人工晶状体光学区的非球面设计对视网膜成像的影响

目的通过对比球面人工晶状体眼和非球面人工晶状体眼的波前相差及对比敏感度表现，探讨人工晶状体光学区的不同设计对视网膜成像影响的差异。方法对我院进行白内障超声乳化联合人工晶状体植入手术的老年性白内障患者60例（60只眼），分为2组，每组30例（30只眼），植入的人工晶状体为球面人工晶状体Acrysof SN60（Alconco，ltd）和非球面人工晶状体Acysof SN60WF（Alcon co，ltd）。于术前、术后3个月应用OrbseanⅡ眼前节分析系统（Baush ＆ Lomb co，hd）对2组病例进行角膜曲率和Q值的检查，同时将瞳孔散大至6．0mm后，应用Zywave波前相差仪（Baush＆Lomb co，hd）进行波前相差检查。应用Opts＆500（Swreo Optical，USA）对比敏感度检测仪进行明视及暗视对比敏感度检查。应用配对的t检验进行数据分析。结果白内障手术后，患者的视力明显改善，术后的总体相差、高阶相差和球差均明显低于术前（P〈0．01）；非球面组与球面组的术后视力没有显著差别（P〉0．05）；在6．0mm瞳孔直径状态下，非球面人工晶状体组的高阶相差明显低于球面人工晶状体组（P〈0．05）。SN60WF人工晶状体组在明视1．5、3．06、6．0、12、18cod及暗视1．5、3．0、6．0、12、18cod的对比敏感度均明显优于SN60人工晶状体组，差别有统计学意义（P〈0．05）。结论白内障手术在明显提高视力的同时，可同时降低术前存在的波前相差和高阶相差。与球面人工晶状体相比，非球面人工晶状体可提高某些频率的对比敏感度。在暗环境（大瞳孔）状态下，非球面人工晶状体眼的高阶相差，尤其是球差，低于球面人工晶状体眼。人工晶状体光学区的非球面设计有利于改善患者的视觉质量。

Difference of visual quantity of spherical intraocular lens eyes and aspherical intraocular lens eyes

Objective We compared spherical aberration and contrast sensitivity in spherical intraocular lens eyes and asphefical intraocular lens eyes in order to obtain an Objective Evalution of the optical quantity of these two kind IOLs eyes. Methods This prospective study included 60 patients （60 eyes） , divided in 2 groups equal. In group I one eye was planted with spheieal iols and the other group were planted with aspherieal iols. The spherical iols were Aerysof SN60. （Alcon co, hd） and the aspherical iols were Aerysof SN6OWF. Before the surgery, cornea eurvation, Q-value ,eyes abbreationswere measured by ocular anterior segment diagnosis systerm （ Orbsean U, Baush ＆ Lomb Co hd） and a Hartmannshack-type aberrometer （ Zywave, Baush ＆ Lomb Co hd） at 6.0 mm pupil diameter or more and assessment of photopie and mesopie contrast sensitivities were measured by Optee -6500 Contrast Sensitivity Tester. Three months after cataract surgery, abbreations ,Q - value and assessment of photopie and mesopie contrast sensitivities were measured again. The RMS value of total abbreafions, total high order abbreations and spherical abbreations in each group were compared. Assessment of photopie and mesopie contrast sensitivities were measured respectively. Results Visual aeeurity were increased greatly post-op. The RMS value of total abbreat/ons, total high order abbreations and spherical abbreations of each group were decreased than that of pre-op. （ P 〈0.01 ） Visual aeeurity were same between spherieal iol eyes and asphefieal iol eyes in daytime （ P 〉 0.05 ）. The SN6OWF IOL eyes provided significantly better contrast sensitivity at almost all spatial frequencies under photopie conditions and mesopie conditions in comparison with the SN60 IOL eyes. When patient＇ s pupil were dilated to 6.0 ram, total high order abbreations and spherical abbreations in aspherieal iol eyes were lower than that of spherical iol eyes （ P 〈 0.05 ） . Conclusion Visual aeeurity and visual quantity were increased and tot