应用三维眼前节分析仪对单片式折叠型人工晶状体在眼内位置分布规律的研究

背景非球面人工晶状体（IOL）的临床应用一定程度上降低了患者的术后全眼球差，但其临床效果取决于精确的轴对位，其眼内位置的研究尤其重要。目的研究IOL植入后IOL在眼内位置的分布规律。方法采用前瞻性对照研究设计。对年龄相关性白内障40例80眼行超声乳化白内障摘出联合单片式折叠型IOL植入术，以系统光轴与IOL最大横截面交点为坐标原点将术眼分为鼻上、颞上、颞下、鼻下4个象限，术后3个月使用三维眼前节分析仪（Pentacam）中的25P／!S模式测量术眼各象限IOL的偏心量和倾斜度。结果右眼IOL植入后IOL颞侧偏心者26眼（65％），颞下偏心16眼（40％），水平颞侧倾斜37眼（92．5％），垂直下方倾斜34眼（85．O％）；左眼颞侧偏心33眼（82．5％），颞下偏心20眼（50％），水平颞侧倾斜37眼（92．5％），垂直下方倾斜36眼（90％）。右眼各象限水平位／垂直位偏心量的总体比较差异均无统计学意义（F=0．221、0．792，P〉0．05）；左眼颞上象限和颞下象限水平偏心量均明显高于鼻上象限，差异均有统计学意义（P〈0．05），但左眼各象限间的垂直偏心量差异无统计学意义（F=0．576，P〉0．05）。双眼IOL植入后水平方向及垂直方向的偏心量与倾斜度均呈正相关（右眼水平方向：r=0．374，P=0．002；右眼垂直方向：r=0．402，P=0．001；左眼水平方向：r=0．377，P=0．002；左眼垂直方向：r=0．347，P=0．002）。结论单片式软性IOL植入术后多偏向颞侧，以颞下象限为著，且IOL的光轴大多偏向颞下方，IOL在双眼对应方向的偏斜具有镜像性。水平方向及垂直方向上偏心量与倾斜度表现一致。

Analysis of position of one-piece soft intraocular lens after implantation of intraocular lens with Pentacam

Background The aspheric intraocular lenses(IOLs)can reduce ocular spherical aberration to some degree.However,the clinical effect depends more on the IOL proper alignment.It becomes more important to study the IOL position in eye,Objective This study was to analyze the position alteration of IOL after phacoemulsification combined with implantation of one-piece soft IOLs.Methods In this prospective control study,80 eyes of 40 patients with age-related cataract were enrolled.The phacoemulsification with IOL implantation was performed in all the eyes.Decentration and tilt of IOL in the nasal superior,superior temporal,inferior temporal and nasal inferior quadrants(the intersection point of the system optical axis and the IOL maximum cross plane were regarded as the ordinate origin)were measured by rotating Scheimpflug camera(Pentacam Oculus)in 3 months postoperatively under the mydriasis condition.Written informed consent was obtained from each subject prior to this trial.Results In the right eye group,the IOL decentered toward temporal in 26 eyes(65％)and infratemporal in 16 eyes(40％).IOLs tilted temporally in the horizontal plane in 37 eyes(92.5％)and tilted inferiorly in the vertical plane in 34 eyes(85.0％).In the left eye group,IOLs decentered temporally 33 eyes(82.5％)and 20 IOLs (50％)infratemporally,IOLs tilted temporally in the horizontal plane in 37 eye(92.5％)and 36 IOLs(90％)tilted inferiorly in the vertical plane.There was no statistical difference for the intercomparsion of horizontal/vertical decentration in various quadrant in the right eye(F =0.221,0.792,P＞0.05).The obvious elevated horizontal decentration was found in the supertemporal and infratemporal quadrants compared with supernasal quadrant in the left eyes but there was no significant difference in the vertical decentration among 3 quadrants(F=0.576,P＞0.05).Decentrations were positively correlated with the tilt in both horizontal and vertical plane(right eye horizontal plane:r=0.374,P=0.002;right eye vertical plane:r=0.402,P=0.001 ;left eye horizontal plane:r=0.377,P=0.002；left eye vertical plane:r=0.347,P=0.002).Conclusions The one-piece soft IOLs(Adapt AO)decenter toward temporal mostly in 3 months after surgery,especially infratemporally in the eye.And the optical axis of the IOL tilt toward infratemperol mostly in both right and left eyes.The decentration and tilt are consisted in the corresponding direction between the right and left eyes.The position of the IOLs showed mirror symmetry between right and left eyes.The IOLs decentration show the positively correlation to tilt whatever in horizontal and vertical plane.