零像差设计的非球面人工晶状体的临床应用研究

目的 比较零像差设计的非球面人工晶状体(IOL)与传统球面IOL对超声乳化自内障吸除联合IOL植入术后患者眼球差、视觉功能以及表观调节力的影响.方法 采用前瞻性随机对照设计,将130例(132只眼)拟行超声乳化白内障吸除联合IOL植入术的年龄相关性白内障患者按随机数字表法分为2组,分别植入零像差设计的非球面IOL(试验组)和传统球面IOL(对照组).术后检测IOL眼的球差、矫正远视力、矫正远视力后的近视力、对比敏感度、眩光敏感度及表观调节力;随访时间为3个月.采用χ~2检验和独立样本t检验分别对计数资料和计量资料进行统计学分析.结果 术后3个月,瞳孔直径5 mm情况下IOL眼的球差试验组为(0.141±0.070)μm,对照组为(0.210±0.108)μm,差异有统计学意义(t=4.365,P=0.000).2.5°视角的对比敏感度试验组为30.62±12.50,对照组为25.92±7.36,差异有统计学意义(t=2.606,P:0.010);眩光敏感度在4.0°、2.5°及1.6°视角上分别为31.25±8.65、26.35±8.72和12.35±4.01,显著高于对照组在相应视角上的26.70±7.98(t=3.116,P=0.002)、22.43±7.35(t=2.772,P=0.006)及9.82±4.12(t=3.553,P=0.001);两组的矫正远视力、矫正远视力后近视力、表观调节力比较,差异均无统计学意义.结论 与传统球面IOL比较,零像差的非球面IOL Akreos AO可以显著减少IOL眼的总球差,改善白内障患者术后的视觉质量,且对患者术后的表观调节力无明显影响.

Study of clinical application of aberration-free aspheric intraocular lens

Objective To compare spherical aberration,visual quality and apparent accommodation between pseudophakic patients with an aberration-free aspheric intraocular lens (IOL) and patients with a spherical IOL Methods A prospective study of 130 consecutive cases (132 eyes) was conducted.All cataract patients underwent phacoemulsification were randomized to receive an aberration-free aspheric IOL (Akreos AO,Bausch & Lomb) or a spherical IOL (KS-1,Cannon Staar).Spherical aberration of total eye,best corrected visual acuity (BCVA) ,near visual acuity (NVA) ,contrast sensitivity,glare sensitivity and apparent accommodation were measured.Data were analyzed using chi-square test and independent t-test.Results The mean spherical aberration in eyes with a Tecnis IOL[(0.141 ±0.070) μm]was significantly lower than that of eyes with a spherical IOL[(0.210 ± 0.108) μm;t = 4.365,P = 0.000].In addition,Akreos AO IOL provided a better contrast sensitivity at 2.5° visual angle (30.62 ± 12.50 vs.25.92 ±7.36;t=2.606,P =0.010),and improved glare sensitivity at 4.0° (31.25 ±8.65 vs.26.70 ±7.98;t =3.116,P=0.002),2.5° (26.35±8.72 vs.22.43 ±7.35;t =2.772,P=0.006) and 1.6° (12.35 ± 4.01 vs.9.82 ± 4.12;t = 3.553,P = 0.001) visual angles.The difference of BCVA,NVA and apparent accommodation between these two groups was not statistically significant Conclusion The present results demonstrated that an aberration-free aspheric IOL,Akreos AO,may reduce the spherical aberration and improve visual performance of pseudophakic eyes and without negative influence on apparent accommodation as compare to conventional spherical IOL.