.5 D to -3.0 D. The modulation transfer function (MTF) cutoff frequency, strehl ratio (SR), Optical Quality Analysis System values (OVs), includes OV100, OV20 and OV9 after the surgery were significantly better than before surgery (P<0.001), but the objective scattering index (OSI) was significantly decreased (P<0.001). UDVA at 3mo after the surgery had correlations with MTF cutoff, OSI, OV100 and OV20 (r=-0.400, 0.431, -0.437, -0.411, P=0.039, 0.025, 0.023, 0.033). The uncorrected intermediate VA after 3mo of the surgery had correlations with OSI and OV100 (r=0.478, -0.411, P=0.012, 0.033). CONCLUSION: Trifocal intraocular lens implantation can provide good distant, intermediate and near VA, and the vision shows a well correlation with objective visual quality during early surgery.     

两种不同类型眼内接触镜(ICL)矫正高度近视术后视觉质量的比较

目的 对比中央带孔型及传统眼内接触镜(intraocular contact lens,ICL)矫正高度近视术后视觉质量.方法 选择行传统ICL植入术的高度近视患者11例(21眼)作为传统组,另外选择行带孔型ICL植入术的高度近视患者12例(20眼)作为带孔型组.术后6个月分别行裂隙灯显微镜检查眼前节,标准对数视力袁检查裸眼视力(uncorrected visual acuity,UCVA)、最佳矫正视力(best corrected visual acuity,BCVA),自动验光仪测量手术前后等效球镜度数(spherical equivalent,SE)、散光度数.OQAS视觉质量检查包括客观散射指数(objective scattering index,OSI)、调制传递函数(modulation transfer function,MTF)、斯特列尔比(stryrby,SR)、不同对比度下OQAS值(OV100％、OV20％、OV9％).结果 两组患者UCVA (logMAR)、BCVA(logMAR)、SE及散光度数术后6个月均较术前减小,差异均有统计学意义(均为P＜0.05);术前及术后6个月两组间UCVA、BCVA、SE及散光度数比较,差异均无统计学意义(均为P＞0.05).带孔型组和传统组患者植入术后6个月OQAS视觉质量参数MTFcutoff、SR、和OV100％、OV20％、OV9％值均较术前增高,差异均有统计学意义(均为P＜0.05).带孔型组和传统组患者植入术后6个月OSI均较术前略降低,但差异均无统计学意义(均为P ＞0.05).对比术后6个月带孔型组和传统组患者OQAS视觉质量参数OSI、MTFcutoff、SR、和OV100％、OV20％、OV9％值两组间差异均无统计学意义(均为P＞0.05).结论 两种类型ICL矫正高度近视均是安全有效的,中央带孔型ICL可以提供和传统ICL接近的视觉质量.     

双通道系统评估不同近视患者行FS-LASIK术后视觉质量的变化

目的：采用视觉质量分析系统(OQAS)评价不同近视患者行飞秒激光制瓣准分子激光原位角膜磨镶术(FS-LASIK)后视觉质量的变化。

方法：共收集行FS-LASIK的患者65例130眼,分为低、中、高度近视三组。采用OQAS系统检查比较三组患者术前术后视觉质量参数的变化。

结果：低度近视组术后10d OV100%、MTF cutoff值高于高度近视组,OV20%、OV9%值高于中、高度近视组(均P<0.017)。术后1d低度近视组和术后1、10、30d中、高度近视组OSI和Mean OSI均比术前显著升高,而MTF cutoff、SR、OV100%、OV20%、OV9%均比术前显著降低(均P<0.0083)。Mean OSI 与OV100%、OV20%、OV9%、SR、MTF cutoff 均呈负相关,与OSI均呈正相关(均P<0.05)。

结论：FS-LASIK术后早期视觉质量下降,泪膜功能与视觉质量变化趋势一致,低度近视比中、高度近视患者恢复更快。     

双通道视觉质量分析系统评价弱视儿童的视觉质量

目的　应用双通道视觉质量分析系统（ｏｐｔｉｃａｌｑｕａｌｉｔｙａｎａｌｙｓｉｓｓｙｓｔｅｍ,ＯＱＡＳⅡ）比较弱视儿童与正常儿童视觉质量和散射的差异,为临床应用提供一定的参考依据。方法　在广西视光中心弱视门诊就诊患儿中随机选取弱视儿童２８例（５３眼）和正常儿童２８例（４７眼）作为弱视组和正常对照组,所有入选儿童行客观视觉质量分析系统（ＯＱＡＳⅡ,Ｖｉｓｉｏｍｅｔｒｉｃｓ公司）检测、散瞳检影验光和标准对数视力表评估。比较两组屈光度、视力、ＭＴＦ截止空间频率（ＭＴＦｃｕｔｏｆｆ）、斯特列尔比值（ｓｔｒｅｈｌｒａｔｉｏ,ＳＲ）、客观散射指数（ｏｂｊｅｃｔｉｖｅｓｃａｔｔｅｒｉｎｇｉｎｄｅｘ,ＯＳＩ）值及对比度为１００％、２０％、９％时的ＯＶ值（ＯＱＡＳｖａｌｕｅ,ＯＶ１００％、ＯＶ２０％和ＯＶ９％）。结果　弱视组矫正视力和等效球镜分别为０．２６±０．１７ｌｏｇＭＡＲ和（２．９１±３．２５）Ｄ,弱视组ＭＴＦｃｕｔｏｆｆ、ＳＲ、ＯＳＩ、ＯＶ１００％、ＯＶ２０％和ＯＶ９％分别为（３０．９１±１５．２４）ｃ?ｄ－１、０．２０±０．１１、１．１５±１．４２、（１．０３±０. ５１）ｃ?ｄ－１、（０．７８±０．４５）ｃ?ｄ－１、（０．５２±０．３８）ｃ?ｄ－１;正常对照组ＭＴＦｃｕｔｏｆｆ、ＳＲ、ＯＳＩ、ＯＶ１００％、ＯＶ２０％和ＯＶ９％分别为（３７. ４９±９．８１）ｃ?ｄ－１、０．２３±０. ０７、０. ７４±１．３９、（１．２５±０．３３）ｃ?ｄ－１、（０．９４±０．３０）ｃ?ｄ－１、（０．６１±０．２１）ｃ? ｄ－１。两组儿童ＭＴＦｃｕｔｏｆｆ、ＯＶ１００％和ＯＶ２０％比较,差异均有统计学意义（均为Ｐ＜０．０５）。弱视儿童的球镜和柱镜度数与ＭＴＦｃｕｔｏｆｆ、ＳＲ、ＯＳＩ、ＯＶ１００％、ＯＶ２０％和ＯＶ９％均存在统计学意义的相关性（均为Ｐ＜０．０５）。结论　弱视儿童的视觉质量较正常儿童差,且主要表现在中高频对比度部分下降,散射不是导致弱视儿童视觉质量下降的因素。     

配戴硬性透气性角膜接触镜对轻中度圆锥角膜患者视觉质量的影响

目的　探讨配戴硬性透气性角膜接触镜(rigid gas-permeable contact lense,RGPCL)对轻中度圆锥角膜患者视觉质量的影响。方法　选取2018年12月至2019年6月在河南省人民医院门诊确诊为轻中度圆锥角膜的患者20例25眼。轻中度圆锥角膜的诊断标准及分期依据全球圆锥角膜专家共识及圆锥角膜评分标准。应用视觉质量分析系统II(OQAS-II)检查患者在配戴RGPCL前及配戴1个月后各视觉质量参数,包括客观散射指数(objective scatter index,OSI)、调制传递函数截止频率(modulation transfer function cut off frequency,MTFcut off)、斯特列尔比(strehl ratio,SR),三种模拟对比度下视力OV100%、OV20%、OV9%及19.5 s内不瞬目情况下泪膜散射指数(tear film objective scatter index,TF-OSI)。同时分析各视觉质量参数与角膜前表面中央3 mm光学区K_steep的相关性。结果　配戴RGPCL前与配戴1个月后相比,OSI明显降低,MTFcut off、SR、OV100%、OV20%、OV9%均明显升高,差异均有统计学意义(均为P<0.05)。配戴RGPCL前与配戴1个月后相比,TF-OSI差异无统计学意义(P>0.05)。配戴RGPCL前,OSI及TF-OSI与K_steep呈正相关,MTFcut off、SR、OV100%、OV20%、OV9%与K_steep均呈负相关(均为P<0.05);配戴RGPCL 1个月后,除TF-OSI与K_steep呈正相关(P<0.05)外,OSI、MTFcut off、SR、OV100%、OV20%、OV9%与K_steep均无相关性(均为P>0.05)。结论　RGPCL可明显提高轻中度圆锥角膜患者的视觉质量。     

有晶状体后房型人工晶状体植入术与飞秒激光LASIK术后视觉质量的比较

背景 随着近视患病率的增加,近视患者如何选择合适的矫正方法以达到更好的视觉质量成为研究热点. 目的 采用双通道视觉质量分析仪(OQAS)对有晶状体眼后房型人工晶状体(ICL)植入术治疗中高度近视的效果和视觉质量与飞秒激光准分子激光角膜原位磨镶术(FS-LASIK)进行对比分析. 方法 采用非随机临床对照研究设计,于2015年1月至2016年1月在西安市第一医院纳入屈光度为-4.00 ～-9.00 D且拟行近视矫正手术者26例52眼,按照角膜厚度分为ICL植入术组和FS-LASIK组,角膜厚度＜500 μm者12例24眼接受ICL植入术,角膜厚度≥500 μm的14例28眼接受FS-LASIK手术,2个组间年龄、性别、术前最佳矫正远视力(BCDVA)和术前等效球镜度(SE)的差异均无统计学意义(均P＞0.05).所有患者随访至术后3个月,对2个组术眼术后裸眼远视力(UCDVA)、SE、OQAS测量的调制传递函数截止频率(MTF cut off)、客观散射指数(OSI)、斯特列尔(Strehl)比率及对比度100％、20％、9％时的对比度视力(OV100、OV20、OV9)进行比较,并对各自组内术眼手术后UCDVA与术前BCDVA进行比较. 结果 ICL组和FS-LASIK组术眼术后BCDVA均优于术前UCDVA(-0.04±0.10与0.05±0.12;-0.07±0.12与0.00±0.12),但差异均无统计学意义(t=3.128、2.358,均P＞0.05).2个组间术眼术后SE、UCDVA和BCDVA的差异均无统计学意义(t=1.292、0.900、-0.653,均P＞0.05).OQAS测量结果显示,2个组间术后MTF cut off、OSI、Streh4比和OV100值差异均无统计学意义(t=-2.032、-1.440、-0.224,均P＞0.05).ICL组术眼术后OV20和OV9值分别为0.82±0.14和0.80±0.21,均明显高于FS-LASIK组的0.59±0.15和0.47±0.13,差异均有统计学意义(t=4.105、4.702,均P＜0.05). 结论 ICL植入术和FS-LASIK矫正中高度近视均可有效改善患者的视力和屈光度,在20％和9％的对比度下,ICL术眼术后的视觉质量优于FS-LASIK.     

Analyses of surgically induced astigmatism and axis deviation in microcoaxial phacoemulsification

To evaluate surgically induced astigmatism (SIA) and axis deviation after coaxial microincision superotemporal clear corneal phacoemulsification incision in eyes with differently located steep axis. This prospective, comparative study included four groups of 45 eyes with age-related cataracts; each group underwent 2.2-mm superotemporal clear corneal incision (CCI) cataract surgery. The four groups of patients were divided by location of the steep axis. Groups were matched according to symmetry of the steep axis for both right and left eyes as follows—0°–45° of steep axis for right eyes, and 136°–180° for left eyes (group 1); 46°–90° for right eyes and 91°–135° for left eyes (group 2); 91°–135° for right eyes and 46°–90° for left eyes (group 3); and 136°–180° for right eyes and 0°–45° for left eyes (group 4). Outcome measures included changes in mean total astigmatism, SIA, and axis deviation. Astigmatism was measured by manual keratometry readings before surgery and week 1, week 4, week 8, and week 12 postoperatively. SIA was calculated by the vector analysis (Holladay–Cravy–Koch method). The magnitude of mean total astigmatism was lowest in group 3 and highest in group 1 at week 12. SIA was 0.39 diopters (D), 0.22 D, 0.17 D, and 0.28 D in group 1, group 2, group 3, and group 4, respectively. The change in astigmatic axis deviation was highest in group 3 (23.6 ± 16.6) (P < 0.05). Axis deviation and SIA were stable after week 4. Planning of CCI on or near the steep axis can help decrease corneal astigmatism.     

双通道视觉质量分析系统评价泪膜稳定性对青少年视网膜成像质量的影响

目的：:利用双通道视觉质量分析系统（OQAS-II）评价泪膜稳定性对青少年视网膜成像质量的影响,为临床研究提供相关数据。方法：:系列病例研究。选取2019年3─10月在福州市中医院眼科门诊就诊的青少年患者,按泪膜破裂时间（BUT）分为研究组（BUT<10 s）32例和对照组（BUT≥10 s）30例。利用基于双通道技术...     

双通道视觉质量分析系统在球面和非球面人工晶状体眼视觉质量评价中的应用

目的　使用双通道视觉质量分析系统（optical quality analysis system,OQAS）对球面和不同球差值非球面人工晶状体（intraocular lens,IOL）眼视觉质量进行评估。方法　选择白内障超声乳化及IOL植入术的年龄相关性白内障患者227例（349眼）分5组，分别植入Bausch & Lomb球面IOL Akreos Adapt、AMO球面IOL Sensar AR40E、Bausch & Lomb非球面IOL Akreos Adapt AO（球差值0 μm）、Alcon非球面IOL Acrysof IQ SN60WF（球差值-0.20 μm）、AMO非球面IOL Tecnis ZCB00（球差值-0.27 μm）。术后3个月采用双通道客观视觉质量分析系统（OQASTMⅡ）、KR-1W像差仪进行检查。比较各组客观散射指数（objective scatter index,OSI）、调制传递函数截止频率（MTF cut off）、斯特列尔比（Strehl ratio,SR）、模拟对比度视力（OV100%、OV20%、OV9%）波前像差。结果　术后3个月，5组间裸眼视力（uncorrected visual acuity,UCVA）、最佳矫正视力（best corrected visual acuity,BCVA）、等效球镜（spherical corrected,SE）比较差异均无统计学意义（均为P＞0.05）。5组间角膜高阶像差差异均无统计学意义（均为P＞0.05）；4 mm瞳孔眼内球面像差（spherical aberration,SA）、全眼SA差异均有统计学意义（均为P＜0.05）；6 mm瞳孔眼内和全眼总高阶像差（total higher order aberration,tHOA）、SA差异均有统计学意义（均为P＜0.05）。5组间OQAS参数差异均有统计学意义（均为P<0.05）。OSI:ZCB00组均优于AK组、AR40E组、AO组（均为P＜0.05）；MTF cut off:SN60WF组、ZCB00组均优于AK组、AR40E组（均为P＜0.05）；SR:SN60WF组、ZCB00组优于AK组（均为P＜0.05）；OV100%:SN60WF组、ZCB00组均优于AK组、AR40E组（均为P＜0.05）；OV20%:SN60WF组均优于AK组、AR40E组、AO组，ZCB00组均优于AK组（均为P＜0.05）；OV9%:SN60WF组、ZCB00组均优于AK组、AR40E组（均为P＜0.05）。其余组间各指标差异均无统计学意义（均为P>0.05）。结论　非球面IOL眼视觉质量优于球面IOL眼；负球差非球面IOL AMO ZCB00和Alcon SN60WF优于零球差非球面IOL Bausch & Lomb Akreos AO；OQAS可以全面、客观地评价白内障术后IOL眼的视觉质量。     

Evaluation of visual quality of spherical and aspherical intraocular lenses by Optical Quality Analysis System

AIM: To evaluate the impact of spherical and aspherical intraocular lenses on the postoperative visual quality of age-related cataract patients using Optical Quality Analysis System (OQAS). METHODS: Seventy-four eyes with age-related cataracts were randomly divided into spherical and aspherical lens implantation groups. Best-corrected visual acuity (BCVA) was measured preoperatively, one day, one week, two weeks, one month and two months after surgery. A biometric systems analysis using the OQAS objective scattering index (OSI) was performed. RESULTS: There were no significant differences in visual acuity (P>0.05) before and after spherical and aspheric lens implantation. There was a negative linear correction between the OSI value and BCVA (r=-0.634, P=0.000), and positive corrections between the OSI value and the lens LOCUS III value of nucleus color (NC), nucleus opacity (NO), cortex (C) and posterior lens capsular (P) (r=0.704, P=0.000; r=0.514, P=0.000; r=0.276, P=0.020; r=0.417, P=0.000, respectively). OSI values of spherical vs aspherical lenses were 11.5±3.6 vs 11.8±3.4, 4.1±0.9 vs 3.3±0.8, 3.5±0.9 vs 2.7±0.7, 3.3±0.8 vs 2.6±0.7, 3.2±0.7 vs 2.5±0.8, and 3.2±0.8 vs 2.5±0.8 before and 1d, 1, 2wk, 1 and 2mo after surgery, respectively. All time points varied significantly (P<0.01) between the two groups. CONCLUSION: Aspherical IOLs does not significantly affect visual acuity compared with spherical IOLs. The OSI value, was significantly lower in the aspherical lens group compared with the spherical lens. This study shows that objective visual quality of aspheric IOLs is better than that of the spherical lens by means of OQAS biological measurement method.     

双通道系统评估甲状腺相关性眼病的视觉质量及相关因素分析

目的：采用以双通道技术为基础的视觉质量分析系统（OQAS）评价甲状腺相关性眼病（TAO）的视觉质量并分析相关影响因素。方法：病例对照研究。收集2016 年10 月至2017 年6 月就诊于四川省人民医院眼科的TAO患者31例（62眼）作为TAO组，其中活动期TAO 28眼，非活动期TAO 34眼；选择就诊于同一医院的眼科健康体检者或门诊眼科检查正常的受检者共31 例（62 眼）作为正常对照组。对TAO患者进行临床活动性评分（CAS）和眼部病变严重度NO SPECS分级。检查内容包括视力、眼压、睑裂高度、眼睑闭合不全程度、眼睑退缩量和眼球突出度并进行眼表Schirmer Ⅰ试验和泪液破裂时间（BUT）测量。采用OQAS测量在100%、20%、9%对比度下的OQAS值（即OV100%、OV20%、OV9%），并检测客观散射指数（OSI）、调制传递函数截止频率（MTFcutoff）、斯特列尔比值（SR）及反映泪膜的OSI平均值（Mean OSI）。2 组定量资料比较采用独立样本t检验或Mann-Whitney U检验，定性资料比较采用卡方检验，采用Spearman检验行相关性分析。结果：TAO组OSI、Mean OSI均显著高于正常对照组，而OV100%、OV20%、OV9%、MTFcutoff、SR均显著低于正常对照组，差异均有统计学意义（均P<0.05）。非活动期和活动期TAO患者睑裂高度、眼睑闭合不全程度、眼睑退缩程度、BUT时间、眼球突出程度、眼压之间差异均有统计学意义（均P<0.05），所有视觉质量参数和Schirmer Ⅰ差异均无统计学意义。TAO患者OSI与睑裂高度呈负相关（r=-0.296，P=0.020），与NO SPECS分级、年龄、Mean OSI呈正相关（r=0.469，P<0.001；r=0.429，P=0.001；r=0.836，P<0.001）；Mean OSI与睑裂高度呈负相关（r=-0.252，P=0.048），与NO SPECS分级、年龄、眼压呈正相关（r=0.404，P=0.001；r=0.347，P=0.006；r=0.311，P=0.014）。OSI、Mean OSI与眼睑闭合不全程度、眼睑退缩、眼球突出度、CAS评分、BUT、Schirmer Ⅰ均无相关性。结论：TAO患者活动期和非活动期的视觉质量均较正常人下降，干眼程度更重，且视觉质量与年龄、睑裂高度、NO SPECS分级、Mean OSI等有关。     

飞秒激光微小切口角膜基质透镜切除术和飞秒激光LASIK近视治疗的双通道系统视觉质量评价

目的:评价飞秒激光微小切口角膜基质透镜切除术(small incision lenticule extraction,SMILE)和飞秒激光制瓣的准分子激光原位角膜磨镶术(laser in situ keratomileusis,LASIK)治疗近视术后的视觉质量。方法:选取11例22眼近视和近视散光患者为全飞秒组(SMILE组),同期23例43眼飞秒激光制瓣LASIK的近视和近视散光患者为飞秒激光制瓣的LASIK组(LASIK组)。使用双通道系统(OQAS)检查、记录两组患者术前及术后1mo内的结果,对比二者的调制传递函数截止空间频率(modulation transfer function cutoff frequency,MTF cutoff)、斯特列尔比(strehl ratio,SR)和眼内客观散射指数(objective scattering index,OSI),分析并评价两种手术方式术后早期的视觉质量。结果:SMILE组和LASIK组术后1mo时的MTF cutoff分别为34.835±10.113c/deg和38.362±10.623c/deg(t=0.925,P=0.362);SR分别为0.204±0.077和0.218±0.072(t=0.557,P=0.582);OSI分别为0.608±0.291和0.545±0.405(t=-0.473,P=0.640)。结论:双通道客观视觉质量分析显示SMILE和飞秒激光LASIK两种术式对视觉质量的影响无明显差异。     

SMILE和Epi-LASIK术后1年患者视觉质量及眼内散射情况——基于双通道视觉质量分析系统（OQAS）的对比研究

目的　采用双通道视觉质量分析系统（optical quality analysis system,OQAS）比较飞秒激光小切口基质透镜取出术（small incision lenticule extraction,SMILE）和去瓣机械法准分子激光角膜上皮瓣下磨镶术（epipolis laser in situ keratomileusis,Epi-LASIK）术后1 a患者视觉质量及眼内散射情况。方法　本研究为回顾性病例对照研究。选取2013年3月至2014年8月在中国人民解放军东部战区总医院接受角膜屈光手术的近视眼患者95例（189眼）。按手术方式分为SMILE组52例（103眼）,去瓣Epi-LASIK组43例（86眼）。观察并比较两组患者术后1 a的裸眼视力 (UCVA) 、最佳矫正视力(BCVA) 、眼内客观散射指数(OSI) 、MTF 截止空间频率(MTF cutoff)、斯特列尔比值（SR）、100%、20%、9%对比度的OQAS值(OV100%、OV20%、OV9%)和患者满意度等。结果　术后1 a,SMILE组和去瓣Epi-LASIK组UCVA较术前均显著提高（均为P<0.05）;但两组间UCVA差异无统计学意义（P>0.05）。术后1 a,两组BCVA与术前相比以及两组间相比差异不大,均无统计学意义（均为P>0.05）。术后1 a,SMILE组和去瓣Epi-LASIK组的有效系数分别为1.039和1.038,安全性指数分别为1.066和1.046。术后1 a,两组患者OSI的差异无统计学意义（P>0.05）。SMILE组MTF cutoff和SR略高于去瓣Epi-LASIK组,但差异均无统计学意义（均为P>0.05）。另外,两组患者OV100%、OV20%、OV9%值随图像对比度的降低均有依次递减的趋势,但两组间差异均无统计学意义（均为P>0.05）。术后1 a,SMILE组中,OSI与年龄呈正相关,与术前等效球镜度、SR呈负相关;MTF cutoff与年龄呈负相关,与SR呈正相关,而与术前等效球镜度无相关性。去瓣Epi-LASIK组中,OSI与年龄呈正相关,与术前等效球镜度、SR呈负相关;MTF cutoff与年龄成负相关,与术前等效球镜度、SR呈正相关。术后1 a,SMILE组和去瓣Epi-LASIK组的手术满意度问卷调查评分分别为（9.52±0.80）分和（9.26±0.99）分（总分为10分）,差异无统计学意义（P>0.05）。SMILE组眩光［（1.090±0.930）分］和干涩感［（1.126±1.152）分］的评分低于去瓣Epi-LASIK组［分别为（1.490±1.200）分和（1.861±1.496）分］,差异均有统计学意义（均为P<0.05）。结论　SMILE与去瓣Epi-LASIK矫正近视安全有效,术后患者都可获得良好的视力及视觉质量。其中患者对SMILE术后眩光和干涩感控制效果的满意度更高。     

双通道视觉质量分析系统评价过敏性结膜炎患者的视觉质量

目的　运用双通道视觉质量分析系统（optical quality analysis system,OQASⅡ）评价过敏性结膜炎患者的视觉质量,为临床研究提供相关的数据。方法　选择30例（60眼）过敏性结膜炎患者纳入过敏性结膜炎组;另选取30例（60眼）正常人纳入对照组。获得并分析两组受试者的视力、屈光参数、泪膜破裂时间（break-up time,BUT）以及泪液分泌试验。通过眼前节相干光断层扫描仪记录各组受试者泪河高度、泪河深度以及泪河横截面面积。采用OQAS II记录调制传递函数截止空间频率（modulation transfer function cut off frequency,MTF cutoff）、斯特列尔比（Strehl ratio,SR）、客观散射指数（objective scattering index,OSI）、对比度分别为100%、20%、9%时的 OV值（OV100%、OV20%、OV9%）。比较两组各数据之间的差异性,采用Spearman秩相关分析法分析数据资料间的相关性。结果　过敏性结膜炎组和对照组球镜度、柱镜度、泪液分泌试验、泪河高度、泪河深度、泪河横截面面积各项指标差异均无统计学意义（均为P>0.05）。过敏性结膜炎组的BUT为（8.12±1.91）s,较对照组（10.81±2.53）s小,差异有统计学意义（P<0.01）。过敏性结膜炎组的MTFcutoff、SR、OV100%、OV20%、OV9%值均低于对照组,差异均有统计学意义（均为P<0.05）;OSI值高于对照组,差异有统计学意义（P<0.05）。MTFcutoff、SR、OV100%、OV20%、OV9%值与BUT呈正相关性（均为P<0.01）;OSI 值与BUT呈负相关性（P<0.01）。结论　过敏性结膜炎患者的视觉质量低于正常人群,而这些改变可能与患者泪膜稳定性下降有关。     

两焦点与三焦点人工晶状体植入术后视觉质量的比较

目的:比较两焦点(AT LISA 809MP)和三焦点(AT LISA tri 839MP)IOL植入术后的视觉质量。方法:回顾性研究。共收集2018-03/2019-02行超声乳化吸除术联合多焦点IOL植入术的白内障患者28例49眼。两焦点组18例30眼,年龄40~85(平均67.08±10.80)岁。三焦点组10例19眼,年龄38~79(平均62.21±14.50)岁。所有患者均行视觉质量分析系统(OQAS)、离焦曲线等检查。结果:两焦点组近BCVA优于三焦点,三焦点组中UCVA和远BCVA均优于两焦点组(P<0.05)。三焦点组+1.5、-1.0、-1.5、-2.0、-2.5、-3.0D视力显著优于两焦点组。两组间OQAS视觉质量参数两焦点组OV 20%、OV 9%、SR均优于三焦点组(P<0.05)。结论:两焦点和三焦点IOL植入术后均可获得良好的裸眼远和近视力,视觉质量均较高,而三焦点IOL可获得更佳的中间视力。