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[术前角膜球差对非球面人工晶状体相对个性化植入的影响]

[The influence of preoperative corneal spherical aberration on relatively personalized implantation of aspheric intraocular lens].

作者信息

Lian Hui-fang, Tang Xin, Song Hui

机构信息

Clinical College of Ophthalmology, Tianjin Medical University, Tianjin Eye Hospital, Tianjin 300020, China.

出版信息

Zhonghua Yan Ke Za Zhi. 2010 May;46(5):410-4.

Abstract

OBJECTIVE

To analysis the feasibility of selectively targeting zero total postoperative spherical aberration by selecting the best fit aspheric intraocular lens (IOL) based on preoperative corneal spherical aberration of patients.

METHODS

It was a prospective case series study. The corneal spherical aberration (Z40) with 6 mm aperture of 57 eyes (46 patients) was measured with a iTrace Visual Function Analyzer 1 day before surgery, the target postoperative total spherical aberration was set at zero. Thus, for corneal spherical aberration<+0.100 microm, the Sofport Advanced Optic (AO)IOL(10 eyes) was selected; for corneal spherical aberration>+0.100 microm but if <+0.235 microm, the AcrySof IQ IOL (20 eyes) was selected; and for corneal spherical aberration>+0.235 microm, Tecnis ZA9003 IOL (27 eyes)was selected. Aspherical IOL was implanted after phacoemulsification through a clear-cornea, 3.2 mm incision without suture. Uncorrected visual acuity, best corrected visual acuity (BCVA), spherical aberration of the whole eye and internal optics (IOL) at 6 mm pupil diameter were examined at 3 months postoperatively. ANOVA and t-test were used to analyze the data at 3 months postoperatively.

RESULTS

Total postoperative ocular spherical aberration at 6 mm pupil diameter for the entire population measured (0.015+/-0.056) microm [AO: (0.081+/-0.013) microm; IQ: (0.006+/-0.038) microm; Tecnis: (0.007+/-0.070) microm]. For the entire population, there was no significantly different between the predicted value and actual value of ocular spherical aberration at 6 mm pupil diameter: t=1.983, P=0.052 (AO:t=1.957, P=0.082; IQ: t=0.030, P=0.976; Tecnis: t=2.031, P=0.053). For the entire population, the predictive error measured (0.014+/-0.044) microm [AO: (0.006+/-0.012) microm; IQ: (-0.000+/-0.037) microm; Tecnis: (0.027+/-0.052) microm; F=2.626, P=0.082]. The postoperative visual activity was not significantly different among the three groups (P>0.05).

CONCLUSION

Customized selection of aspheric IOL based on preoperative corneal spherical aberration of patients is feasible and produces satisfactory target postoperative total spherical aberration.

摘要

目的

通过根据患者术前角膜球差选择最适配的非球面人工晶状体(IOL),分析选择性靶向术后总球差为零的可行性。

方法

这是一项前瞻性病例系列研究。术前1天使用iTrace视觉功能分析仪测量46例患者57只眼6mm孔径的角膜球差(Z40),设定目标术后总球差为零。因此,对于角膜球差<+0.100μm,选择Sofport Advanced Optic(AO)IOL(10只眼);对于角膜球差>+0.100μm但<+0.235μm,选择AcrySof IQ IOL(20只眼);对于角膜球差>+0.235μm,选择Tecnis ZA9003 IOL(27只眼)。经透明角膜3.2mm切口行超声乳化白内障吸除术后植入非球面IOL,无需缝合。术后3个月检查未矫正视力、最佳矫正视力(BCVA)、6mm瞳孔直径下全眼及眼内光学部分(IOL)的球差。采用方差分析和t检验分析术后3个月的数据。

结果

测量的全部人群6mm瞳孔直径下术后总眼球差为(0.015±0.056)μm [AO:(0.081±0.013)μm;IQ:(0.006±0.038)μm;Tecnis:(0.007±0.070)μm]。对于全部人群,6mm瞳孔直径下眼球差的预测值与实际值之间无显著差异:t = 1.983,P = 0.052(AO:t = 1.957,P = 0.082;IQ:t = 0.030,P = 0.976;Tecnis:t = 2.031,P = 0.053)。对于全部人群,测量的预测误差为(0.014±0.044)μm [AO:(0.00  6±0.012)μm;IQ:(-0.000±0.037)μm;Tecnis:(0.027±0.052)μm;F = 2.626,P = 0.082]。三组术后视觉活动无显著差异(P>0.05)。

结论

根据患者术前角膜球差定制选择非球面IOL是可行的,并且能产生令人满意的目标术后总球差。

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