Kershner Robert M
Eye Laser Center, Tucson, Arizona 85704-1152, USA.
J Cataract Refract Surg. 2003 Sep;29(9):1684-94. doi: 10.1016/s0886-3350(03)00523-6.
To compare the effects of an aspheric intraocular lens (IOL) (Tecnis Z-9000, Pharmacia Corp.) with those of conventional silicone (AA4207VF, Staar Surgical) and acrylic (AcrySof SA60AT, Alcon Surgical) lenses on retinal imaging and functional visual performance.
Eye Laser Center, Tucson, Arizona, USA.
In this prospective study, 221 eyes of 156 patients were randomly assigned to receive 1 of 3 IOLs. Visual acuity was measured preoperatively and 1 day, 1 and 3 weeks, and 1, 3, and 6 months postoperatively. Fundus photography and photopic and mesopic functional acuity contrast testing were performed preoperatively and 3 months postoperatively.
The differences in the preoperative and postoperative spherical and astigmatic refractive errors and best corrected visual acuity among groups were not statistically significant. The postoperative uncorrected visual acuity was best in the aspheric group in the first month. Functional acuity contrast testing showed the aspheric IOL group had a 38% to 47% increase in photopic vision, 38% in photopic with glare, 43% to 100% in mesopic, and 9% to 100% in mesopic with glare. There was no increase in photopic vision in the acrylic group but increases of 38% in photopic with glare, 25% to 50% in mesopic, and 36% to 50% in mesopic with glare. The spherical silicone IOL group had no increase in contrast testing from preoperatively. Digital analysis of retinal imaging showed increased threshold luminance levels in the aspheric group (range 116 to 208 cd/m2) and a 4-fold increase in image contrast.
All 3 IOLs led to improved visual acuity after cataract surgery. The aspheric IOL provided a significant improvement in retinal image contrast and visual performance measured by visual acuity and functional acuity contrast testing. This improvement was greatest in night vision and night vision with glare compared to the performance of conventional spherical silicone and acrylic IOLs.
比较非球面人工晶状体（IOL）（Tecnis Z - 9000，法玛西亚公司）与传统硅凝胶（AA4207VF，STAAR外科公司）和丙烯酸酯（AcrySof SA60AT，爱尔康外科公司）人工晶状体对视网膜成像和功能性视觉表现的影响。
美国亚利桑那州图森市眼激光中心。
在这项前瞻性研究中，156例患者的221只眼被随机分配接受3种人工晶状体中的一种。术前以及术后1天、1周和3周、1个月、3个月和6个月测量视力。术前和术后3个月进行眼底照相以及明视觉和暗视觉功能性视力对比测试。
各组术前和术后的球镜和柱镜屈光不正以及最佳矫正视力的差异无统计学意义。术后第1个月非球面组的裸眼视力最佳。功能性视力对比测试显示，非球面人工晶状体组的明视觉提高了38%至47%，有眩光时的明视觉提高了38%，暗视觉提高了43%至100%，有眩光时的暗视觉提高了9%至100%。丙烯酸酯组的明视觉无提高，但有眩光时的明视觉提高了38%，暗视觉提高了25%至50%，有眩光时的暗视觉提高了36%至50%。球形硅凝胶人工晶状体组对比测试结果与术前相比无提高。视网膜成像的数字分析显示，非球面组的阈值亮度水平增加（范围为116至208 cd/m²），图像对比度增加了4倍。
所有3种人工晶状体均使白内障手术后视力得到改善。非球面人工晶状体在视网膜图像对比度以及通过视力和功能性视力对比测试测量的视觉表现方面有显著改善。与传统球形硅凝胶和丙烯酸酯人工晶状体的表现相比，这种改善在夜间视力和有眩光的夜间视力方面最为明显。
