蓝光滤过型非球面人工晶状体植入术后高阶像差及MTF值临床对比观察

Objective To observe the value of RMSh and MTF 3 months after implantation of bluelight-blocking aspherical intraocular lens. Methods Patients were divided into three groups according to their selection among three kinds of implant IOL: GroupⅠ(PY-60AD), Group Ⅱ (Acrysof IQ),and Group Ⅲ (YA-60BB), Wavefront aberrations were measured across different pupil diameters (PD)(3mm,4mm,5mm,6mm) to record the values of the Z40, coma,total higher order aberration and modulation transfer function (MTF) under pupil diameters of 3mm,5mm three months after cataract phacoemusification and implantation of IOL. Results The values of Z40 in the two aspherical IOL groups were significantly lower than the spherical IOL group at all different pupil diameters (P＜0.05).There was no significant difference between two aspherical IOL groups about the value of Z40.There were no statistically significant differences about the values of coma among three groups (P ＞0.05). The values of RMSh in the two aspherical IOL groups were significantly lower than the spherical IOL group (P＜0.05) when the PD≥5mm, but had no significant difference when the PD＜5mm(P＞0.05).There was no significant difference between two aspherical IOL groups about the RMSh at all different pupil diameters (P＞0.1). At a 3mm pupil diameter,there were no statistically significant differences about the values of MTF at all spatial frequency (5,10,15,20,25,30cpd) among three groups (P＞0.05).At a 5mm pupil diameter,the values of MTF in the two aspherical IOL groups were significantly lower than the spherical IOL group at spatial of 5,10,15,20,25cpd (P＜0.05). There was no significant difference between two aspherical IOL groups about the values of MTF, but in the following order group Acrysof IQ＞group PY-60AD (P＞0.05). Conclusions PY-60AD and Acrysof IQ IOL can decrease the spherical aberration even when the pupil diameter at only 3mm and decrease the higher order aberration when the pupil diameter at or greater than 5mm. Thereby the patients who implanted with aspherical IOLs can acquire better visual quality.There is no significant difference when PY-60AD comparing to Acrysof IQ about the values of wavefront aberrations and MTF. And HOYA PY-60AD is a preloaded IOL that have many advantages fit for widely applied in clinical field.     

不同瞳孔直径下非球面及球面人工晶状体植入术后高阶像差的比较

目的:比较不同瞳孔直径下非球面及球面人工晶状体植入术后的高阶像差。方法:回顾性选择60例(60眼)双眼老年性白内障患者。白内障超声乳化术后,按照植入AcrysofIQ(SN60WF)非球面人工晶状体及AcrysofNatural(SN60AT)球面人工晶状体,分为2组。主要观察项目为术后3mo球差(C12)及总高阶像差的均方根(RMSh)。结果:两组术后3mo波前像差检查,瞳孔直径在4,5,6mm时,AcrysofIQ组球差均低于AcrysofNatural组,两组差异有统计学意义(P<0.01)。瞳孔直径4mm时,AcrysofIQ组总高阶像差小于AcrysofNatural组,但差异无统计学意义(P>0.05)。瞳孔直径5mm及6mm时,AcrysofIQ组总高阶像差均低于AcrysofNatural组,且差异有统计学意义(P<0.01)。结论:AcrysofIQ非球面人工晶状体在瞳孔直径大于5mm时能明显降低球差及总高阶像差,从而使患者获得更好的视觉质量。     

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。     

非球面和球面人工晶状体植入术后高阶像差的比较

目的对比同一个体两眼分别植入非球面和球面人工晶状体(IOL)后高阶像差的差异。设计前瞻性、病例对照研究。研究对象33例(66眼)双眼老年性白内障患者。方法患者接受超声乳化白内障吸除术后,两眼分别植入球面(Canon Staar KS-3)和非球面(Canon Staar KS-3Ai)IOL。按照IOL设计的差异分成两组,球面组和非球面组,手术后3个月观察患者的视力、最佳矫正视力、IOL位置、屈光状态、高阶像差、瞳孔大小等指标。比较两组高阶像差的差异。主要指标视力、最佳矫正视力,IOL的居中性、屈光状态、瞳孔直径、3阶像差、4阶像差、4阶球差(Z40)、5阶像差及总高阶像差的均方根(RMS)。结果在瞳孔直径6mm时,非球面IOL组的4阶像差(0.193±0.098)μm、4阶球差(0.037±0.099)μm、总像差RMS(0.498±0.072)μm均低于球面IOL组(0.403±0.155)μm、(0.381±0.142)μm、(0.737±0.164)μm,而在瞳孔直径6mm时的3阶和5阶像差RMS,瞳孔直径5mm时总像差RMS两组间比较差异无统计学意义(P均>0.05)。低对比度条件下,10例(30%)非球面组患者视物较球面组患者清晰。瞳孔6mm时,非球面组和球面组平均近视漂移分别是(-0.29±0.09)D和(-0.87±0.16)D,差异有统计学意义(P=0.033)。结论植入非球面IOL后,虽然可以明显降低4阶球差,但是两组间在术后视力和最佳矫正视力方面并没有统计学差异,高阶像差的差异主要表现夜间近视漂移的减少和瞳孔直径5mm以上时的低对比度视力的提高。     

单焦点及多焦点非球面IOL植入术后的高阶像差对比

目的:比较不同瞳孔直径下单焦点AcrySofIQ(SN60WF)及多焦点非球面人工晶状体AcrySofReStor+3(SN6AD1)植入术后的高阶像差。方法:回顾性选取2009-08/2010-04在我院眼科行超声乳化吸出术联合人工晶状体植入术的患者54例62眼,按照植入人工晶状体的不同类型分为两组:AcrySofIQ组及AcrySofReStor组。主要观察项目为术后球差(C12)及总高阶像差的均方根(RMSh)。结果:两组术后3mo应用波前像差仪(AllegroAnalyzer)检查,瞳孔直径在5,6,7mm时,A组球差和B组球差和RMSh均方根均随着瞳孔直径增大而增加,差异有统计学意义(P<0.01);瞳孔直径为5,6,7mm时,A组总高阶像差与B组相比,差异均无统计学意义(P>0.05)。结论:在瞳孔直径5,6,7mm的时候AcrySofIQ及AcrySofReStor的高阶像差基本无差别。     

正常瞳孔下非球面与球面人工晶状体眼高阶像差对比观察

目的 探讨正常瞳孔下非球面及球面晶状体眼高阶像差的差别,分析计算非球面与球面晶状体消除球面像差的差值,以客观评价非球面人工晶状体的临床效果.方法 回顾性临床对照研究.选取2010年1～4月在深圳市眼科医院行白内障超声乳化联合人工晶状体植入术的患者50例(66只眼).病人进行随机分组,分别植入非球面人工晶状体(KS-AIN)和球面人工晶状体(KS-X).术后1月正常瞳孔下(3～5mm),由itrace波前像差仪测量高阶像差及i-trace3.1软件模拟瞳孔直径3mm及5mm的调制传递函数值MTF.运用两样本t检验进行比较分析.结果 正常瞳孔下非球面组球面像差小于球面组,其差异具有统计学意义(P<0.05);非球面晶状体与球面晶状体相比较可消除球面像差(0.069 ±0.026)μm(D-Value);非球面组高阶像差均方根小于球面组,但差异无统计学意义(P>0.05);彗差、三叶草比较亦无统计学意义(P>0.05);3mm瞳孔下两组晶状体MTF值的比较仅在空间频率5周/度差异有统计学意义(P<0.05).5mm瞳孔下非球面晶状体眼在各空间频率的MTF值均好于球面晶状体眼,比较有统计学意义(P<0.05).结论 正常瞳孔下非球面人工晶状体眼与球面人工晶状体相比,可以有效减少球面像差,提高部分空间频率的对比敏感度,使患者拥有更好地视觉质量,但其不能体现可以减少术眼高阶像差的优势.

Abstract：

Objective To compare the high order aberrations between implantations of aspherical and spherical intraocular lens with normal pupil diameter, calculate and analyze the differences in spherical aberration between the eyes implanted with aspherical and spherical intraocular lens in order to assess the visual quality and investigate the clinical results. Methods Fifty patients(66 eyes)with cataract underwent surgery from Jan 2010 to Apr 2010, and were divided into 2 groups randomly. Group 1: unifocal and aspherical intraocular lens(negative aberration KS-AIN), Group2: unifocal and spherical intraocular lens(KS-X). Sixty-six eyes were included in this study. The aberrations at normal pupil diameter(interval 3mm-5mm)were measured with the i-Trace wavefront aberrometer. Modulation transfer functions were collected at 3mm and 5mm pupil size. Independent-Samples t Test was used to analyze the data. Results No post-operative complication occurred in each group. The average uncorrected visual acuity(UCVA)was ≥ 0.5, and the average best corrected visual acuity(BCVA)was ≥ 0.6. With normal pupil diameter(mean 3.73± 0.49mm), aspheric IOL group showed less spherical aberration than spherical IOL group with statistical significance(P =0.0040.05, t =-3.216), the difference value(D-value)of spherical aberration was 0.069± 0.026?m. Also aspheric IOL group showed less aberration than spherical IOL group in total higher-order root-mean-square(total HOA RMS)values, but with no statistical difference(P >0.05). There were no significant differences in coma and trefoil values between each group(P >0.05). With 3mm pupil diameter, aspheric IOL group provided a statistically better contrast sensitivity only in 5 cycle/degree while a statistically better contrast sensitivity in all spatial frequencies with 5mm pupil diameter. Conclusions The aspheric lens provides the patients better quality of vision at normal pupil size compared to spherical lens because of the decreased spherical aberration and a better contrast sensitivity in part frequencies. However, aspheric lens cannot express its superiority in decreasing total HOA RMS with normal pupil diameter.     

亲水性非球面与球面人工晶状体植入术后高阶像差的研究

目的：比较亲水性球面和非球面人工晶状体（intraocular lenses,IOL）对术后高阶像差（higher order aberrations,HOA）的影响。方法：66例78眼行白内障超声乳化术并顺利植入球面Softec或者非球面Ocuva人工晶状体。术前和术后第3mo使用VISX Wavescan像差计进行像差测量与比较。结果：两组间统计学无显著性差异。术后的高阶像差均方根值（root-mean-square,RMS）：Softec组0.27±0.11,Ocuva组0.28±0.13,球面像差（spherical aberration,SA）：Softec组0.11±0.07,Ocuva组0.11±0.08。结论：与球面Softec人工晶状体比较,Ocuva非球面人工晶状体似乎没有减少术后高阶像差的优势。     

正常瞳孔下非球面与球面人工晶状体眼高阶像差对比观察

Objective To compare the high order aberrations between implantations of aspherical and spherical intraocular lens with normal pupil diameter, calculate and analyze the differences in spherical aberration between the eyes implanted with aspherical and spherical intraocular lens in order to assess the visual quality and investigate the clinical results. Methods Fifty patients(66 eyes)with cataract underwent surgery from Jan 2010 to Apr 2010, and were divided into 2 groups randomly. Group 1: unifocal and aspherical intraocular lens(negative aberration KS-AIN), Group2: unifocal and spherical intraocular lens(KS-X). Sixty-six eyes were included in this study. The aberrations at normal pupil diameter(interval 3mm-5mm)were measured with the i-Trace wavefront aberrometer. Modulation transfer functions were collected at 3mm and 5mm pupil size. Independent-Samples t Test was used to analyze the data. Results No post-operative complication occurred in each group. The average uncorrected visual acuity(UCVA)was ≥ 0.5, and the average best corrected visual acuity(BCVA)was ≥ 0.6. With normal pupil diameter(mean 3.73± 0.49mm), aspheric IOL group showed less spherical aberration than spherical IOL group with statistical significance(P =0.0040.05, t =-3.216), the difference value(D-value)of spherical aberration was 0.069± 0.026?m. Also aspheric IOL group showed less aberration than spherical IOL group in total higher-order root-mean-square(total HOA RMS)values, but with no statistical difference(P >0.05). There were no significant differences in coma and trefoil values between each group(P >0.05). With 3mm pupil diameter, aspheric IOL group provided a statistically better contrast sensitivity only in 5 cycle/degree while a statistically better contrast sensitivity in all spatial frequencies with 5mm pupil diameter. Conclusions The aspheric lens provides the patients better quality of vision at normal pupil size compared to spherical lens because of the decreased spherical aberration and a better contrast sensitivity in part frequencies. However, aspheric lens cannot express its superiority in decreasing total HOA RMS with normal pupil diameter.     

非球面与球面人工晶状体植入术后高阶像差及对比度视力的比较

目的:比较非球面和球面人工晶状体植入术后波前像差、裸眼远视力、最佳矫正远视力、对比度视力的差异。方法:年龄相关性白内障患者46例50眼,将其随机分成两组,球面人工晶状体组(A组)23例24眼术中植入ACR6DSE球面人工晶状体;非球面人工晶状体组(B组)23例26眼术中植入具有负球面像差Acri.Smart36A非球面人工晶状体。术后3mo,观察两组患者的裸眼视力、最佳矫正视力、暗背景(25cd/m2)和高亮背景(255cd/m2)下的对比度视力、瞳孔直径(6mm)时的球面像差、彗差和高阶像差的均方根是否存在差异。结果:两组患者术后裸眼远视力、最佳矫正远视力比较差异无统计学意义,亮背景下各对比度视力以及暗背景下100%,25%对比度视力两组比较差异无统计学意义,暗背景下5%,10%低对比度时B组视力好于A组。瞳孔直径6mm时,B组高阶像差的均方根(RMS)、球差、彗差和A组比较差异均有统计学意义,B组RMS、球差、彗差低于A组。结论:Acri.Smart36A非球面人工晶状体植入术后与ACR6DSE球面人工晶状体比较可以明显的减少患者的高阶像差,改善患者的术后暗环境下的低对比度视力。     

非球面人工晶体植入术后高阶像差对比研究

目的 与球面人工晶体比较观察Canon Staar公司KS-3Ai非球面人工晶体植入术后早期的临床效果。方法 2组病人进行常规的白内障超声乳化联合人工晶体植入术，术后一个月检查像差，裸眼和最佳校正视力。结果 KS-3Ai组术总高阶像（0．90±0．48um）、球差（0．22±0．17）uin和彗差（0．34±0．23）um低于球面人工晶体组（1．2±0．43）um、（0．46±0．20）um、（0．50±0．24um）。BCVA、UCVA和彗差、总高阶像差有相关性。结论 与球面人工晶体比较，KS-3AI非球面人工晶体植入术后球差、彗差和总高阶像差显著降低。非球面人工晶体可以减少白内障术后眼的正性球面像差，同时降低总高阶像差，提示高阶像差在术后视觉质量方面有一定的作用。     

非球面多焦点人工晶状体植入术后视觉质量的临床研究

目的比较2种多焦点人工晶状体IQReSTOR+3D和IQReSTOR+4D的临床效果。方法选择年龄相关性白内障患者32例(41眼)行白内障超声乳化吸除联合人工晶状体植入术,其中IQReSTOR+3D组15例(20眼),IQReSTOR+4D组17例(21眼),比较术后3个月2组患者的远距离、中距离和近距离视力、对比敏感度、视野、离焦曲线和生活问卷调查结果。结果术后3个月,IQReSTOR+3D组裸眼中距离视力为1.38±0.06,优于IQReSTOR+4D组(1.07±0.09),差异有统计学意义(P<0.05)。2组间近距离和远距离视力差异均无统计学意义(均为P>0.05)。离焦曲线IQReSTOR+3D组在-1.5D、-2.0D、-2.5D的视力均优于IQReSTOR+4D组,差异均有统计学意义(均为P<0.05)。结论 IQReSTOR+3D较IQReSTOR+4D能够提供更好的中距离视力和一定距离范围的近视力。     

超声乳化白内障吸除联合人工晶状体植入术后眼内生物测量参数变化及人工晶状体类型选择的临床研究

目的探讨超声乳化白内障吸除联合人工晶状体植入术后眼内生物测量参数变化及人工晶状体类型的选择方法。 方法收集2016年2月至2018年2月在内蒙古自治区包头市中心医院眼科就诊且接受超声乳化白内障吸除联合人工晶状体植入术治疗的患者60例(60只眼)进行研究。其中,男性33例(33只眼),女性27例(27只眼)。年龄42～78岁,平均(60.8±10.2)岁。依据选用的人工晶状体类型,将全部患者分为Bigbag人工晶状体组和ReSTOR人工晶状体组两组。检查患者手术前后的裸眼视力、最佳矫正视力、晶状体后囊膜至视网膜的距离、眼轴长度、前房深度及眼压变化,采用均数±标准差( ±s)表示。Bigbag人工晶状体组和ReSTOR人工晶状体组的组间比较采用t检验,组内比较采用配对t检验。 结果两组年龄、性别、发病类型、晶状体核硬度及合并症,经统计学分析,差异均无统计学意义(t＝1.89,χ²＝1.32,0.86,0.76,0.45;P>0.05)。治疗前两组患者裸眼视力、最佳矫正视力、晶状体后囊膜至视网膜的距离、眼轴长度及眼压的比较,差异无统计学意义(t＝0.683,0.432,0.963,0.862,0.634;P>0.05)。治疗后两组患者眼压之间、眼压和两组间眼压比较,差异无统计学意义(t＝0.031,0.079,0.091,0.29;P>0.05)。治疗前后两组患者裸眼视力的比较,治疗后比治疗前有显著提高,差异有统计学意义(t＝21.779,13.326;P<0.05)。治疗后,Bigbag人工晶状体组患者的裸眼视力明显高于ReSTOR人工晶状体组,差异有统计学意义(t＝5.136,P<0.05)。治疗后与治疗前两组患者最佳矫正视力的比较,治疗后比治疗前有显著提高,差异有统计学意义(t＝13.689,9.683;P<0.05)。治疗后Bigbag人工晶状体组患者的最佳矫正视力明显高于ReSTOR人工晶状体组,差异有统计学意义(t＝3.679,P<0.05)。治疗后与治疗前两组患者晶状体后囊膜至视网膜距离的比较,治疗后比治疗前有显著增加,差异有统计学意义(t＝19.689,12.683;P<0.05)。治疗后,Bigbag人工晶状体组的患者晶状体后囊膜至视网膜距离明显高于ReSTOR人工晶状体组(t＝2.924,P<0.05)。Bigbag人工晶状体组患者手术前后的裸眼视力、最佳矫正视力、晶状体后囊膜到视网膜距离差值均显著小于ReSTOR人工晶状体组,差异有统计学意义(t＝35.45,27.25,2.05;P<0.05)。治疗后与治疗前比较,两组患者的眼轴长度均有显著提高,差异有统计学意义(t＝15.249,7.358;P<0.05)。Bigbag人工晶状体组患者手术后的眼轴长度均显著高于ReSTOR人工晶状体组,差异有统计学意义(t＝13.982,P<0.05)。治疗后与治疗前比较,两组患者的前房深度均有显著加深,差异有统计学意义(t＝16.489,8.0951;P<0.05)。Bigbag人工晶状体组患者手术后的前房深度均显著深于ReSTOR人工晶状体组,差异有统计学意义(t＝12.97,P<0.05)。Bigbag人工晶状体组患者手术前后的眼轴长度及前房深度的差值均显著大于ReSTOR人工晶状体组,差异有统计学意义(t＝8.45,16.49;P<0.05)。 结论超声乳化白内障吸除联合人工晶状体植入术后眼内生物测量参数裸眼视力、最佳矫正视力、晶状体后囊膜至视网膜的距离、眼轴长度、前房深度会发生变化,而眼压无明显变化。选用Bigbag人工晶状体较ReSTOR人工晶状体更具优势。     

超声乳化后新型多焦点人工晶状体植入术疗效观察

目的观察和评估白内障超声乳化后Array多焦点人工晶状体植入术后的临床疗效。方法老年性白内障患者6例12眼(均为男性)进行超声乳化摘出Array多焦点人工晶状体植入手术,观察术中并发症、术后远近视力及角膜曲率。结果术后1周平均非矫正远近视力分别为0.98和0.55;术后1个月平均非矫正远视力及最佳矫正近视力均达1.0。术后角膜散光度与术前无明显变化。结论Array多焦点人工晶状体植入术后患者远近视力均较为理想,且手术引起的角膜散光度小,是一种较为理想的人工晶状体。     

两种非球面衍射型多焦点人工晶状体植入术后的短期视觉质量比较

目的 比较Tecnis ZM A00和ReSTOR+3.0D两种多焦点衍射型人工晶状体（IOL）植入后的视觉功能。设计 回顾性比较性病例系列。研究对象 老年性白内障行超声乳化白内障吸除联合IOL植入术患者78例（113眼）。其中Tecnis ZM A00 组41例（60眼）,ReSTOR +3.0D组37例（53眼）。方法 比较两组患者术后1、3个月明暗环境下的最佳近距离矫正视力（BCNVA）、最佳中距离矫正视力（BCMVA,60 cm）和最佳远距离矫正视力（BCDVA）,离焦曲线和伪调节力。并采用问卷调查的方式了解两组患者术后视觉效果。主要指标 明暗环境下的BCNVA、BCMVA和BCDVA,离焦曲线,伪调节力,问卷调查。结果 术后3个月,Tecnis ZM A00和ReSTOR+3.0D组在正常光线下的BCDVA、BCNVA 、BCMVA分别为0.975±0.182和0.953±0.133,0.713±0.234和0.621±0.299,0.262±0.110和0.309±0.090（P均>0.05）;两组在暗环境下BCNVA分别为0.283±0.103和0.201±0.082（P<0.05）,BCMVA分别为0.339±0.097和0.367±0.101（P>0.05）;离焦曲线显示,两组分别在-0.25 D、-0.25 D及-2.75 D、-2.25 D处形成远近两个峰值焦点;两组IOL的伪调节力分别为1.323±1.033和1.301±1.127（P>0.05）;两组患者脱镜率、产生眩光光晕等不良视觉质量差异无统计学意义。结论 Tecnis ZMA00和ReSTOR+3.0D衍射多焦点IOL均能提供较好的远、中距离视力及一定范围的近视力,改善患者的视觉质量。Tecnis ZM A00 能提供更好的暗环境下的近视力及中距离视力。     

白内障超声乳化人工晶体术后视网膜脱离临床分析

目的 探讨超声乳化白内障人工晶体术后视网膜脱离的特点及手术疗效。方法 对16例视网膜脱离患者做常规巩膜扣带术或玻璃体切割联合眼内填充进行回顾性分析。结果 视网膜脱离手术后完全复位14例，一次复位率为87．5％，另2例患者经二次手术后完全复位，视力均有不同程度提高。结论 对该类患者术前应仔细检查，选择合适的手术方式尽早施行手术，以提高疗效。     

衍射型非球面多焦点人工晶状体眼视功能的初步观察

目的:初步观察植入TecnisZM900衍射型非球面多焦点人工晶状体眼视功能,以评价TecnisZM900衍射型非球面多焦人工晶状体植入的有效性及安全性。方法:共21例(30眼)行白内障超声乳化术患者植入Tec-nisZM900衍射型非球面多焦点人工晶状体,观察患者术后远、近视力,角膜散光度数,对比敏感度,手术并发症,问卷形式调查脱镜率、视觉不良症状和满意度,随访时间为术后3～12mo。结果:植入TecnisZM900MIOL患者术后3mo裸眼远、近视力分别为1.00±0.20,0.86±0.27;术前与术后3mo角膜散光度数比较,差异无显著意义(P>0.05);对比敏感度在低、中空间频率段均位于正常范围内,高空间频率段则有部分病例稍下降;脱镜率为86%(18/21)。结论:TecnisZM900衍射型非球面多焦点人工晶状体可为患者提供良好的远、近视力,86%的患者可摘掉眼镜。     

后房型人工晶状体植入术后瞳孔上移原因分析

目的：分析后房型人工晶状体植入术后瞳孔上移的原因,方法：对236例白内障行后房型人工晶状体入术,其中225眼行囊袋植入,11眼行睫状沟植入,结果：瞳孔上移22眼,发生率9．32％,主要原因素虹膜萎缩及玻璃体脱出所致。结论：避免瞳孔上移的关键在于提高手术者的显微手术技巧和减少对虹膜的损伤,术后合理地应用散瞳剂及彻底地控制虹膜炎性反应。     

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.