白内障术后不同设计与不同材料人工晶状体眼高阶像差分析

目的 利用波阵面像差仪分析不同设计、不同材料的折叠式人工晶状体植入患眼术后高阶像差的特点，旨在指导临床合理选择人工晶状体。方法 随机选取自愿接受超声乳化合并人工晶状体植入手术的白内障患者101人105眼，随机分为四组：A组植入一片式疏水性丙烯酸酯（Acrysof SA60AT）人工晶状体32例32眼；B组植入一片式亲水性丙烯酸酯（Isotechnics HP25B）人工晶状体30例36眼；C组植入三片式疏水性丙烯酸酯（Sensar AR40e）人工晶状体20例20眼{D组植入三片式疏水性丙烯酸酯（Acrysof MA60MA）人工晶状体15例15眼。其中4例8眼为左右眼自身对比。各组年龄之间具有可比性。术后3m观察患眼高阶像差的变化（WaveLight像差分析仪）。结果1、在瞳孔直径为4．0mm、5．0mm时，B组的高阶像差均方根（RMSh）值明显高于C组（P〈0．05）。2、在瞳孔直径为4．0-6．0mm时，B组的（RMS3）值明显高于C组（P〈0．05）。3、在瞳孔直径为6.0-7．0mm时，A组的球差（C12）值显著高于C组（P〈0．05）。结论 1、从波阵面像差角度分析全长13．Omm人工晶状体的光学质量和囊袋稳定性优于全长12．5mm人工晶状体。2、在瞳孔直径为6．0-7．0mm时，植入光学部周边前后面均为方型直角锐边设计的双凸型（前面较凸）人工晶状体患眼的球差高于植入光学部周边前圆后方（后表面直角锐边）设计的双凸型（前后凸度相同）人工晶状体的患眼。3、亲水性和疏水性丙烯酸酯人工晶状体眼之间高阶像差无差异。4、相同设计的一片式和三片式丙烯酸酯人工晶状体眼之间高阶像差无差异。     

超声乳化白内障吸除联合人工晶状体植入术后波阵面像差变化的研究

目的 :研究白内障患者在超声乳化联合人工晶状体植入术后客观波阵面像差的改变及与人工晶状体的关系。方法 :连续选取北京大学眼科中心行超声乳化联合人工晶状体植入术的白内障患者 79例 111只眼 ,术前 1天和术后 2周分别由同一技术员进行客观波阵面像差检查 ,得到 6阶 2 7项Zernike系数 (Z1～Z2 7) ,1～ 6阶的均方根 (RMS1～ 6 ) ,总体均方根(RMSg)和高阶均方根 (RMSh)。结果 :Z4 ,Z9,Z12和Z2 4手术前后有显著性差异 (P <0 0 5 ) ;RMS1～ 6、RMSg、RMSh术后较术前均显著性下降 (P <0 0 0 1)。折叠人工晶状体的类型 (三片 ,一片 )与术后RMS3(r =- 0 319)、RMS4 (r =- 0 4 75 )、RMS5 (r =- 0 30 4 )和RMSh(r =- 0 4 0 8)有显著相关性 (P均 <0 0 5 )。结论 :白内障术后各阶像差较术前均显著性减小 ,光学成像质量提高 ;具特征性的改变是三叶草形的像差和四阶球差 ;三片式折叠人工晶状体眼的高阶像差小于一片式折叠人工晶状体眼。     

白内障超声乳化联合人工晶状体植入术后眼高阶像差的多因素研究

目的 观察白内障超声乳化并人工晶状体植入术后眼高阶像差与人工晶状体各参数的关系,探讨改善白内障术后眼高阶像差的途径.方法 采用Zywave波前像差仪,检测白内障超声乳化并人工晶状体植入术后129例(129眼)患者的术眼总高阶像差、球差、彗差等各高阶像差的均方根值,常规检查裸眼视力、最佳矫正视力、人工晶状体位置、前后囊混浊情况、眼压、眼底,并记录术眼的人工晶状体类型、人工晶状体度数、眼轴长度、瞳孔直径、白内障分级、泪膜破裂时间等影响波前像差的多种临床因素资料,进行多元逐步回归分析.结果 术后3个月,平均裸眼视力(LogMAR视力)为0.29±0.09,最佳矫正视力(LogMAR视力)为0.02±0.06.所有患者的术眼除Z310、Z420、Z530外,其余高阶像差与多种临床因素存在线性回归关系(均为P<0.05).其中,人工晶状体类型是术后眼高阶像差的主要影响因素,白内障分级与眼轴长度等对其也有一定影响.总高阶像差的回归方程中,眼轴长度与人工晶状体类型的标准化线性回归系数分别为0.25和-0.38,后者对总高阶像差的影响较大.结论 白内障超声乳化并人工晶状体植入术后患眼高阶像差受多种临床因素影响,非球面人工晶状体可以降低术眼高阶像差.     

高阶像差对人工晶状体眼视觉质量的影响

目的 观察高阶像差对超声乳化并人工晶状体植入术后眼视觉质量的影响,探讨改善术后视觉质量的方法.方法 检测129例（129眼）白内障超乳并人工晶状体植入术后眼总高阶像差、球差（Z400）、彗差（Z310、311）等各高阶像差均方根值（RMS）,并用问卷调查表进行视觉质量评分,行Pearson相关分析检验.结果 所用问卷调查表的信度较高,重复测量效果良好;球差（Z400）、二级散光（Z420）、总高阶像差与术后患者的主观视觉质量之间存在较强的关联,相关性具有统计学意义（P＜0.05）.结论 白内障超乳并人工晶状体植入术后,眼高阶阶像差会影响术后患者的主观视觉质量,尤其是总高阶像差、球差,二级散光.     

非球面预装式人工晶状体植入术后的临床观察

目的 观察非球面预装式人工晶状体（KS-3Ai）植入术后的临床效果。设计 回顾性病例系列。研究对象 老年性白内障患者74例（82眼）。方法 将上述患者随机分为A、B两组，A组38例（43眼），B组36例（39眼），两组均行超声乳化白内障吸除术联合人工晶状体植入术（A组KS-3，B组KS-3Ai），术后3个月观察术眼的对比敏感度和波阵面像差的改变。主要指标对比敏感度和波阵面像差。结果 两组患者均未发生手术并发症。A组高频段空间频率（1．0deg、0．7deg）对比敏感度低于B组（t=3．69，2．71，P均=0．00），差异有统计学意义。A组高阶像差均方根值高于B组（t=4．32，P=0．00），差异有统计学意义。结论 非球面预装式人工晶状体可减少球面像差，提高患者的对比敏感度。     

白内障超声乳化并人工晶状体植入术后高阶像差变化及意义

目的 观察白内障超声乳化并人工晶状体植入术后眼高阶像差的变化,探讨其临床意义.方法 采用 Zywave 波前像差仪,检测129例(129只眼)白内障超声乳化并人工晶状体植入术后(非球面人工晶状体60例,球面人工晶状体69例)患者与107例(107只眼)对照人群的眼总高阶像差、球差 (Z400)、彗差(Z310、311)等各高阶像差均方根值(RMS),行协方差分析检验.结果 与对照组相比,人工晶状体眼组的总高阶像差、Z331、Z311、Z441、Z400、Z420、Z440、Z511、Z510、Z550的均方根值(RMS)的差异具有统计学意义(P＜0.05).其中,与对照组相比,非球面人工晶状体亚组的总高阶像差、Z331、Z441、Z400、Z440、Z511、Z510、Z550的均方根值(RMS)差异具有统计学意义(P＜0.05),除了Z331、Z400,其余6个高阶像差均表现增高;球面人工晶状体亚组的总高阶像差、Z331、Z311、Z400、Z420、Z440、Z511、Z550的均方根值(RMS)差异具有统计学意义(P＜0.05),且均表现增高.结论 白内障超声乳化并人工晶状体植入术后眼总高阶像差在内的多数高阶像差均明显增高;根据植入人工晶状体类型的不同,增高的分阶像差会略有差异,但总高阶像差、Z331、Z400、Z440、Z511、Z550等始终表现增高;非球面人工晶状体能有效降低白内障术后眼的球差.     

白内障术后波阵面像差的临床研究

目的 借助波阵面像差仪研究白内障超声乳化及人工晶体植入术后高阶像差的变化。方法 33眼白内障超声乳化术及人工晶体植入术后1周、1月及3月散瞳后用基于Tscheming原理的波阵面像差仪进行测量，记录6阶像差的Zernike系数和均方根值，并进行统计学分析。结果 7mm瞳孔下，白内障术后眼在1周时与1月和3月时高阶像差的差异有显著性；术后1月和3月时的差异没有显著性；术后1周和1个月时PMMA硬性晶状体与Acrylic丙烯酸酯折叠晶状体的高阶像差间的差异有显著性；而3个月时，二者的高阶像差间的差异没有显著性。结论 像差是影响人眼视力的一个重要因素，对超声乳化术后白内障患者像差的评价有助于临床选择适当的人工晶体及手术方式以进一步提高术后视力。     

有晶状体眼前房型人工晶状体植入矫治高度近视术后波阵面像差分析

目的 探讨2种不同前房型人工晶状体植入矫治高度近视术后波阵面像差及成像质量的差异。方法 使用WASCA波阵面像差仪,在瞳孔直径5 mm时,测量有晶状体眼前房型人工晶状体植入矫治高度近视患者36例63眼（虹膜夹型33眼;房角支撑型30眼）,并选择年龄匹配的近视患者21例30眼,排除眼病疾患作为对照组。获得整体像差、各分阶像差的均方根（RMS）,及Z6-Z14项系数。结果 ①实验组两亚组总高阶像差（RMSh）和3-7阶各阶均方根均比对照组大,指标的差异均有统计学意义（P〈0.05〉。②房角支撑型RMS5、Z13大于虹膜夹型,而Z10、Z12项小于虹膜夹型,差异均有统计学意义。③实验组术后整体高阶像差（RMSh）的均方根与术前等效球镜屈光度均呈显著正相关。（R=0.826,P〈0.05 R=0.754,P〈0.05）。结论 实验组眼的视网膜成像质量较自然晶状体眼差。二种人工晶状体眼高阶像差差异性不大,房角支撑型视网膜成像质量可能优于虹膜夹型。实验组术前近视度数越高的眼,术后视网膜成像质量越差。     

非球面人工晶状体植入术后的高阶像差观察

目的 探讨Canon Staar KS-3Ai非球面人工晶状体及Canon Staar KS-3球面人工晶状体植入术后，两组之间人眼波前像差的差异。方法 老年性白内障患者71例（80眼），随机分为两组，每组40眼，行超声乳化白内障吸除术联合人工晶状体植入术，分别植入Canon Staar KS-3Ai非球面人工晶状体及CanonStaarKS-3球面人工晶状体，术后3个月做波前像差检查。测量人工晶状体眼的球差、第三、第四、第五、第六阶像差及总体高阶像差，对检查结果进行T检验。结果 瞳孔直径在5．0mm状态下Canon Staar KS-3Ai非球面人工晶状体组的球差、第四、第五、第六阶像差及总体高阶像差均明显低于Canon Staar KS-3球面人工晶状体组，两组间差异具有统计学意义（P〈0．05）.结论 非球面人工晶状体眼视觉质量明显优于球面人工晶状体眼。     

相同直径亲水性和疏水性丙烯酸酯人工晶状体波阵面像差研究

目的利用波阵面像差仪检测探讨白内障患者行超声乳化并植入不同材料的折叠式人工晶状体术后波阵面像差的变化,讨论其相关性,对人工晶状体的材料选择具有指导意义,最大限度消除术后像差的存在,使患者获得最佳视网膜成像质量。方法随机选取自愿接受超声乳化合并人工晶状体植入手术的白内障患者(排除眼科其它疾病及相关全身疾病)共66人70眼,随机分为两组:A组植入光学直径6.0mm疏水性丙烯酸酯(Acrysof SA60AT)人工晶状体32例32眼;B组植入光学直径6.0mm亲水性丙烯酸酯(Isotechnics HP25B)人工晶状体38例38眼;其中4例8眼患者为左右眼自身对比。各组年龄之间具有可比性,由同一术者施行此手术,术后观察患眼波阵面像差及其它相关的变化。结果在瞳孔直径为4.0mm、5.0mm、6.0mm、7.0mm时,A组和B组的高阶像差均方根RMSh无显著性差异(P>0.05);两组RMS3无显著性差异(P>0.05);两组C12值亦无显著性差异(P>0.05)。结论1.人工晶状体眼的高阶像差随瞳孔直径增大而增大;2.在瞳孔直径4.0mm、5.0mm、6.0mm、7.0mm时,亲水性与疏水性丙烯酸酯人工晶状体眼的高阶像差均方根、彗差和球差均无显著性差异。     

Comparison of wavefront aberration after cataract surgery with acrylic intraocular lens implantation

PURPOSE: To compare aberration changes in pseudophakic eyes with 3 types of acrylic intraocular lenses (IOLs) and in normal phakic eyes. SETTING: Department of Ophthalmology, Asan Medical Center, Seoul, Korea. METHODS: This single-center prospective study comprised 51 cataract patients who had cataract surgery and 12 phakic eyes. Fourteen eyes received an AcrySof MA60BM (Alcon), 18 eyes received a Sensar AR40 (AMO), and 19 eyes, a Corneal ACR6D (Corneal Laboratoire). One month after cataract surgery, aberrations in the eyes were measured using a Hartmann-Shack-type aberrometer. The same measurements were done in the 12 age-matched normal phakic eyes. Individual Zernike polynomials and the root-mean-square (RMS) 3rd- and 4th-order aberrations in the 2 groups were compared. The total RMS value was also compared. RESULTS: The RMS value of the 3rd- and 4th-order aberrations did not differ significantly between groups, nor did the total RMS value. In all IOL groups, an individual Zernike coefficient (C3(3), triangular astigmatism with base on the y-axis) was significantly different than that in the normal phakic group. CONCLUSION: There was no statistically significant difference in overall higher-order aberrations between normal eyes and eyes implanted with 3 types of acrylic IOLs.     

Wavefront aberrations in eyes with Acrysof monofocal intraocular lenses

PURPOSE: To characterize and measure the ocular aberrations in eyes implanted with monofocal intraocular lenses (IOLs) and to study any correlation between postoperative aberrations and surgical factors. METHODS: A Tscherning aberroscope was used to measure the wavefront aberrations of 62 eyes that had undergone phacoemulsification with the implantation of foldable monofocal Acrysof MA60BM IOLs (Alcon Laboratories Inc, Ft Worth, Tex). The Zernike coefficients, measured with a pupil diameter of 6 mm, were compared with those of a normal dataset of 82 eyes of healthy young myopes. RESULTS: Spherical aberration (Z(0)4) was the most predominant higher order aberration, with a mean value of 0.37 +/- 0.16 microm. A statistically significant linear relationship was noted between the magnitude of postoperative spherical aberration and the dioptric power of the IOL. The mean spherical aberration was 33 times more in the pseudophakic group than in normal young myopic eyes. The other major higher order aberrations were trefoil (Z(-3)3) with a mean of -0.13 +/- 0.22 microm and vertical coma (Z(-1)3) with a mean value of -0.11 +/- 0.23 microm. On average, the root-mean-square of higher order aberrations in pseudophakic eyes was 2.1 times that in a normal population of young myopic eyes. CONCLUSIONS: Eyes that undergo cataract surgery with monofocal IOL implantation suffer from significant higher order aberrations. The optical design of the IOL is most likely responsible for the increase in spherical aberration, the magnitude of which is a function of the dioptric power of the IOL.     

Effect of cataract surgery incision location and intraocular lens type on ocular aberrations

PURPOSE: To determine whether Hartmann-Shack wavefront sensing detects differences in optical performance in vivo between poly(methyl methacrylate) (PMMA) and foldable acrylic intraocular lenses (IOLs) and between clear corneal and scleral tunnel incisions and whether optical differences are manifested as differences in visual performance. SETTING: Department of Optometry, University of Bradford, West Yorkshire, United Kingdom. METHODS: This study comprised 74 subjects; 17 were phakic with no ocular pathology, 20 had implantation of a Pharmacia 722C PMMA IOL through a scleral tunnel, 21 had implantation of an Alcon AcrySof IOL through a scleral tunnel, and 16 had implantation of an AcrySof IOL through a corneal incision. Visual acuity and contrast sensitivity testing, ocular optical quality measurement using Hartmann-Shack wavefront sensing, and corneal surface measurement with a videokeratoscope were performed in all cases. RESULTS: There were significant differences between groups in the total root-mean-square (RMS) wavefront aberration over a 6.0 mm pupil (F=3.91; degrees of freedom=3,70; P<.05) mediated at the 4th-order RMS, specifically spherical and tetrafoil aberrations. The PMMA-scleral group had the least aberrations and the AcrySof-corneal group the most. For a 3.5 mm diameter pupil, the total higher-order RMS wavefront aberration was not significantly different between the groups (P>.05). There were no differences between groups in corneal shape, visual acuity, or contrast sensitivity. CONCLUSIONS: Implantation of the spherical PMMA IOL led to a slight reduction in total wavefront aberration compared to phakic eyes. AcrySof IOLs induced more aberrations, especially spherical aberration. Corneal-based incisions for IOL implantation compounded this increase. Studies of the optical performance of IOLs in vivo should use wavefront sensing as the main outcome measure rather than visual measures, which are readily confounded by multiple factors.     

Corneal and total wavefront aberrations in phakic and pseudophakic eyes after implantation of monofocal foldable intraocular lenses

PURPOSE: To compare the correlation between corneal and total wavefront aberrations in normal phakic and pseudophakic eyes after implantation of foldable monofocal intraocular lenses (IOLs). SETTING: University Hospital, Eye Clinic, Zurich, Switzerland. METHODS: Wavefront aberrations and corneal topography of 29 eyes that had cataract surgery with implantation of hydrophobic monofocal foldable IOL (AcrySof, Alcon Labs) were measured at least 2 months postoperatively and compared with wavefront measurements performed in 33 normal young phakic eyes. The total wavefront aberrations were measured by means of a Tscherning wavefront sensor at a wavelength of 660 nm (Allegro Wave Analyzer, WaveLight Laser Technology). The corneal aberrations were derived from corneal topography measurements ascertained with a Placido-based topography system (Keratograph 70600, Oculus). The correlations between corneal and total wavefront aberrations were calculated for all Zernike coefficients from 2nd up to 6th order. RESULTS: There was a significant correlation between corneal and total wavefront aberrations in astigmatism C3 and C5 as well as for all 3rd-order Zernike coefficient in both groups (except C8 in the pseudophakic group). The correlation between corneal and total astigmatism (C3 and C5) was higher in the pseudophakic than in the phakic eyes. In contrast, the correlation for the coma-like aberrations was weaker in the pseudophakic eyes (R>0.18) than in the group of phakic eyes (R>0.58). In both groups, there was no significant correlation between spherical aberration C12 of the cornea and the C12 of the total eye. CONCLUSION: After cataract surgery with an IOL implantation, both vertical and horizontal coma, as well as spherical aberration, were of higher value than in normal eyes. The compensation effect for corneal aberrations of the natural lens is absent in the IOL and explains these findings. The corneal aberrations in pseudophakic eyes reflect better the optical quality of the total eye than the phakic eyes. Nevertheless, the missing correlation in some specific aberrations, such as C8 and C10, shows the inability of corneal topography to provide suitable information on the optical quality of the total eye after cataract surgery. Thus, both corneal and total wavefront measurements are relevant for the assessment of outcomes after cataract surgery.     

Change in corneal aberrations after cataract surgery with 2 types of aspherical intraocular lenses

PURPOSE: To study the effect of cataract surgery through 3.2 mm superior incisions on corneal aberrations with 2 types of monofocal intraocular lenses (IOLs) with an aspherical design. SETTING: Instituto de Optica, Consejo Superior de Investigaciones Científicas, and Fundación Jiménez Díaz, Madrid, Spain. METHODS: Corneal topography of 43 eyes was obtained before and after small corneal incision cataract surgery. Twenty-two eyes had implantation of a Tecnis Z9000 silicone IOL (Advanced Medical Optics) and 21 had implantation of an AcrySof IQ SN60WF acrylic IOL (Alcon Research Labs) using the recommended injector for each IOL type. The intended incision size (3.2 mm) was similar in the 2 groups. Corneal aberrations were estimated using custom-developed algorithms (based on ray tracing) for 10.0 mm and 5.0 mm pupils. Comparisons between preoperative and postoperative measurements and across the groups were made for individual Zernike terms and root-mean-square (RMS) wavefront error. RESULTS: The RMS (excluding tilt and defocus) did not change in the AcrySof IQ group and increased significantly in the Tecnis group with the 10.0 mm and 5.0 mm pupil diameters. Spherical aberration and coma-like terms did not change significantly; however, vertical astigmatism, vertical trefoil, and vertical tetrafoil changed significantly with surgery with the 10.0 mm and 5.0 mm pupil diameters (P<.0005). The induced wave aberration pattern for 3rd- and higher-order aberrations consistently showed a superior lobe, resulting from a combination of positive vertical trefoil (Z(3)(-3)) and negative tetrafoil (Z(4)(4)). The mean vertical astigmatism increased by 2.47 microm +/- 1.49 (SD) and 1.74 +/- 1.44 microm, vertical trefoil increased by 1.81 +/- 1.19 microm and 1.20 +/- 1.34 microm, and tetrafoil increased by -1.10 +/- 0.78 microm and -0.89 +/- 0.68 microm in the Tecnis group and AcrySof IQ group, respectively. There were no significant differences between the corneal aberrations in the 2 postoperative groups, although there was a tendency toward more terms or orders changing statistically significantly in the Tecnis group, which had slightly higher amounts of induced aberrations. CONCLUSIONS: Cataract surgery with a small superior incision induced consistent and significant changes in several corneal Zernike terms (vertical astigmatism, trefoil, and tetrafoil), resulting in a significantly increased overall corneal RMS wavefront error. These results can be used to improve predictions of optical performance with new IOL designs using computer eye models and identify the potentially different impact of incision strategies on cataract surgery.     

Optical performance of monofocal and multifocal intraocular lenses in the human eye

PURPOSE: To study the optical performance of intraocular lenses (IOLs) in the human eye to ascertain how multifocality affects the optical performance of refractive and diffractive technologies and the relationship to pupil size. SETTING: Vissum-Instituto de Oftalmológico de Alicante, Alicante, Spain. METHODS: Ten eyes each received the monofocal AcrySof MA60 IOL (Alcon) or 1 of the following multifocal pupil-dependent IOLs: diffractive AcrySof ReSTOR (Alcon) or refractive ReZoom (Advanced Medical Optics). The intraocular optical quality in vivo with 3.0 mm and 5.0 mm pupils was characterized by comparing the means of the difference between the total and corneal optical aberrations 3 months postoperatively. The main outcomes measures were total, higher-order, spherical, and coma aberrations (root-mean-square values); modulation transfer function values; point-spread function; and the Strehl ratio. RESULTS: The ReZoom group had higher in vivo intraocular aberrations than the AcrySof ReSTOR and AcrySof MA60 groups (P = .022). The difference in spherical aberration between the AcrySof ReSTOR and ReZoom groups was statistically significant with 5.0 mm pupils (P = .003) and 3.0 mm pupils (P = .001). The AcrySof ReSTOR group had statistically significant lower coma aberration values with a 5.0 mm pupil (P = .012); there were no differences between IOLs with a 3.0 mm pupil (P = .185). CONCLUSIONS: Multifocal refractive IOLs resulted in higher intraocular aberrations. The hybrid refractive-diffractive IOL was the least affected by pupil diameter in terms of intraocular aberrations and showed significantly less increase in optical aberrations when the pupil was enlarged.     

Limitations of correcting spherical aberration with aspheric intraocular lenses

PURPOSE: Aspheric intraocular lenses (IOLs) are deigned to correct spherical aberration in pseudophakic eyes. We predict the benefit from correcting spherical aberration based on simulations and aberrometry of pseudophakic eyes implanted with spherical IOLs. METHODS: Ray tracing was performed through a model eye with an equi-biconvex spherical IOL and with a spherical aberration-correcting aspheric IOL. The IOLs were increasingly tilted and/or displaced, and the resulting transverse aberrations of 169 rays were transformed into Zernike coefficients for different pupil sizes. The benefit from correcting spherical aberration at individual esopic pupils was investigated by canceling C4(0) in the sets of Zernike coefficients for 41 eyes implanted with spherical IOL. RESULTS: Both the model eye and the real eye data predict that age-related miosis reduces spherical aberration in the eye implanted with a spherical IOL to approximately 1/3 of the spherical aberration at a 6-mm pupil. A reduction of similar magnitude occurs when spherical aberration-induced non-paraxial defocus is corrected by a spectacle lens. For natural mesopic pupils, canceling the Zernike C4(0) coefficient improved the objective image quality at a rate similar to changing defocus by 0.05 diopters. Average decentration and tilt levels diminish the lead of aspheric IOLs over spherical IOLs, depending on the direction of decentration. CONCLUSIONS: The benefit from correcting spherical aberration in a pseudophakic eye is limited for some or all of the following reasons: wearing glasses, age-related miosis, tilt and decentration of IOL, small contribution of spherical aberration to all aberrations, and intersubject variability.     

Postoperative optical aberrations in eyes implanted with AcrySof spherical and aspheric intraocular lenses

PURPOSE: To evaluate and compare optical and visual quality of eyes implanted with spherical and aspheric intraocular lenses (IOLs). METHODS: Twenty eyes of 17 patients were implanted with the AcrySof Natural IQ aspheric IOL (SN60WF) and 20 eyes of 15 patients were implanted with the AcrySof Natural spherical IOL (SN60AT). Photopic monocular distance best spectacle-corrected visual acuity (BSCVA) was recorded at 6 months postoperatively. Corneal aberrations were measured with the CSO Eyetop topographer, and ocular aberrations were measured with a Hartmann-Shack aberrometer for a 6-mm pupil. Ocular spherical aberration was computed for different pupil diameters (3, 4, 5, and 6 mm). RESULTS: No statistically significant differences were found between the BSCVA of the AcrySof IQ IOL (0.023 +/- 0.004 logMAR) and AcrySof Natural IOL (0.031 +/- 0.003 logMAR) (P = .15). The corneal higher order aberrations showed no statistically significant differences between groups (P > .1). However, spherical aberration and higher order ocular aberrations in the AcrySof IQ eyes were lower than eyes implanted with the AcrySof Natural IOL (P < .01). A statistically significant increase in the spherical aberration coefficient with pupil diameter was found only for the spherical IOL group (P = .0023). Statistically significant differences in the spherical aberration coefficient were found between groups at all pupil diameters (P < .001). CONCLUSIONS: A significant reduction in ocular spherical aberration was noted after AcrySof IQ IOL implantation at all pupil diameters compared to the spherical IOL, although photopic BSCVA between groups remained similar.     

白内障手术植入球面和非球面人工晶状体后视觉质量的比较

目的 评估白内障手术植入负球差设计的非球面折叠式人工晶状体(Intraocularlen,IOL)后的视觉质量.方法 取112例(152只眼)白内障超声乳化手术患者按数字表法被分为三组,第一组植入TecnisZ9003IOL(美国 AMO 公司),第二组植入AcrysofIQIOL(美国Alcon公司),第三组植入HQIOL(法国Hexavision公司).于术后一周、一月、三月分别检测裸眼视力、最佳矫正视力,无眩光及有眩光环境下的白天夜晚对比敏感度,同时检测全眼的球差、第三、第四、第五阶像差均方根(root mean square,RMS)、总高阶像差(higher-order aberration,HOA)RMS以及总像差(total ocular aberration,TOA)RMS.结果 术后三次随访三组患者的裸眼视力和最佳矫正视力差异均没有统计学意义.术后一周、一月时三组白天对比敏感度未见显著差异,术后一月、三月时TecnisZ9003组和AcrysofIQ组的夜间对比敏感度在中、低空间频率上明显好于HQ组,同时术后三月时该两组的白天对比敏感度亦好于HQ组,差异均具有统计学意义(P＜0.05).另外,术后三次随访TecnisZ9003组和AcrysofIQ组全眼的球差、RMS4均低于HQ组,在术后一月、三月时HOA较HQ组低,同时术后三次随访在瞳孔直径6mm大小时TOA亦较低,差异均有统计学意义(P＜0.05).结论 植入负球差设计的非球面人工晶状体可提高白内障患者术后对比敏感度,降低球差和高阶像差,获得更好的视觉质量.     

白内障手术植入球面和非球面人工晶状体后视觉质量的比较

目的 评估白内障手术植入负球差设计的非球面折叠式人工晶状体(Intraocularlen,IOL)后的视觉质量.方法 取112例(152只眼)白内障超声乳化手术患者按数字表法被分为三组,第一组植入TecnisZ9003IOL(美国 AMO 公司),第二组植入AcrysofIQIOL(美国Alcon公司),第三组植入HQIOL(法国Hexavision公司).于术后一周、一月、三月分别检测裸眼视力、最佳矫正视力,无眩光及有眩光环境下的白天夜晚对比敏感度,同时检测全眼的球差、第三、第四、第五阶像差均方根(root mean square,RMS)、总高阶像差(higher-order aberration,HOA)RMS以及总像差(total ocular aberration,TOA)RMS.结果 术后三次随访三组患者的裸眼视力和最佳矫正视力差异均没有统计学意义.术后一周、一月时三组白天对比敏感度未见显著差异,术后一月、三月时TecnisZ9003组和AcrysofIQ组的夜间对比敏感度在中、低空间频率上明显好于HQ组,同时术后三月时该两组的白天对比敏感度亦好于HQ组,差异均具有统计学意义(P＜0.05).另外,术后三次随访TecnisZ9003组和AcrysofIQ组全眼的球差、RMS4均低于HQ组,在术后一月、三月时HOA较HQ组低,同时术后三次随访在瞳孔直径6mm大小时TOA亦较低,差异均有统计学意义(P＜0.05).结论 植入负球差设计的非球面人工晶状体可提高白内障患者术后对比敏感度,降低球差和高阶像差,获得更好的视觉质量.