非球面人工晶状体植入术后视觉质量对比分析

目的:评价3种非球面人工晶状体(AcrySof SN60WF、TecnisZ9001和KS-3Ai)植入术后的视觉质量。方法:采用前瞻性随机对照研究方法,收集我院老年性白内障手术患者88例126眼,平均年龄67.3±8.7岁,将入选患者按植入不同的人工晶状体(Intraocular lens,IOL)随机分为4组:AcrySofSN60WF(IQ)组(23例33眼)、TecnisZ9001组(23例33眼)、KS-3Ai组(20例29眼),SN60AT球面人工晶状体组为对照组(22例31眼)。术后随访3mo,观察指标:裸眼视力(uncorrected visual acuity,UCVA)及最佳矫正视力(best corrected visual acuity,BCVA),眼压,等效球镜度数,角膜Q值,瞳孔直径,6mm全眼球总高阶像差及四阶球差均方根值(root mean square,RMS),夜光、昼光及夜眩光3种视觉条件下的对比敏感度(contrast sensitivity,CS)。结果:术后各组的UCVA、BCVA、等效球镜度数和瞳孔直径均无统计学差异。总高阶像差和四阶球差RMS:非球面组低于球面组,差异具有统计学意义(P<0.05);非球面组间比较无统计学差异。术后角膜Q值与球差成正相关(r=0.183,P<0.05)。术后对比敏感度:与球面IOL相比,IQ,Tecnis可提高术后3种视觉条件下的CS,KS-3Ai可提高术后夜光、夜眩光两种视觉条件下的CS;非球面IOL组间比较,IQ组在昼光、夜眩光视觉条件下的CS好于Tecnis组和KS-3Ai组,TECNIS组和KS-3Ai组之间在3种视觉条件下均无统计学差异。结论:3种非球面IOL均可有效地减少术眼的总高阶像差和四阶球差。3种非球面IOL均可以提高术眼术后的CS,IQ组在昼光、夜眩光视觉条件下的CS与Tecnis组和KS-3Ai组相比较差异具有统计学意义,Tecnis组和KS-3Ai组之间在3种视觉条件下的CS均无统计学差异。

Comparative analysis of visual quality after aspheric intraocular lens implantation

AIM:To evaluate the visual quality after implantation of 3 types aspheric intraocular lens(IOL)(AcrySof SN60WF,Tecnis Z9001,KS-3Ai).·METHODS:One hundred and twenty-six eyes of 88 age-related cataract patients in our hospital underwent invest-gation for this prospective randomized control study.The mean age was 67.3±8.7 year.All patients were divided into 4 groups:AcrySof SN60WF(IQ) IOL group(23 patients/33 eyes),Tecnis Z9001 IOL group(23 patients/33 eyes),KS-3Ai IOL group(20 patients/29 eyes).The group of spherical IOL was taken as the control group:SN60AT IOL group(22 patients/31 eyes).All patients were followed up for 3 months.The uncorrected visual acuity(UCVA),best corrected visual acuity(BCVA) before and after cataract PHACO,the intraocular pressure,cornea Q-value,spherical equivalent degree(SE) and pupil diameter,the root mean square(RMS) of whole high order aberration and spherical aberration,the contrsat sensitivity(CS) of mesopic,photopic and mesopic with glare were examinated after surgery.·RESULTS:There was no statistically significant difference in UCVA,BCVA,SE and pupil diameter after surgery between 4 groups.The whole high order aberration and spherical aberration RMS in aspheric IOL groups was less than that in spherical IOL group with statistically significant difference(P<0.01).There were no statistical difference between Aspheric IOL groups.There was a positive relationship between the corneal Q-value and spherical aberration after surgery(r=0.183,P<0.05).The CS after surgery:Contrast to spherical IOL,IQ and Tecnis could improve postoperative CS in mesopic,photopic,mesopic with glare vision conditions,KS-3Ai could improve postoperative CS in mesopic and mesopic with glare vision conditions.IQ was better than Tecnis and KS-3Ai in photopic and Mesopic with glare vision conditions.There was no statistical difference between Tecnis group and KS-3Ai group in all of vision conditions.·CONCLUSION:All of the three types of Aspheric IOL could decrease efficiently the whole high order aberration and spherical aberration.All of The three types of Aspheric IOL could improve the postoperative CS.There was statistical difference between IQ group and Tecnis group and KS-3Ai group in photopic and Mesopic with glare vision conditions.There was no statistical difference between Tecnis group and KS-3Ai group in all of vision conditions.