Lian Hui-fang, Tang Xin, Song Hui
Clinical College of Ophthalmology, Tianjin Medical University, Tianjin Eye Hospital, Tianjin 300020, China.
Zhonghua Yan Ke Za Zhi. 2010 May;46(5):410-4.
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.
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.
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).
Customized selection of aspheric IOL based on preoperative corneal spherical aberration of patients is feasible and produces satisfactory target postoperative total spherical aberration.
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。
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。
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)。
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。