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双侧白内障患者非球面与球面人工晶状体的一年期前瞻性患者内比较。

One-year prospective intrapatient comparison of aspherical and spherical intraocular lenses in patients with bilateral cataract.

作者信息

Ohtani Shinichiro, Gekka Susumu, Honbou Masato, Kataoka Yasushi, Minami Keiichiro, Miyata Kazunori, Oshika Tetsuro

机构信息

Meiwakai Medical Foundation, Miyata Eye Hospital, Miyazaki, Japan.

出版信息

Am J Ophthalmol. 2009 Jun;147(6):984-9, 989.e1. doi: 10.1016/j.ajo.2008.12.037. Epub 2009 Mar 13.

DOI:10.1016/j.ajo.2008.12.037
PMID:19285656
Abstract

PURPOSE

To conduct longitudinal, intrapatient comparisons of aspherical and spherical silicone intraocular lenses (IOL) of the same material and platform in patients undergoing bilateral cataract surgery.

DESIGN

Prospective, randomized study.

METHODS

Sixty-two eyes of 31 patients were randomized to receive a silicone aspherical IOL (Tecnis Z9000; AMO Inc, Santa Ana, California, USA) in 1 eye and a silicone spherical IOL (CeeOn 911A; AMO Inc) in the other eye. Best spectacle-corrected visual acuity (BSCVA); corneal and ocular wavefront aberrations; contrast sensitivity under photopic (180 lux), intermediate (75 lux), and scotopic (15 lux) illumination; amount of IOL decentration and tilt; and degree of posterior capsular opacification were measured at 1, 3, 6, and 12 months after surgery. All-distance visual acuity (VA) was measured 3 months after surgery.

RESULTS

There were no significant differences between IOLs with regard to BSCVA, amount of IOL decentration and tilt, degree of posterior capsule opacification, and all-distance VA at any point after surgery. Regarding corneal wavefront aberrations, there was no difference in third- and fourth-order root mean square (RMS). In ocular wavefront aberrations, aspherical IOLs showed significantly lower fourth-order RMS (P < .001) than spherical IOLs throughout the study, but not in third-order RMS. Contrast sensitivity under photopic and mesopic conditions was not different between IOLs, but contrast sensitivity under scotopic conditions was significantly better with aspherical IOLs than with spherical IOLs (P < .01) at all measurement points.

CONCLUSIONS

The silicone aspherical IOL (Tecnis Z9000; AMO Inc) significantly reduced ocular spherical aberration and improved scotopic contrast sensitivity, and these results were consistent through the 1-year follow-up.

摘要

目的

在接受双侧白内障手术的患者中,对相同材料和平台的非球面和球面硅水凝胶人工晶状体(IOL)进行纵向、患者内比较。

设计

前瞻性随机研究。

方法

31例患者的62只眼被随机分为1只眼植入硅水凝胶非球面IOL(Tecnis Z9000;美国加利福尼亚州圣安娜市AMO公司),另1只眼植入硅水凝胶球面IOL(CeeOn 911A;AMO公司)。在术后1、3、6和12个月测量最佳眼镜矫正视力(BSCVA)、角膜和眼波前像差、明视(180勒克斯)、中间视觉(75勒克斯)和暗视(15勒克斯)照明下的对比敏感度、IOL偏心和倾斜量以及后囊膜混浊程度。术后3个月测量全距离视力(VA)。

结果

术后任何时间点,两种IOL在BSCVA、IOL偏心和倾斜量、后囊膜混浊程度及全距离VA方面均无显著差异。关于角膜波前像差,三阶和四阶均方根(RMS)无差异。在眼波前像差方面,整个研究期间非球面IOL的四阶RMS显著低于球面IOL(P <.001),但三阶RMS无差异。两种IOL在明视和中间视觉条件下的对比敏感度无差异,但在所有测量点,非球面IOL在暗视条件下的对比敏感度显著优于球面IOL(P <.01)。

结论

硅水凝胶非球面IOL(Tecnis Z9000;AMO公司)显著降低了眼的球差并改善了暗视对比敏感度,且这些结果在1年随访期内保持一致。

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