定制非球面人工晶状体植入的临床研究
Clinical study of customized aspherical intraocular lens implants.
作者信息
Jia Lie-Xi, Li Zhao-Hui
机构信息
Department of Ophthalmology, Chinese PLA General Hospital, Beijing 100853, China.
出版信息
Int J Ophthalmol. 2014 Oct 18;7(5):816-21. doi: 10.3980/j.issn.2222-3959.2014.05.14. eCollection 2014.
AIM
To compare if there is an improvement in visual functions with age-related cataracts between patients receiving a aspherical intraocular lens (IOL) based on corneal wavefront aberration and patients randomly assigned lenses.
METHODS
A total of 124 eyes of 124 patients with age-related cataracts were placed in experimental group and a group receiving randomly assigned (RA) lenses. The experimental group was undergone Pentacam corneal spherical aberration measurement before surgery; the targeted range for residual total spherical aberration after surgery was set to 0-0.3 µm. Patients with a corneal spherical aberration <0.3 µm were implanted with a zero-spherical aberration advanced optics (AO) aspherical IOL and patients with an aberration ≥0.3 µm received a Tecnis Z9003 aspherical lens in experimental group. RA patients were randomly implanted with an AO lens or a Tecnis Z9003 lens. Three months after surgery total spherical aberration, photopic/mesopic contrast sensitivities, photopic/mesopic with glare contrast sensitivities, and logMAR vision were measured.
RESULTS
Statistical analysis on logMAR vision showed no significant difference between two groups (P=0.413). The post-surgical total spherical aberration was 0.126±0.097 µm and 0.152±0.151 µm in the experimental and RA groups, respectively (P=0.12). The mesopic contrast sensitivities at spatial frequencies of 6, 12 and 18 c/d in the experimental group were significantly higher than of the RA group (P=0.00; P=0.04; P=0.02). The mesopic with glare contrast sensitivity in the experimental group at a spatial frequency of 18 c/d was also significantly higher vs the RA group (P=0.01).
CONCLUSION
Pre-surgical corneal spherical aberration measurement in cataract patients followed by customized selection of aspherical IOL implants improved mesopic contrast sensitivities at high spatial frequencies, and thus is a superior strategy compared to the random selection of aspherical IOL implants.
目的
比较基于角膜波前像差植入非球面人工晶状体（IOL）的年龄相关性白内障患者与随机分配晶状体的患者之间视觉功能是否有所改善。
方法
将124例年龄相关性白内障患者的124只眼分为实验组和随机分配（RA）晶状体组。实验组在手术前进行Pentacam角膜球差测量；设定术后残余总球差的目标范围为0 - 0.3 µm。角膜球差<0.3 µm的患者植入零球差高级光学（AO）非球面IOL，角膜球差≥0.3 µm的患者在实验组接受Tecnis Z9003非球面晶状体。RA组患者随机植入AO晶状体或Tecnis Z9003晶状体。术后三个月测量总球差、明视/间视对比敏感度、有眩光时的明视/间视对比敏感度和logMAR视力。
结果
logMAR视力的统计分析显示两组之间无显著差异（P = 0.413）。实验组和RA组术后总球差分别为0.126±0.097 µm和0.152±0.151 µm（P = 0.12）。实验组在空间频率为6、12和18 c/d时的间视对比敏感度显著高于RA组（P = 0.00；P = 0.04；P = 0.02）。实验组在空间频率为18 c/d时有眩光时的间视对比敏感度也显著高于RA组（P = 0.01）。
结论
白内障患者术前进行角膜球差测量，然后定制选择非球面IOL植入物，可提高高空间频率下的间视对比敏感度，因此与随机选择非球面IOL植入物相比是一种更优的策略。
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