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.     

Effect of a modified optic edge design on visual function: textured-edge versus round-anterior, slope-side edge

PURPOSE: To compare the impairment in visual function caused by glare with 2 acrylic intraocular lenses (IOLs) with different modified optic edges. SETTING: Hayashi Eye Hospital, Fukuoka, Japan. METHODS: Fifty-four patients had implantation of an IOL with a textured edge (Alcon MA60AC) in 1 eye and an IOL with a round-anterior, sloped-sided edge (AMO AR40e) in the opposite eye. Visual acuity was measured at 5 contrast visual targets (100%, 25%, 10%, 5%, and 2.5%) (contrast visual acuity) under photopic and mesopic conditions with and without a glare source approximately 1 month after surgery using the Contrast Sensitivity Accurate Tester (Menicon CAT-2000). RESULTS: The mean mesopic contrast visual acuity at moderate- to low-contrast visual targets was significantly worse in the presence of a glare source in both groups, whereas photopic contrast visual acuity did not change significantly. There were no significant differences between the 2 groups in the mean visual acuity or in photopic or mesopic lighting contrast visual acuity with and without a glare source. Furthermore, there was no significant difference in loss of contrast visual acuity in the presence of glare. CONCLUSION: Mesopic contrast sensitivity with both acrylic IOLs was impaired significantly in the presence of glare, but the impairment of contrast sensitivity from glare was approximately the same between eyes with a textured-edge IOL and eyes with a round-anterior, sloped-sided edge IOL.     

Spherical aberration and contrast sensitivity after cataract surgery with the Tecnis Z9000 intraocular lens

PURPOSE: To determine whether implantation of an intraocular lens (IOL) with a modified prolate anterior surface (Tecnis Z9000, AMO) results in reduced spherical aberration and improved contrast sensitivity after cataract surgery. SETTING: Hospital NISA Virgen del Consuelo, Valencia, Spain. METHODS: In an intraindividual randomized prospective study of 30 patients with bilateral cataract, the Tecnis Z9000 IOL was compared with 2 IOLs with spherical surfaces, the AR40e (AMO) and the Stabibag (Ioltech). Ocular aberrations for a 4.0 mm pupil and 6.0 mm pupil were measured with a Hartmann-Shack aberrometer. Quality of vision was measured by visual acuity and contrast sensitivity under mesopic and photopic conditions. RESULTS: Eyes with the Tecnis Z9000 IOL had significantly less spherical aberration and a greater Strehl ratio after surgery. Significant reduction in coma aberration was also found in some cases. Refraction, visual acuity, and contrast sensitivity were not significantly different between the 3 IOL groups. CONCLUSION: A significant reduction in spherical aberration after Tecnis Z9000 IOL implantation was achieved, but visual acuity and contrast sensitivity were not affected by the aspheric silicone IOL compared to spherical acrylic IOLs.     

非球面人工晶状体植入术后视觉质量对比分析

目的:评价3种非球面人工晶状体(AcrySof SN60WF、TecnisZ9001和KS-3Ai)植入术后的视觉质量。方法:采用前瞻性随机对照研究方法,收集我院老年性白内障手术患者88例126眼,平均年龄67.3±8.7岁,将入选患者按植入不同的人工晶状体(Intraocular lens,IOL)随机分为4组:AcrySofSN60WF(IQ)组(23例33眼)、TecnisZ9001组(23例33眼)、KS-3Ai组(20例29眼),SN60AT球面人工晶状体组为对照组(22例31眼)。术后随访3mo,观察指标:裸眼视力(uncorrected visual acuity,UCVA)及最佳矫正视力(best corrected visual acuity,BCVA),眼压,等效球镜度数,角膜Q值,瞳孔直径,6mm全眼球总高阶像差及四阶球差均方根值(root mean square,RMS),夜光、昼光及夜眩光3种视觉条件下的对比敏感度(contrast sensitivity,CS)。结果:术后各组的UCVA、BCVA、等效球镜度数和瞳孔直径均无统计学差异。总高阶像差和四阶球差RMS:非球面组低于球面组,差异具有统计学意义(P<0.05);非球面组间比较无统计学差异。术后角膜Q值与球差成正相关(r=0.183,P<0.05)。术后对比敏感度:与球面IOL相比,IQ,Tecnis可提高术后3种视觉条件下的CS,KS-3Ai可提高术后夜光、夜眩光两种视觉条件下的CS;非球面IOL组间比较,IQ组在昼光、夜眩光视觉条件下的CS好于Tecnis组和KS-3Ai组,TECNIS组和KS-3Ai组之间在3种视觉条件下均无统计学差异。结论:3种非球面IOL均可有效地减少术眼的总高阶像差和四阶球差。3种非球面IOL均可以提高术眼术后的CS,IQ组在昼光、夜眩光视觉条件下的CS与Tecnis组和KS-3Ai组相比较差异具有统计学意义,Tecnis组和KS-3Ai组之间在3种视觉条件下的CS均无统计学差异。     

非球面人工晶状体植入后的视功能观察

目的 观察非球面折叠人工晶状体与传统球面人工晶状体对患者术后视功能的影响.方法 对收治的白内障患者62例62只眼行超声乳化联合人工晶状体植入术.随机分为两组,术中分别选用美国ALCON公司AcrySof R Natural和AcrySof R IQ两种人工晶状体,术后1月行最佳矫正视力、对比敏感度及视觉心理问卷调查,并对各项检查结果行统计分析.结果 术后1月两组患者最佳矫正视.力差异无统计学意义(P>0.05);对比敏感度检查显示在明视有或无眩光状态下,两组患者差异无统计学意义(P>0.05),在3c～18.0c/d 4个空间频率的暗视及暗视有眩光状态下,两组患者差异有统计学意义,非球面人工晶状体组对比敏感度值高于球面人工晶状体组(P<0.05);视觉心理问卷调查结果显示两组差异无统计学意义(P>0.05).结论 与球面人工晶状体相比,非球面人工晶状体能有效提高白内障患者术后的对比敏感度,改善视功能,但对患者术后视觉心理改变不明显,尚需要增大样本量进一步分析.     

Influence on posterior capsule opacification and visual function of intraocular lens optic material

PURPOSE: To examine the influence of optic material on posterior capsule opacification (PCO) by comparing PCO and visual functions between eyes with an acrylic intraocular lens (IOLs) and those with a silicone IOL of the same optic design and with the same haptics. DESIGN: Randomized clinical trial. METHODS: One hundred patients scheduled for phacoemulsification surgery underwent implantation of an acrylic IOL (AMO Sensar; AR40e) in one eye and implantation of a silicone IOL (ClariFlex) of the same optic design and loops in the fellow eye. Eighty-nine patients (89%) remained for analysis. The PCO value was measured using the Scheimpflug videophotography system at one, three, six, 12, 18, 24, 30, and 36 months postoperatively. The incidence of eyes that required a neodymium:yttrium-aluminum-garnet (Nd:YAG) laser capsulotomy was examined; visual acuity and contrast sensitivity with and without a glare source were also evaluated. RESULTS: The mean PCO value did not increase significantly during follow-up in either the acrylic or silicone IOL group. When comparing the groups, no statistically significant difference was found in the PCO or in the incidence of Nd:YAG capsulotomy, although both tended to be slightly better in the silicone group than in the acrylic group. There was also no significant difference between the groups in visual acuity or in photopic and mesopic contrast sensitivity with or without glare. CONCLUSIONS: When acrylic and silicone IOLs are of the same optic design and with the same haptics, the optic material does not influence the development of PCO enough to impair visual function.     

蓝光滤过型非球面人工晶状体植入术后视觉质量的临床研究

目的观察行超声乳化白内障吸除联合植入蓝光滤过型非球面人工晶状体（HOYA PY-60AD）眼的术后视觉质量。设计前瞻性临床研究。研究对象57例（57眼）年龄相关性白内障患者。方法接受超声乳化白内障吸除术的年龄相关性白内障患者57例（57眼）按就诊顺序登记及随机表法将患者分为2组,术中分别植入非球面人工晶状体HOYAPY-60AD（29眼）和球面人工晶状体HOYA AF-1（UY）（28眼）。术后随访3个月。随访时进行一般眼科检查,包括视力、眼压、眼前节及眼底,并记录术后3个月时的裸眼视力（UCVA）、最佳矫正视力（BCVA）、低对比度视力（ETDRS低对比度视力表）、对比敏感度（OPTEC6500,明视、明视眩光、间视和间视眩光）并填写调查问卷（Catquest-9SF）。主要指标UCVA,BCVA,低对比度视力,对比敏感度和调查问卷分值。结果术后3个月,非球面组患者明视（400Lux）条件下5％对比度视力（0．35±0．13）及间视（30Lux）条件下5％（0．49±0．13）和25％（0．25±0．12）对比度视力均好于球面组,分别为（0．43±0．15）、（0．61±0．12）、（0．32±0．14）,差异有统计学意义（P均≤0．05）,间视及间视＋眩光条件下低中频（1．5c／d、3c/d、6c／d、12c/d）的对比敏感度非球面组均好于球面组,差异有统计学意义（P均40．05）。两组患者UCVA、BCVA及调查问卷分值均无统计学差异（P均≥0．05）。结论非球面人工晶状体能够提供较好的低对比度视力和暗环境下的对比敏感度,提示非球面人工晶状体能够提供较好的视觉质量。（眼科,2010,19：89-92）     

Spherical aberration and contrast sensitivity in eyes implanted with aspheric and spherical intraocular lenses: a comparative study

PURPOSE: To determine whether implantation of an intraocular lens (IOL) with a modified anterior aspheric surface results in reduced spherical aberration and improved contrast sensitivity after cataract surgery. DESIGN: Prospective, comparative, interventional case series. METHODS: In an intraindividual randomized prospective study of 25 patients with bilateral cataract, an IOL with a modified anterior surface (Tecnis Z9001; Advanced Medical Optics, Santa Ana, California, USA; group 1) was compared with biconvex lens with spherical surfaces (ClariFlex; Advanced Medical Optics; group 2). Ocular aberrations for a 5.0-mm pupil and 6.0-mm pupil were measured with Hartmann-Shack aberrometer. Quality of vision was measured by visual acuity and contrast sensitivity under mesopic and photopic conditions. All patients were followed up for three months. RESULTS: No statistically significant difference in postoperative uncorrected and best-corrected distance vision acuity after a follow-up of three months existed between the groups. Postoperative contrast sensitivity testing revealed significant differences between the groups under photopic and mesopic conditions. These differences reached statistical significance under photopic conditions at three spatial frequencies and under mesopic conditions at all spatial frequencies. When analyzing higher-order aberrations, the difference between the groups was statistically significant at the 5.00-mm and 6.00-mm pupil diameters, with the group 1 inducing less higher-order aberration and also less spherical aberration compared with group 2. CONCLUSIONS: Results show the Tecnis Z9001 IOL with a modified anterior aspheric surface induced significantly less higher-order aberration and spherical aberration compared with the ClariFlex IOL. Contrast sensitivity revealed better values under photopic and mesopic conditions with the Tecnis Z9001 IOL.     

Wavefront analysis and contrast sensitivity of aspheric and spherical intraocular lenses: a randomized prospective study

PURPOSE: To compare visual performance, total and high order wavefront aberrations (coma, spherical aberration, and other terms), and contrast sensitivity in 120 eyes implanted with one monofocal aspheric intraocular lens (IOL) and two spherical IOLs. DESIGN: Randomized prospective study. METHODS: Sixty patients were randomized to receive three IOL types: Alcon AcrySofIQ (40 eyes), AcrySofNatural (40 eyes), and advanced medical optic (AMO)Sensar (40 eyes). Complete ophthalmologic examination including uncorrected visual acuity (UCVA), best-spectacle corrected visual acuity (BSCVA), corneal topography, and wavefront analysis were performed preoperatively, 30 days, and 90 days postoperatively. Pelli-Robson chart test and functional acuity contrast testing (FACT-Optec6500) were performed approximately 50 days after surgery. Statistical analyses were performed using analysis chi(2), analysis of variance (ANOVA), and multiple comparisons Tukey test. RESULTS: After 90 days, all eyes had postoperative BSCVA > or =20/32. The AcrySofIQ IOL showed statistically significant less induction of spherical aberration (P < .001) when compared with the AMOSensar and the AcrySofNatural IOLs. The AMOSensar presented significantly less spherical aberration then the AcrySofNatural (P < .05). The AcrySofIQ also had lower values of total and high-order aberration (HOA) (P < .05) when compared with the AMOSensar and the AcrySofNatural. The mean values of trefoil 9, coma, and HOA root mean square (RMS) decreased between one and three months (P < .001, P < .001, P = .023, P < .001, respectively) in all groups. Mean Pelli-Robson contrast sensitivity values in photopic condition were similar between the groups. The AcrySofIQ showed better results in 3cpd spatial frequency in mesopic condition using FACT-Optec 6500 (P = .008), although there were no statistical differences in photopic and mesopic with glare conditions.     

Intraindividual comparison of a blue-light filter on visual function: AF-1 (UY) versus AF-1 (UV) intraocular lens

PURPOSE: To evaluate the effect of the AF-1 (UY) blue-light-filtering intraocular lens (IOL) with a yellow chromophore (Hoya) on visual function, including contrast vision and color perception. SETTINGS: Five clinical ophthalmology centers in Germany. METHODS: Two types of IOLs that were identical except for a blue-light filter on 1 were compared in a prospective randomized multicenter study with intraindividual comparisons. Postoperatively, uncorrected and best corrected visual acuities, pupil size, contrast vision (Early Treatment Diabetic Retinopathy Study chart, functional acuity contrast test, photopic, mesopic, mesopic with glare), and color discrimination (Farnsworth-Munsell 100-hue test, photopic and mesopic) were evaluated. RESULTS: There were no significant differences between the 2 IOLs except in color vision dependent on blue light. Color perception for blue with the blue-light-filtering IOL was significantly reduced under mesopic conditions over the 12-month follow-up and under photopic conditions over 6 months. Despite the difference, all measured total error scores were within normal range and no patient reported impaired color vision. CONCLUSIONS: The blue-light-filtering IOL with a yellow chromophore had no effect on contrast vision and visual acuity. However, the impairment of color perception for blue was statistically significant. The impairment of the blue perception did not exceed the normal range or induce subjective disturbance of color vision.     

Visual function in patients with yellow tinted intraocular lenses compared with vision in patients with non-tinted intraocular lenses

AIM: To compare the visual function in patients with short wavelength blue light blocking yellow tinted intraocular lenses (IOLs) with that in patients with non-tinted IOLs. METHODS: 74 patients scheduled for bilateral cataract surgery underwent implantation of either yellow IOLs (HOYA YA60BB) or non-tinted IOLs (VA60BB) in both eyes. Contrast visual acuity with and without a glare source was measured under photopic (100 cd/m2) and mesopic (slightly higher luminance than typically used-5 cd/m2) conditions at 2 weeks and 3 months after surgery using the contrast sensitivity accurate tester. Visual acuity and the incidence of patients who noted cyanopsia were also examined. RESULTS: No significant differences between the yellow tinted and non-tinted IOL groups were observed in mean visual acuity or in photopic or higher luminance mesopic contrast visual acuity with and without glare source at either 2 weeks or 3 months after surgery. Furthermore, there was no significant difference in contrast visual acuity loss as a result of glare. The incidence of patients who noticed cyanopsia was significantly less in the yellow tinted IOL group than in the non-tinted IOL group at 2 weeks after surgery (p = 0.0234), but no patients reported cyanopsia at 3 months. CONCLUSION: Visual function in patients with yellow tinted IOLs is virtually the same as that in patients with non-tinted IOLs.     

白内障手术前后角膜球面像差的比较及非球面人工晶状体评估

目的研究白内障手术前后角膜球面像差的变化,并评估非球面人工晶状体（IOL）术后的临床表现。方法90例（120只眼）白内障患者手术前后分别测量角膜球差;植入非球面IOL者84只眼,植入球面IOL者36只眼,比较两组术后的裸眼视力、最佳矫正视力及明暗条件下对比敏感度。结果术前平均角膜球差为（0．498±0．189）um,术后为（0．491±0．135）um,（P〉0．05）;植入非球面IOL组在6、12、18cpd空间频率的对比敏感度优于球面IOL组（P〈0．01）,且裸眼视力略优于后者。结论植入非球面IOL可以获得更好的视功能,且白内障手术不改变角膜球差。     

儿童白内障手术中应用非球面变色人工晶状体的疗效观察

目的 比较植入黄色人工晶状体（IOL）及非球面变色IOL的白内障患儿术后对比度视力和色觉的差异。设计 回顾性病例系列。研究对象 白内障接受超声乳化联合IOL植入手术治疗的患儿43例（56眼）。方法 患儿按照术中植入的IOL不同分为两组：黄色IOL组（26眼）和非球面变色IOL组（30眼）,所有复查患眼均在术后3个月以上,进行视力、眼压、裂隙灯检查、眼底、对比度视力和色棋检查。主要指标 视力、对比度视力、色棋错误评分。结果 两组患儿的术后裸眼视力和矫正远视力无显著差异。在40 lux光照下,5%对比度下非球面变色IOL组的视力（0.21±0.14）要优于黄色IOL组（0.39±0.11）（P=0.001）。明视下（户外日照和室内1000 lux光照）,两组间的FM100测试的总错误评分无显著差异,黄昏视下（40 lux）黄色IOL组的辨色力错误总评分（48.51±16.73）明显高于非球面变色IOL组（31.25±11.39）（P=0.003）。结论 黄色IOL和非球面变色IOL在强光下对比度视力无明显差别,而非球面变色IOL在弱光下能够提供更好的对比度视力和更强的色彩辨别能力。     

多焦点人工晶状体与非球面人工晶状体植入术后视觉质量的临床研究

目的客观与主观检测结合评价非球面设计的多焦点与单焦点人工晶状体植入术后的视觉质量。方法132例（207只眼）白内障患者分别植入非球面的多焦点人工晶状体AcrySof IQ ReSTOR IOL和单焦点人工晶状体AcrySof IQ IOL。记录患者手术后的裸眼远、近视力,矫正远、近视力。术后3个月检测患者明视、暗视和暗视眩光状态的对比敏感度。采用VF-14（Visual function-14）视功能和生存质量调查问卷评价患者主观的视觉质量。结果术后两组裸眼远视力（t=0．61,P〉0．05）最佳矫正近视力（t=1．877,P〉0．05）差异无统计学意义。非矫正近视力多焦点组优于单焦点组（t=11．38,P〈0．001）,单焦点组在明光、暗光、暗光眩光条件下各空间频率对比敏感度均高于多焦点组,明光条件下3cpd和6cpd空间频率差异有统计学意义（P〈0．05）,暗光眩光条件下中高频率差异有统计学意义（P〈0．05）,两组无患者存在严重的视觉干扰现象。两组术后视远时脱镜率均大于98％,视近时脱镜率多焦点组为78．9％,单焦点组为10．9％。结论与单焦点人工晶状体相比,除了对比敏感度下降,多焦点人工晶状体能提供令人满意的术后视功能和生活质量,患者能获得较高的视觉质量。     

Tecnis Z9000人工晶状体植入术后的视功能改变

目的:评价非球面人工晶状体(intraocular lens,IOL)TecnisZ9000对提高年龄相关性白内障患者术后视功能的作用。方法:选取年龄相关性白内障患者34例36眼,其中18眼为Tecnis Z9000组,18眼为传统球面人工晶状体组。检查术后3mo最佳矫正远视力,不同亮度环境及有、无散瞳条件下的对比敏感度(contrast sensitivity,CS)。结果:手术后3mo最佳矫正远视力Tecnis Z9000组为0.89±0.17,球面人工晶状体组为0.76±0.16,两组差异有显著性(P<0.05)。正常瞳孔下,两组晶状体在不同空间频率(1.5,3,6,12,18c/d)、不同照明条件下CS无显著差别。散瞳后Tecnis组亮环境(亮度为85cd/m2)下的12,18c/dCS及暗环境(亮度为3cd/m2)下1.5,3c/dCS均分别与同条件下的球面人工晶状体组比较差异有显著性。结论:白内障术后早期,Tecnis Z9000可提高最佳矫正远视力和对比敏感度,改善术眼视功能。     

Prospective randomized study of clinical performance of 3 aspheric and 2 spherical intraocular lenses in 250 eyes

PURPOSE: To compare the quality of vision with aspheric and spherical intraocular lenses (IOLs) in pseudophakic patients. METHODS: This prospective, comparative, randomized study included 250 eyes of 125 patients with bilateral cataracts. Patients were randomly assigned to receive either IOLs with a spherical biconvex optic (Acrysof SN6OAT [Alcon] or Sensar AR40e [Advanced Medical Optics, AMO]) or IOLs with an aspheric optic (Acrysof IQ SN6OWF [Alcon], Tecnis Z9000 [AMO], or Sofport L161AO [Bausch & Lomb]). Ophthalmologic examination including best spectacle-corrected visual acuity, pupil size, ocular dominance investigation, contrast sensitivity under mesopic and photopic conditions, and wavefront analysis was performed 2 months postoperatively. RESULTS: Aspheric IOLs showed better contrast sensitivity compared to spherical IOLs at spatial frequencies of 6, 12, and 18 cycles per degree (cpd) under photopic conditions and at all spatial frequencies under mesopic conditions. There was no significant difference among the three aspheric IOLs at all spatial frequencies under either photopic or mesopic conditions. Mean total spherical aberration was statistically lower in dominant eyes with aspheric IOLs (0.05 +/- 0.06, 0.11 +/- 0.1, and 0.19 +/- 0.08 pm for the Tecnis Z9000, Acrysof IQ SN6OWF, and Sofport L161AO, respectively) compared with eyes with spherical IOLs (0.62 +/- 0.24 and 0.46 +/- 0.19 microm for the Acrysof SN6OAT and Sensar AR40e, respectively) for a 5-mm pupil diameter. CONCLUSIONS: The aspheric IOLs had less wavefront aberrations and performed better under both photopic and mesopic contrast sensitivity compared to the spherical IOLs. These findings confirm it is possible to improve the optical performance of IOLs by modifying the surfaces.     

Improving quality of vision with an anterior surface modified prolate intraocular lens: A prospective clinical trial

AIM: To compare the optical performance of the anterior surface modified prolate Tecnis Z9000 IOL with the standard 911A IOL in terms of contrast sensitivity outcomes. · METHODS: The Tecnis Z9000 silicone IOL shares the same basic characteristics with the 911A IOL including a 12.0mm overall diameter, 3-piece equiconvex 6.0mm optic and angulated cap C polyvinylidene fluoride haptics. This is a randomized prospective study that involved ten consecutive patients (20 eyes) with bilateral cataracts. Each patient underwent phacoemulsification and received randomly the Tecnis Z9000 IOL in one eye and the control (911A IOL) in the fellow eye within 6 weeks period of one another. Contrast sensitivity was measured after six postoperative weeks. The collected data were analyzed through using Mann Whitney U test. · RESULTS: The mean pre-operative best spectacle corrected Snellen visual acuity in the eyes that were randomly selected to receive the Tecnis IOL was 6/8.5 (0.70) and in the eye selected to receive the 911A IOL was 6/9.4(0.64). Postoperatively all 20 eyes achieved best corrected Snellen visual acuity of 6/6 (1.0). Postoperative contrast sensitivity testing showed statistically significant differences (P <0.05) between the two IOLs at 12 and 18 cpd under photopic, at 1.5 and 3 cpd under mesopic, and at 1.5 and 3 cpd under mesopic with glare conditions. · CONCLUSION: The Tecnis Z9000 IOL proved to have statistically significant superior contrast sensitivity to the 911A IOL at high spatial frequencies under photopic conditions and at low spatial frequencies under mesopic and mesopic with glare conditions.     

Comparison of three different diffractıve multifocal intraocular lenses with a +2.5, +3.0, and +3.75 diopter additıon power

PurposeTo compare the functional outcomes and astigmatic tolerability after implantation of multifocal intraocular lenses (IOLs) with a +2.5, +3.0, and +3.75 diopter (D) addition power.MethodsThis study included 122 eyes of 61 patients who had bilateral cataract extraction and implantation of diffractive aspheric multifocal acrylic IOLs with +2.5 D (+2.5 group), +3.0 D (+3.0 group), and +3.75 D (+3.75 group) addition powers. 1-year after surgery, distance corrected near (DNVA) and intermediate (DIVA) visual acuities at 32, 40, 45, 50, 55, and 60 cm; and contrast sensitivity measurements under photopic, mesopic and mesopic with glare conditions; spherical and astigmatic defocus testing; distance-intermediate-near vision patient satisfaction levels; spectacle dependance; patient-reported outcomes were assessed binocularly.ResultsThe +2.50 D group had better DIVA than both +3.0 group and +3.75 groups at 45 cm, 50 cm, 55 cm, and 60 cm (p < 0.05). The +3.75 group had better DNVA than both +2.5 and +3.0 IOL groups at 32 cm (p < 0.05). There was no significant difference in mean contrast values at all frequencies between three IOL groups (p > 0.05). The +2.50 D group showed better astigmatic tolerability than +3.00 group (at 2.00 D) and +3.75 group (at 1.50 D, and at 2.00 D) (p < 0.05).ConclusionMultifocal IOLs with +2.5 add power have better intermediate vision, but worse near vision compared to multifocal IOLs with +3.00 D and +3.75 D add power. Multifocal IOLs with +2.50 D add power tend to have better astigmatic defocus tolerability than multifocal IOLs with +3.00 D and +3.75 D add powers.     

人工晶状体前表面非球面化改良能够改善视觉质量

目的:根据对比敏感度结果比较前表面改良的非球面Tecnis Z9000 IOL和标准的911A IOL的光学性能.方法:Tecnis Z9000硅凝胶IOL和911A IOL具有共同的基本特征包括12mm总长度、三片直边双凸6mm的光学直径和成角的聚丙乙烯C襻.对连续10例双侧白内障患者(20眼)进行了随机前瞻研究,所有患者都接受了白内障超声乳化手术并随机于1眼植入Tecnis Z9000IOL,另1眼在术后6wk内植入911A IOL作为对照,术后6wk进行对比敏感度检查,所得数据采用秩和检验进行比较.结果:随机植入Tecnis IOL组的术前平均最佳Snellen矫正视力为6/8.5(0.70),植入911A I0L组为6/9.4(0.64),所有20眼术后最佳矫正视力都达到了6/6(1.0).术后对比敏感度分析发现两组在12和18 cpd(明视)、1.5和3 cpd(暮视)以及1.5和3 cpd(暮视伴眩光)均有统计学差异(P＜0.05)结论:Tecnis Z9000 I0L被证明其对比敏感度在明视高空间频率和暮视低空间频率方面均显著优于911A IOL.