不同设计的人工晶状体的倾斜与偏心及其对调制解调函数的影响
发布时间：2018-09-07 10:37
【摘要】：目的：比较白内障超声乳化联合后房型人工晶状体(IOL)囊袋内植入后,不同IOL的倾斜度对调制解调函数(MTF)的影响。并比较一体式与三片式人工晶体的稳定性。 方法：回顾性系列病例研究。对单纯性白内障患者112例(112眼),年龄50-75岁。按照IOL类别分组分为负球差的ZA9003组、0球差的ADAPT-AO组和正球差的AR40E组,其中ZA9003组42例、ADAPT_AO组37例和AR40E组35例。术后2个月进行随访,散瞳至8mm后,用Pentcam眼前节成像系统采集Scheimpflug图像,分析IOL的倾斜度与偏心值,itrace采集5mm瞳孔下的各空间频率(5、10、15、20、25、30 c/d)MTF值。三组再根据倾斜度大小以0.5。为组距分为倾斜小、倾斜中和倾斜大3组,对倾斜度与偏心值进行Peason相关分析,3种IOL组间的倾斜度与偏心值之间、多个倾斜度组间及其所对应的空间频率为(5、10、15、20、25、30c/d)下的MTF采用单因素方差分析,3组1OL的倾斜对MTF影响用中心调整后的数值进行kolmogorov-smirnovz检验。3组不同球差的IOL在5mm瞳孔下不同空间频率的MTF值进行单因素方差分析。 对82例82眼单纯性白内障患者进行术后2月的随访。这些患者分别植入一体式IOL(PY-60AD,HOYA,)和三片式IOL(ZA9003,AMO).散瞳后,用眼前节成像系统Pentcam(oculus)采集各眼的Scheimpflug图像,用图像分析的方法得出IOL的倾斜度与偏心值。采用t检验对获得的数据进行统计学分析。 结果：所有IOL的倾斜与偏心无显著相关(r=0.183,,p=0.051).ZA9003、AR40组和ADAPT-AO组患者IOL的平均倾斜度分别为(0.93±0.71)。、(1.12±0.73)。(0.76±0.51)。；平均偏心值为(0.13±0.10)mm、(0.18±0.12)mm、(0.13±0.08)mm,3组差异均无统计学意义(P0.05)。ZA9003组小、中、大倾斜度组的平均倾斜度分别为(0.28±0.15)。、(0.78±0.12)。、(1.67±0.60)AR40E组内平均倾斜度(0.38±0.20)。、(0.71±0.12)。、(1.77±0.56)。；ADAPT-AO组内平均倾斜度(0.31±0.16)。、(0.66±0.17)。、(1.40±0.39)。,差异有统计学意义(p0.05)。ZA9003组小、中、大倾斜度组的平均偏心值为(0.09±0.05)mm、(0.11±0.08)mm、(0.16±0.12)mm:AR40E组平均值为(0.15±0.06)mm、(0.13±0.15)mm、(0.16±0.08)mm；ADAPT-AO组平均值为(0.13±0.06)mm、(0.14±0.15)mm、(0.13±0.08)mm,差异均无统计学意义(P0.05)；在5mm瞳孔下,ZA9003组、AR40E组及ADAPT-AO组各倾斜度组在在各空间频率下的MTF值差异均无统计学意义(P0.05)。ZA9003、AR40E与ADAPT-AO (?)顷斜大中小下的各空间频率的MTF值调整后比较,在小倾斜值组和中倾斜值组之间三组之间在各空间频率下差异均无统计学差异(P0.05),在大倾斜值组只有在空间频率为20、25(c/d)时3种IOL之间差异有统计学意义(P0.05),其他空间频率下差异均无统计学差异(P0.05)；其中,ZA9003组与AR40E和ADAPT-AO之间差异均有统计学意义(P0.05),而AR40AE组与ADAPT-AO组之间差异无统计学意义(P0.05)。ZA9003、AR40E与ADAPT-AO在5mm瞳孔下各空间频率下的MTF差异均有统计学意义；其中ZA9003与AR40E和ADAPT-AO之间均有统计学差异,AR40E与ADAPT-AO之间均无统计学差异。 大瞳孔下PY-60AD与ZA90032组患者IOL的平均倾斜值分别为(0.81±0.62)、(0.93±0.71),其差异无统计学意义(P=0.478),平均偏心值为(0.11±0.09)、(0.13±0.10).其差异无统计学意义(P=0.637)。 结论：在现在的手术技术条件下,对大倾斜度所造成的视觉质量改变在一些空间频率下负球差IOL比球差和O球差的IOL敏感,0球差与正球差之间具有相似的敏感性。但是,无论是球面还是非球面的IOL的倾斜不足以引起人眼视觉质量的明显改变。一体式与三片式IOL囊袋内植入术后在大瞳孔下均具有相似的稳定性。
[Abstract]:Objective: To compare the effects of different IOL inclination on the modulation-demodulation function (MTF) after cataract phacoemulsification combined with posterior chamber intraocular lens (IOL) implantation in capsular bag, and to compare the stability of monolithic and Trilithic IOL.
Methods: A retrospective series of case studies was conducted in 112 patients (112 eyes) with simple cataract aged 50-75 years. They were divided into ZA9003 group with negative spherical aberration, ADAPT-AO group with zero spherical aberration and AR40E group with positive spherical aberration, including 42 cases in ZA9003 group, 37 cases in ADAPT-AO group and 35 cases in AR40E group. Scheimpflug images were collected by anterior segment imaging system, and the inclination and eccentricity of IOL were analyzed. The MTF values of spatial frequencies (5,10,15,20,25,30 c/d) under 5 mm pupil were collected by itrace. The three groups were divided into three groups according to the inclination of 0.5. The MTF values between tilt and eccentricity were analyzed by one-way ANOVA, and the effects of tilt on MTF were examined by Kolmogorov-smirnovz test with center-adjusted values. The MTF values of three groups of IOLs with different spherical aberrations at different spatial frequencies were entered at 5 mm pupils. One way ANOVA was used.
Eighty-two eyes of 82 patients with simple cataract were followed up for 2 months after operation. All patients were implanted with integrated IOL (PY-60AD, HOYA,) and three-slice IOL (ZA9003, AMO). After mydriasis, Scheimpflug images of each eye were collected by Pentcam (oculus) imaging system. The tilt and eccentricity of IOL were obtained by image analysis. The data obtained were statistically analyzed.
Results: There was no significant correlation between IOL tilt and eccentricity (r = 0.183, P = 0.051). ZA9003, AR40 and ADAPT-AO groups had no significant difference (P 0.05). The mean inclination of the ADAPT-AO group was (0.28.15), (0.78.12), (1.67.60) the mean inclination of the AR40E group was (0.38.20), (0.71.12), (1.77.56)., and (0.31.16), (0.66.17, (1.40.39). The difference was statistically significant (p0.05). The mean inclination of the ADAPT-AO group was (0.40.39). The The mean values of AR40E group were (0.15 + 0.06) mm, (0.15 + 0.06) mm, (0.13 + 0.15) mm, (0.16 + 0.15) mm, (0.16 + 0.08) mm, (0.16 + 0.08) mm, (0.16 + 0.08) mm, (0.09 + 0.05) mm, (0.11 + 0.08) mm, (0.11 + 0.08) mm, (0.16 + 0.12) mm: AR40E group was (0.15 + 0.06) mm, (0.15 + 0.06) mm, (0.16 + 0.08) mm, (0.14 + 0.15 mm, (0.13 + 0.15) mm, (0.13 + 0.08) mm, Groups of inclination groups in each space There was no significant difference in MTF values among different frequencies (P 0.05). ZA9003, AR40E and ADAPT-AO (?) were used to adjust the MTF values of different spatial frequencies. There was no significant difference among the three groups at different spatial frequencies (P 0.05). At 25 (c/d), there were significant differences among the three IOLs (P 0.05), and no significant differences in other spatial frequencies (P 0.05); among them, there were significant differences between ZA9003 group and AR40E and ADAPT-AO group (P 0.05), but there was no significant difference between AR40AE group and ADAPT-AO group (P 0.05). ZA9003, AR40E and ADAPT-AO were all empty under 5 mm pupil. The MTF of ZA9003 and AR40E were significantly different from that of ADAPT-AO, and there was no significant difference between AR40E and ADAPT-AO.
The mean IOL tilt values of PY-60AD and ZA90032 groups were (0.81.62), (0.93.71), respectively, with no significant difference (P = 0.478), and the mean eccentricity was (0.11.09), (0.13.10). There was no significant difference (P = 0.637).
CONCLUSIONS: Under current surgical conditions, the visual quality changes caused by high tilt are more sensitive to negative IOL than to spherical IOL and O spherical IOL at some spatial frequencies, and there is a similar sensitivity between zero spherical IOL and positive spherical IOL. Obvious changes. The integration and three slice IOL bag implantation have similar stability in the large pupil.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R779.6
本文编号：2228020
[Abstract]:Objective: To compare the effects of different IOL inclination on the modulation-demodulation function (MTF) after cataract phacoemulsification combined with posterior chamber intraocular lens (IOL) implantation in capsular bag, and to compare the stability of monolithic and Trilithic IOL.
Methods: A retrospective series of case studies was conducted in 112 patients (112 eyes) with simple cataract aged 50-75 years. They were divided into ZA9003 group with negative spherical aberration, ADAPT-AO group with zero spherical aberration and AR40E group with positive spherical aberration, including 42 cases in ZA9003 group, 37 cases in ADAPT-AO group and 35 cases in AR40E group. Scheimpflug images were collected by anterior segment imaging system, and the inclination and eccentricity of IOL were analyzed. The MTF values of spatial frequencies (5,10,15,20,25,30 c/d) under 5 mm pupil were collected by itrace. The three groups were divided into three groups according to the inclination of 0.5. The MTF values between tilt and eccentricity were analyzed by one-way ANOVA, and the effects of tilt on MTF were examined by Kolmogorov-smirnovz test with center-adjusted values. The MTF values of three groups of IOLs with different spherical aberrations at different spatial frequencies were entered at 5 mm pupils. One way ANOVA was used.
Eighty-two eyes of 82 patients with simple cataract were followed up for 2 months after operation. All patients were implanted with integrated IOL (PY-60AD, HOYA,) and three-slice IOL (ZA9003, AMO). After mydriasis, Scheimpflug images of each eye were collected by Pentcam (oculus) imaging system. The tilt and eccentricity of IOL were obtained by image analysis. The data obtained were statistically analyzed.
Results: There was no significant correlation between IOL tilt and eccentricity (r = 0.183, P = 0.051). ZA9003, AR40 and ADAPT-AO groups had no significant difference (P 0.05). The mean inclination of the ADAPT-AO group was (0.28.15), (0.78.12), (1.67.60) the mean inclination of the AR40E group was (0.38.20), (0.71.12), (1.77.56)., and (0.31.16), (0.66.17, (1.40.39). The difference was statistically significant (p0.05). The mean inclination of the ADAPT-AO group was (0.40.39). The The mean values of AR40E group were (0.15 + 0.06) mm, (0.15 + 0.06) mm, (0.13 + 0.15) mm, (0.16 + 0.15) mm, (0.16 + 0.08) mm, (0.16 + 0.08) mm, (0.16 + 0.08) mm, (0.09 + 0.05) mm, (0.11 + 0.08) mm, (0.11 + 0.08) mm, (0.16 + 0.12) mm: AR40E group was (0.15 + 0.06) mm, (0.15 + 0.06) mm, (0.16 + 0.08) mm, (0.14 + 0.15 mm, (0.13 + 0.15) mm, (0.13 + 0.08) mm, Groups of inclination groups in each space There was no significant difference in MTF values among different frequencies (P 0.05). ZA9003, AR40E and ADAPT-AO (?) were used to adjust the MTF values of different spatial frequencies. There was no significant difference among the three groups at different spatial frequencies (P 0.05). At 25 (c/d), there were significant differences among the three IOLs (P 0.05), and no significant differences in other spatial frequencies (P 0.05); among them, there were significant differences between ZA9003 group and AR40E and ADAPT-AO group (P 0.05), but there was no significant difference between AR40AE group and ADAPT-AO group (P 0.05). ZA9003, AR40E and ADAPT-AO were all empty under 5 mm pupil. The MTF of ZA9003 and AR40E were significantly different from that of ADAPT-AO, and there was no significant difference between AR40E and ADAPT-AO.
The mean IOL tilt values of PY-60AD and ZA90032 groups were (0.81.62), (0.93.71), respectively, with no significant difference (P = 0.478), and the mean eccentricity was (0.11.09), (0.13.10). There was no significant difference (P = 0.637).
CONCLUSIONS: Under current surgical conditions, the visual quality changes caused by high tilt are more sensitive to negative IOL than to spherical IOL and O spherical IOL at some spatial frequencies, and there is a similar sensitivity between zero spherical IOL and positive spherical IOL. Obvious changes. The integration and three slice IOL bag implantation have similar stability in the large pupil.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R779.6
【参考文献】
相关期刊论文 前3条
1 朱海丰;方志良;刘永基;;人工晶体倾斜与偏心对人眼视功能的影响[J];光子学报;2008年01期
2 张钰,郝燕生,王薇;超声乳化白内障吸除联合人工晶状体植入术后波阵面像差变化的研究[J];眼科;2005年01期
3 方艳文;卢奕;汪琳;;折叠式人工晶状体囊袋内植入后偏心与倾斜的临床研究[J];眼视光学杂志;2008年04期
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