白内障眼的波前像差、对比敏感度及眩光敏感度研究

目的分析早期年龄相关性白内障患者的波前像差、对比敏感度和眩光敏感度改变。设计前瞻性病例对照研究。研究对象年龄相关性白内障患者62例(107眼),其中皮质性白内障组31例(50眼)、核性白内障组17例(32眼)、后囊下白内障组14例(25眼);正常对照组36例(36眼)。方法使用主观像差仪和自动眩光对比敏感度检查仪对受试者进行波前像差、对比敏感度及眩光敏感度检测。主要指标波前像差、对比敏感度及眩光敏感度。结果各组白内障患者整体像差和总高阶像差普遍高于正常对照组(P均<0．05)。皮质性白内障组和核性白内障第5阶像差高于正常组(P均<0．05)。所有受试者眩光敏感度均比对比敏感度下降明显(P均<0．05)。与正常组相比,皮质性白内障组的对比敏感度和眩光敏感度在低频段和中频段下降显著,核性白内障组的对比敏感度和眩光敏感度在低频段下降显著,后囊下白内障组的对比敏感度和眩光敏感度在全频段下降显著(P<0．05)。白内障组对比敏感度及眩光敏感度和高阶像差存在相关性,但在不同类型白内障,在对比敏感度和眩光敏感度的不同频段,在各阶像差中结果有所不同(r=-0．716-0．191,P<0．05)。结论早期白内障患者波前像差增高,对比敏感度及眩光敏感度下降。对比敏感度及眩光敏感度检查和波前像差测定结合进行,可有效、客观、定量地反映早期白内障患者的视觉质量下降。

Wavefront aberrations and contrast sensitivity, glare disability study in eyes with cataract

Objective To investigate the characteristics and changes of wavefront aberrations and contrast sensitivity, glare sensitivity in age-related cataract patients. Design Prospective, case-controlled study. Participants 107 eyes of 62 age-related cataract patients, who had been classified into cortical cataract group (50 eyes of 31 subjects), nuclear cataract group (32 eyes of 17 subjects), posterior subcapsular cataract group (25 eyes of 14 subjects); and normal contrastive group (36 eyes of 36 subjects). Methods In this study, a subjective wavefront aberrometer and a contrast glare tester were used to measure age-related cataract patients and normal contrastive group. Main Outcome Measures Wavefront aberrations, contrast sensitivity and glare sensitivity (glare disability). Results The overall aberrations and higher-order aberrations of cataract group were higher than normal control group, the difference was significant (P<0.05). The fifth-order aberrations of cortical cataract and nuclear cataract were higher than normal contrastive group, the difference was significant (P<0.05). Glare sensitivity was lower than contrast sensitivity at almost every visual angle in every group (P<0.05). The contrast sensitivity and the glare sensitivity of cortical cataract at low, medium spatial frequency, the contrast sensitivity and the glare sensitivity of nuclear cataract at low spatial frequency, the contrast sensitivity and the glare sensitivity of posterior subcapsular cataract at all spatial frequency were significantly lower than them of normal subjects (P<0.05). The correlation between the higher-order aberrations and contrast sensitivity, or glare sensitivity was significant of cataract eyes (r=-0.716--0.191, P<0.05). But different type cataract eyes, different spatial frequency of contrast sensitivity and glare sensitivity, different order of higher-order aberrations had some different. Conclusion In early cataract, wavefront aberrations are increasing, contrast sensitivity and glare sensitivity are decreasing. The wavefront aberrations, the contrast sensitivity and glare sensitivity reflect effectively, objectively and quantitatively the decreasing in visual quality of early cataract.