三种折叠式单焦球面设计人工品状体对比敏感度及眩光敏感度的比较研究

目的比较3种折叠式单焦球面设计人工晶状体在植入术后。其对比敏感度和眩光对比敏感度的差异。方法将所有待植入人工晶状体的单纯老年性白内障患者120例120眼随机分成3组：A组植入一片式肝素表面处理亲水性丙烯酸酯人工晶状体（HQ-201HEP，Hexa Vision），B组植入三片式疏水性丙烯酸酯人工晶状体（Sensar AR40e，AMO），C组植入蓝光滤过人工晶状体（AcrySof Natural SN60AT，A0CON）；另选取一组与病例组年龄相近的正常人作为对照组；每组均40例40眼。术后测量各组最佳矫正视力。使用CSV-1000E对比敏感度仪测量对比敏感度及眩光对比敏感度进行比较。结果对比敏感度及眩光对比敏感度在各空间频率（3cpd、6cpd、12cpd、18cpd）的互相比较，其差异均无统计学意义（P〉0．05），但均低于同年龄正常组。结论白内障摘出植入单焦球面人工晶状体可部分恢复患者因白内障引起的对比敏感度降低，但尚未达到正常同龄人水平。人工晶状体的设计原理对对比敏感度的影响尚需进一步探讨。     

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.     

不同类型人工晶状体对白内障术后对比敏感度的影响

目的:研究不同类型人工晶状体植入术后暗视和明视下对比敏感度(contrast sensitivity,CS)的变化,评估患者术后的视觉质量。方法:采用对照研究的方法:实验组为2010-03/10期间于我院行超声乳化白内障吸除联合人工晶状体植入术的老年性白内障患者50例55眼。全部患者分为3组,分别植入Sensar AR40e人工晶状体17眼,Bausch&Lomb LI61SE人工晶状体18眼和Array SA40N多焦点人工晶状体20眼,对照组为年龄相匹配的志愿者12例24眼。SensarAR40e人工晶状体的光学材料为疏水性丙烯酸酯,另外2种人工晶状体的光学材料为硅凝胶。检查患者术后和志愿者的最佳矫正视力后暗视和明视下对比敏感度。结果:Array SA40N组的CS除明视下0.8cpd以外在各空间频率较正常对照组均明显下降;Bausch&Lomb LI61SE组的CS在除0.8cpd以外其余各空间频率较正常对照组均明显下降;Sensar AR40e组在0.8cpd,1.5cpd的CS与正常对照组无明显差异,在其余各空间频率较正常对照组均明显下降。Array SA40N组在12cpd,20cpd的CS较其他两组人工晶状体眼下降。Sensar AR40e组和Bausch&LombLI61SE组各空间频率的CS相比较均无明显差异。结论:人工晶状体眼的CS较同龄正常对照组均明显下降;多焦点人工晶状体眼较单焦点人工晶状体眼的CS在高频区明显下降;疏水性丙烯酸酯与硅凝胶两种材料的人工晶状体对白内障术后CS的影响无明显差异。     

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.     

对比敏感度及眩光测试在白内障检查中的应用

对比敏感度和眩光检查是评估早期白内障患者视功能的有效方法。白内障摘除人工晶状体植入术后患者的对比敏感度值在有或无眩光下均较术前显著提高,且接近恢复到正常范围。其中,植人多焦人工晶状体患者的对比敏感度值较植入单焦人工晶状体者低。本文就白内障检查中对比敏感度及眩光测试的应用做一综述。     

对比敏感度及眩光测试在白内障检查中的应用

对比敏感度和眩光检查是评估早期白内障患视功能的有效方法。白内障除人工晶状体植入术后患的对比敏感度值在有或无眩光下均较术前显提高，且接近恢复到正常范围。其中，植入多焦人工晶状体患的对比敏感度值较植入单焦人工晶状体低。本就白内障检查中对比敏感度及眩光测试的应用做一综述。     

衍射型多焦点人工晶状体眼对比敏感度和高阶像差研究

目的 对比研究衍射型多焦点和单焦点人工晶状体眼的对比敏感度和高阶像差.方法 所有患者按照植入的人工晶状体类型分成多焦组和单焦组.多焦组植入衍射型多焦点人工晶状体AcrySofReSTOR(Alton),72例(109只眼);单焦组植入单焦点人工晶状体AcrySofSA60AT(Alcon),88例(130只眼).术后随访6～24月,观察远近视力,脱镜率,对比敏感度,高阶像差.结果 单焦组在明光、暗光、暗光眩光条件下各空间频率对比敏感度均高于多焦组,明光条件下3epd和6cpd(中频)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(除1.5cpd外)差异有统计学意义(P＜0.05).术后3阶慧差,4阶球差,总高阶像差均方根(RMS)多焦组略高于单焦组,但差异无统计学意义(P＞0.05).两组间远视力无显著性差异,近视力多焦组101只眼(91.8%)≥J3,单焦组12只眼(9.2%).两组完全脱镜率分别为98只眼(89.1%)和9只眼(6.9%).结论 衍射型多焦点人工晶状体在某些空间频率对比敏感度低于单焦组,没有明显增加高阶像差和视觉干扰;患者具有良好的远近视力和较高的脱镜率.     

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.     

白内障摘除蓝光滤过型人工晶状体植入术后的临床观察

目的 比较研究白内障超声乳化植入蓝光滤过型人工晶状体和普通一片式人工晶状体的临床效果.方法 选取行白内障超声乳化摘除联合人工晶状体植入患者60例,60只眼,术后裸眼视力大于等于0.8.根据植入人工晶状体的类型不同,分为试验组和对照组,试验组植入YA-60BB人工晶状体组,30只眼;对照组植入AR40e人工晶状体组,30只眼.术后一个月检查患者的对比敏感度、畏光蓝视和色觉等主观视觉症状.结果 (1)YA-60BB人工晶状体组对比敏感度和AR40e人工晶状体组相比,术后一个月昼眩光状态1.5cpd空间频率下,和夜眩光状态1.5、3cpd空间频率下,两组对比敏感度相比差异有统计学意义(P<0.05),蓝光滤过组明显高于非蓝光滤过组.其余状态下,两组相比差异无统计学意义(P0.05).(2)术后一个月两组间畏光症状相比,差异无统计学意义(P0.05).两种晶体间色觉相比也无明显差异.蓝视症状相比,两组间差异有统计学意义(P<0.05),蓝光滤过组的术后蓝视症状明显少于非蓝光滤过组.结论 植入YA-60BB人工晶状体可提高眩光状态下低空间频率下的对比敏感度,也可以减轻患者术后的蓝视症状,而对色觉无负面的影响.     

Tritan colour contrast sensitivity function in refractive multifocal intraocular lenses

AIMS: To compare tritan colour contrast sensitivity (CCS), without and with glare, in patients with refractive multifocal intraocular lenses (IOLs) and with monofocal intraocular lenses. METHODS: Tritan CCS was determined (Moorfields Vision System, CH Electronics) in 15 eyes (14 patients, 75.7 (+/-6.6) years) with a refractive multifocal IOL (Allergan SA 40N) and in 11 eyes (10 patients, 73.7 (+/-6.4) years) with a monofocal IOL (Allergan SI 40 NB). Measurements were made monocularly under mesopic conditions at a distance of 2 metres from the monitor with best distance refraction plus 0.5 D at 0.5, 1, 3, 6, 11.4, and 22.8 cycles per degree (cpd). The test was then repeated for the multifocal IOLs, adding minus 2.5 D to the best distance refraction to force the patient to use the near focus. Both lenses were also investigated under glare conditions with the same set-up and using the brightness acuity tester (BAT). RESULTS: The tritan CCS function without glare in multifocal lenses through the distance focus was nearly identical to that through the near focus. The following statistically significant differences were measured: the CCS function without glare for the multifocal lens was worse at 0.5 cpd and 1.0 cpd than that of the monofocal lens. In CCS testing of the multifocal group with glare at 6 cpd, the results through the distance focus were better than the results through the near focus. For the CCS function with glare, the values for the distance focus in the multifocal lens were worse than the values for the monofocal lens at 0.5 cpd and 1 cpd. In CCS testing with glare through the near focus and CCS testing through the monofocal lens, the monofocal lens performed better at 0.5 cpd, 1 cpd, 3 cpd, and 6 cpd. CONCLUSION: Refractive multifocal intraocular lenses influence tritan CCS function compared to monofocal lenses.     

Contrast sensitivity and glare disability by halogen light after monofocal and multifocal lens implantation

BACKGROUND: Standard examination of contrast sensitivity under conditions of glare disability is performed with incandescent light. A new halogen glare test that simulates glare as seen with oncoming vehicle headlights was used to measure glare disability in patients implanted with multifocal and monofocal intraocular lenses (IOLs). METHODS: 28 patients with an average age of 69 years (SD 12 years) were implanted with a monofocal IOL (SI-40NB, Allergan) and 28 patients with an average of 66 years (12 years) were implanted with a refractive multifocal IOL (Array-SA-40N, Allergan). All patients were followed for 5 months postoperatively. Contrast sensitivity at four spatial frequencies (3, 6, 12, and 18 cycles per degree, cpd) with and without a glare source were measured using the halogen glare test (CSV-1000 HGT). Statistical analysis was performed using the two sample Wilcoxon test. The local significance level was set at 0.05. RESULTS: When tested at the lowest spatial frequency (3 cpd) without halogen glare, contrast sensitivity was lower in the multifocal group than in the monofocal group (p=0.0292). With additional glare, there was no difference between both groups. At all other spatial frequencies (6, 12, and 18 cpd), when tested without halogen glare (6 cpd, p=0.5250; 12 cpd, p=0.8483; 18 cpd, p=0.9496) and with moderate (3 cpd, p=0.7993; 6 cpd, p=0.4639; 12 cpd, p=0.7456; 18 cpd, p=1.0) and high halogen glare (3 cpd, p=0. 1513; 6 cpd, p=0.2016; 12 cpd, p=0.3069; 18 cpd, p=0.9933), there was no statistically significant difference between groups. Patients in both groups of age 70 or older had reduced contrast sensitivity without halogen glare and with moderate and strong glare. When monofocal and multifocal patients older than 70 years of age were analysed separately, there was no statistically significant difference in contrast sensitivity with and without glare. Astigmatism >1 dioptre had no significant influence on contrast sensitivity and glare disability when monofocal and multifocal eyes were compared. CONCLUSION: Reduced contrast sensitivity was found in the multifocal group only at the lowest spatial frequency without halogen glare. The monofocal and multifocal groups had no statistically significant differences in contrast sensitivity with moderate and strong glare. These results suggest no difference in glare disability induced by halogen light similar to oncoming vehicle headlights for patients implanted with monofocal and multifocal IOLs.     

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。     

光变色IOL、蓝光滤过IOL和普通IOL植入术后对比敏感度、眩光对比敏感度对比分析

目的观察光变色人工晶状体(intraocular lens,IOL)、蓝光滤过IOL和普通非蓝光滤过IOL植入术后的对比敏感度(contrast sensitivity,CS)和眩光CS的差异。方法 60例老年性白内障随机分为3组,均行白内障超声乳化吸出联合IOL植入术,分别植入光变色MATRIXTM400型IOL(A组)、Acrysof Nutural SN60AT蓝光滤过IOL(B组)、不具有光线滤过功能的LEN-STEC SofTec I普通折叠IOL(C组),术后3个月对3组患者进行最佳矫正视力、CS和眩光CS检查。结果术前A组最佳矫正视力为0.27±0.10,B组为0.27±0.09,C组为0.27±0.09,术后分别为0.75±0.08、0.70±0.09、0.70±0.09,术前、术后组间差异均无统计学意义(均为P>0.05),组内术前、术后差异均有统计学意义(均为P<0.05)。在3c.d-1、6c.d-1、12c.d-1空间频率上A组CS均高于B组和C组,差异均有统计学意义(均为P<0.05);在18c.d-1空间频率上A组与B组、C组的差异无统计学意义(均为P>0.05)。A组的眩光CS较CS有所提高,在各空间频率上差异均有统计学意义(均为P<0.05);B组和C组的眩光CS和CS比较,在各空间频率上差异均无统计学意义(均为P>0.05)。A组的CS函数曲线在正常人群范围之内,B组和C组的CS函数曲线低于正常人群。结论光变色MATRIXTM400型IOL比蓝光滤过Acrysof SN60AT IOL和不具有光线滤过功能的LENSTECS of TecI普通IOL有更好的CS和眩光CS,可以显著改善视觉质量。     

非球面单焦点及多焦点人工晶体眼高阶像差及对比敏感度比较

目的探讨非球面、单焦点及多焦点人工晶体眼的对比敏感度及高阶像差的差别。方法病人进行随机分组,其中一组病人植入非球面人工晶体Z9001,一组植入单焦点人工晶体SA60AT,一组植入多焦点人工晶体SA40N,共124只眼进入本研究。术后由Allegretto Wave Analyzer(Allegretto,Germany)像差仪测量高阶像差,由CSV-1000E(Vector Vision,USA)测量对比敏感度。结果术后的最佳矫正视力,瞳孔直径,撕囊口直径的大小及角膜高阶像差比较,组间差异不具有统计学意义。术后的高阶像差测量,其中球面像差、4阶高阶像差及总体像差比较中SA40N组大于SA60AT组,SA60AT组大于Z9001组。对比敏感度比较,在所有的空间频率3、6、12、18cpd,Z9001组大于SA60AT组,SA60AT组大于SA40N组。结论多焦点人工晶体眼较单焦点人工晶体相比,可以引起眼的高阶像差增加,对比敏感度降低。非球面人工晶体可以减少球面像差、增加对比敏感度。     

Assessment of contrast sensitivity loss after intrastromal femtosecond laser and LASIK procedure

AIM: To assess the loss of contrast sensitivity (CS) function for INTRACOR or intrastromal femtosecond laser presbyopia procedure to conventional LASIK procedures. METHODS: Patients were recruited from a refractive surgery center for either INTRACOR or conventional LASIK. INTRACOR was performed on 8 eyes and LASIK was performed for 40 eyes in an overlapping period. Pre-operative evaluation and post-operative follow up for up to three months was done. Drops of CS in 4 spatial frequency (3 cpd, 6 cpd, 12 cpd and 18 cpd) right before and 3mo after the surgery were compared by Wilcoxon signed ranks test. RESULTS: For INTRACOR, CS threshold showed significant drop at both glare and non-glare condition, the drop was seen in all 4 spatial frequency. The averaged loss over the 4 spatial frequencies 3mo after surgery was 1.18 for non-glare and 0.71 for glare. For LASIK the CS threshold drop was most significant in 12 cpd for glare. CONCLUSION: INTRACOR procedure produces a gain of near vision for presbyopia patients but also introduces a high lost of contrast sensitivity plus worsen of vision quality. Pre-surgical patient selection and advise should be given with specific regards to night driving and glare conditions.     

Aberration and contrast sensitivity comparison of aspherical and monofocal and multifocal intraocular lens eyes

BACKGROUND: Higher-order aberrations and contrast sensitivity were evaluated in patients who underwent phacoemulsification cataract extraction followed by implantation of aspherical, monofocal or multifocal intraocular lens (IOL) replacements. METHODS: In this comparative trial, 124 patients with an average age of 66.8+/-5.2 years and their 124 eyes were randomly divided into three surgical implantation groups to receive one of three types of IOLs in replacement of cataract lenses. The patients of group 1 were given an aspherical IOL Z9001 (AMO, Santa Ana, CA, USA) replacement, and group 2 was implanted a monofocal IOL SA60AT (Alcon, Fort Worth, TX, USA) and group 3 the multifocal IOL SA40N (AMO). Post-surgical best-corrected visual acuity, corneal aberrations, total ocular aberrations, pupil diameters, capsulorhexsis sizes and contrast sensitivity were measured and compared. RESULTS: There was no statistical difference for mean best-corrected visual acuity, pupil diameter, curvilinear capsulorhexis size and corneal aberration among the three groups. For the spherical aberration, fourth-order higher-order aberration and total ocular higher-order aberration, the SA40N group was higher than the SA60AT group and the SA60AT group was higher than the Z9001 group, and the differences between the three groups were statistically significant for these measurements. Contrast sensitivity was higher for the Z9001 group than the SA60AT group and the SA60AT group was higher than the SA40N group, and the difference was statistically significant in all the spatial frequencies of 3, 6, 12 and 18. CONCLUSIONS: Although the multifocal IOL can provide near vision, it can increase higher-order aberration and negatively influence contrast sensitivity. However, the aspherical IOL can reduce aberration and improve contrast sensitivity as compared with the monofocal IOL.