非球面人工晶状体植入术后视觉质量的临床观察

目的 观察白内障超声乳化非球面人工晶状体植入术后视觉质量方面的临床效果.方法 选择65例(70只眼)年龄相关性白内障患者.随机分成两组,每组35只眼.在超声乳化术后,实验组植入非球面人工晶状体,对照组植入传统球面人工晶状体.并分别于术后1周、1月、3月检测两组裸眼远、近视力,最佳矫正远视力,最佳矫正远视力后的近视力,对比敏感度,波前相差,立体视觉.视功能与生存质量(VF/QOL)问卷调查等.结果 在术后1周、1月,两组裸眼远、近视力,最佳矫正远视力、最佳矫正远视力后的近视力比较无明显差异(P>0.05);术后3月两组裸眼远视力、最佳矫正远视力比较有明显差异(P<0.05);实验组裸眼近视力,最佳矫正远视力后的近视力明显优于对照组,差异有统计学意义(P<0.05);术后1月、3月,实验组在昼及昼眩光,夜及夜眩光的各频段对比敏感度(1.5cpd,3.0cpd,6.0cpa,12cpd,18cod)均明显优于对照组,差异有统计学意义(P<0.05);术后1月、3月,两组在瞳孔直径≥6mm时的三阶彗差、四阶球差、五阶次级彗差、高阶像差的均方根(RMS值)比较,实验组均低于对照组,两组差异具有统计学意义(P<0.05);术后1月、3月,两组在最佳矫正视力下的远、近立体视觉的比较.差异无统计学意义(P>0.05);术后3月,VF/QOL问卷调查显示两组近视力视觉相关活动、视力有关的感觉适应的比较.差异有统计学意义(P<0.05).结论 白内障超声乳化植入非球面人工晶状体与植入传统的球面人工晶状体相比,能够有效减少术后的高阶像差尤其是球差,提高对比敏感度,改善术后的视觉质量.

The observation of visual quality in Cataract patients after implantation with Aspheric Intraocular Lens

Objective To evaluate clinical effects of visual quality after implantation with aspberie intraoeular lens( IOL )in phacoemulsificafion for cataract extract. Methods Seventy eyes of sixty-five patients undergoing cataract surgery were randomly divided into two groups:thirty-five eyes of thirty patients received aspheric IOLs and thirty-five eyes of thirty-five patients received spherical IOLs.At one week, one month, three months after surgery,the following investigations were performed to assess near and distance uncorrected visual acuity (UCVA),best corrected distance visual acuity (BCDVA),best corrected near visual acuity (BCNVA), contrast sensitivity, wavefront aberration, stereupsis of eyes and visual function and quality of life (VF / QOL) survey .Results The difference of UCVA, BCDVA and BCNVA between these two groups was not significant after sugery at one week, one month ;but the UCVA,BCDVA and BCNVA in eyes with an aspherie IOL were obviously better than that of eyes with a spherical IOL at three months postoperatively.After one week and three months,the aspherie IOL provided significantly better contrast sensitivity at almost all spatial frequencies under photopie conditions and mesopie conditions in comparison with the spherical IOL.In these two groups, the wavefront aberration showed the significant difference after one month and three months. The differences of distaace and near stereopisis with BCDVA and BCNVA between these two groups were not signifieant after sugery at one month and three months. After three months, visual function and quality of life (VF / QOL) survey showed significant difference between two groups (P <0.05). Conclusion The present clinical results demonstrated that an aspherie IOL can improve contrast sensitivity at almost all spatial frequencies under photupie conditions and mesopie conditions and decrease spherical aberration as compare to a spherical IOL.