双通道视觉质量分析系统在球面和非球面人工晶状体眼视觉质量评价中的应用

目的使用双通道视觉质量分析系统(optical quality analysis system,OQAS)对球面和不同球差值非球面人工晶状体(intraocular lens,IOL)眼视觉质量进行评估。方法选择白内障超声乳化及IOL植入术的年龄相关性白内障患者227例(349眼)分5组,分别植入Bausch&Lomb球面IOL Akreos Adapt、AMO球面IOL Sensar AR40E、Bausch&Lomb非球面IOL Akreos Adapt AO(球差值0μm)、Alcon非球面IOL Acrysof IQ SN60WF(球差值-0.20μm)、AMO非球面IOL Tecnis ZCB00(球差值-0.27μm)。术后3个月采用双通道客观视觉质量分析系统(OQASTMⅡ)、KR-1W像差仪进行检查。比较各组客观散射指数(objective scatter index,OSI)、调制传递函数截止频率(MTF cut off)、斯特列尔比(Strehl ratio,SR)、模拟对比度视力(OV100%、OV20%、OV9%)波前像差。结果术后3个月,5组间裸眼视力(uncorrected visual acuity,UCVA)、最佳矫正视力(best corrected visual acuity,BCVA)、等效球镜(spherical corrected,SE)比较差异均无统计学意义(均为P>0.05)。5组间角膜高阶像差差异均无统计学意义(均为P>0.05);4 mm瞳孔眼内球面像差(spherical aberration,SA)、全眼SA差异均有统计学意义(均为P<0.05);6 mm瞳孔眼内和全眼总高阶像差(total higher order aberration,tHOA)、SA差异均有统计学意义(均为P<0.05)。5组间OQAS参数差异均有统计学意义(均为P<0.05)。OSI:ZCB00组均优于AK组、AR40E组、AO组(均为P<0.05);MTF cut off:SN60WF组、ZCB00组均优于AK组、AR40E组(均为P<0.05);SR:SN60WF组、ZCB00组优于AK组(均为P<0.05);OV100%:SN60WF组、ZCB00组均优于AK组、AR40E组(均为P<0.05);OV20%:SN60WF组均优于AK组、AR40E组、AO组,ZCB00组均优于AK组(均为P<0.05);OV9%:SN60WF组、ZCB00组均优于AK组、AR40E组(均为P<0.05)。其余组间各指标差异均无统计学意义(均为P>0.05)。结论非球面IOL眼视觉质量优于球面IOL眼;负球差非球面IOL AMO ZCB00和Alcon SN60WF优于零球差非球面IOL Bausch&Lomb Akreos AO;OQAS可以全面、客观地评价白内障术后IOL眼的视觉质量。

Evaluation of visual quality of spherical and aspheric intraocular lenses by dual channel optical quality analysis system

Objective　To evaluation the vision quality of spherical and aspheric intraocular lenses (IOL) with different spherical differences by optical quaity analysis system (OQAS).Methods　Totally 227 age-related cataract patients (349 eyes) with phacoemulsification and IOL implantation were collected in the research,and they were divided into five groups,followed by implantation with the Bausch&Lomb spherical IOL Akreos Adapt (AK group),AMO spherical IOL Sensar AR40E (AR40E group),Bausch&Lomb aspheric IOL Akreos Adapt AO (spherical aberration value was 0) (AO group),Alcon aspheric IOL Acrysof IQ SN60WF (spherical aberration value was -0.20 μm) (SN60WF group),AMO aspheric IOL Tecnis ZCB00 (spherical aberration value was -0.27 μm) (ZCB00 group),respectively.At 3 months after surgery,the visual and optical quality of pseudophakic eyes were measured by the OQASTMⅡ and the KR-1W aberrometer.Then,the parameters including objective scatter index (OSI),modulation transfer function (MTF-cutoff),strehl ratio (SR),100%,20%,9% contrast visual acuity (OV100%,OV20%,OV9%) and wave-front aberrations in each group.Results　At 3 months after surgery,there was no significant difference in uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA) and spherical equivalent (SE) in the 5 groups (all P>0.05).There was no significant difference between the 5 groups in corneal high-order aberration (all P>0.05).There were significant differences in internal SA and ocular SA with 4 mm pupil between the 5 groups,there were significant differences between internal SA and ocular tHOA and ocular SA with 6 mm pupil (all P<0.05).For the parameters of OQAS,there were significant differences in the 5 groups (all P<0.05).The OSI was better in ZCB00 group than that in AK group,AR40E group and AO group (all P<0.05).MTF-cutoff was better in SN60WF group and ZCB00 group than that in AK group and AR40E group (all P<0.05).SR was better in SN60WF group and ZCB00 group than that in AK group (all P<0.05).OV100% was better in SN60WF group and ZCB00 group than that in AK group and AR40E group (all P<0.05).OV20% was better in SN60WF group than that in AK group,AR40E group and AO group,and ZCB00 group was better than AK group (all P<0.05);OV9% was better in SN60WF group and ZCB00 group than that in AK group and AR40E group (all P<0.05).Conclusion　The vision quality of aspheric IOL is better than spherical IOL.The vision quality of AMO aspheric IOL ZCB00 and Alcon aspheric IOL SN60WF are better than Bausch & Lomb aspheric IOL Akreos AO.OQAS can be comprehensively and objectively to evaluate the visual quality of cataract patients after phacoemulsification and aspheric IOL implantation.