非球面人工晶状体囊袋内植入后的倾斜和偏心及视觉质量的研究
发布时间：2018-10-24 22:42
【摘要】：目的： 用Pentacam三维眼前节分析系统测量非球面人工晶状体(intraocular lens,IOL)囊袋内植入后的倾斜和偏心及其对高阶像差(higher-order aberration, HOA)和视觉质量的影响。 方法： 1、选择年龄相关性白内障患者90例(120眼),行超声乳化白内障吸除术,随机植入非球面IOL Tecnis ZA9003(30只眼)、Acrysoft IQ(30只眼)以及Akreos AO(30只眼)；球面IOL AR40e(30只眼)。用Pentacam三维眼前节分析系统测量四组术后1周、1月和3月IOL的倾斜和偏心。 2、取50例单纯性老年性白内障患者60只眼,30只眼随机植入AMO公司的球面IOL SensarAR40e,30只眼植入非球面IOL Tecnis ZA9003。术后3到4个月,检测患者在5.0mm瞳孔下的HOA以及5、10、15、20、25、30周每度(cycles per degree, cpd)空间频率下的调制传递函数(modulation transfer function, MTF)。通过Scheimpflug像,测量IOL的倾斜与偏心。比较两组间倾斜度和偏心值、HOA及各空间频率下去除低阶像差的MTF (MTF(HOA))值。使用多元回归分析来确定倾斜和偏心对HOA和视觉质量的影响。 结果： 1、ZA9003组、IQ组、AO组和AR40e组,四组组内在术后1周、1月、3月不同随访时间的倾斜度,差异都无统计学意义(P0.05)。四组组间在不同随访时间的倾斜度,差异也都无统计学意义(P0.05)；四组组内在不同随访时间的偏心量,差异都无统计学意义(P＞0.05)。四组组间在不同随访时间的偏心量,均表现出AO组和ZA9003组、IQ组、AR40e组差异有统计学差异(F=6.391,4.265,7.692; P=0.021,0.030,0.011). ZA9003组、IQ组、AR40e组两两之间无统计学差异(P0.05)； 2、光学部倾斜AR40e组(2.99+0.94)°, ZA9003组(2.98+1.15)°。光学部偏心AR40e组(0.30±0.13)mm, ZA9003组(0.31±0.14)mm。组间倾斜和偏心差异无统计学意义(t=-0.044,-0.525, P=0.965,0.600);总球差,AR40e组(0.366±0.163)μm大于ZA9003组(0.027±0.032)μm,差异有统计学意义(t=-10.386, P=0.000); ZA9003组在5mm瞳孔直径下各频段的MTF(HOA)值均高于AR40e组,差异有统计学意义(P0.05)；两组IOL倾斜和偏心对各自的HOA及各频段的MTF(HOA)值均无明显影响。 结论： 1、Pentacam三维眼前节分析系统可以动态观察并评价IOL在眼内的位置；一片式软袢IQ非球面IOL具有与三片式硬袢ZA9003非球面IOL相似的良好囊袋稳定性；四襻式非球面IOL AO的眼内偏心稳定性可能好于两袢式非球面IOL ZA9003、IQ; 2、在正常条件下,白内障超声乳化联合IOL植入术后球面IOL AR40e和非球面IOL ZA9003的倾斜度和偏心量是很小的；当IOL的倾斜和偏心在正常限度内时,不会危害非球面IOL对球差的补偿作用,不足以导致视觉质量的下降。
[Abstract]:Aim: to measure the inclination and eccentricity of aspherical intraocular lens (intraocular lens,IOL) after implantation into the capsular bag and its effect on higher order aberration (higher-order aberration, HOA) and visual quality by using Pentacam three-dimensional anterior segment analysis system. Methods: 1. 90 patients (120 eyes) with age-related cataract underwent phacoemulsification cataract extraction, and 30 eyes of aspherical IOL Tecnis ZA9003 (30 eyes of), Acrysoft IQ (and 30 eyes of Akreos AO () and 30 eyes of spherical IOL AR40e (30 eyes) were randomly implanted with aspherical IOL Tecnis ZA9003 (30 eyes) and Akreos AO (30 eyes). The tilt and eccentricity of IOL in four groups were measured by Pentacam three-dimensional anterior segment analysis system at 1 week, 1 month and 3 months after operation. 60 eyes of 50 patients with simple senile cataract and 30 eyes were randomly implanted with spherical IOL SensarAR40e,30 of AMO Company. Ocular aspherical IOL Tecnis ZA9003. implantation From 3 to 4 months after operation, the modulation transfer function (modulation transfer function, MTF).) was measured under the pupil of 5.0mm and at the spatial frequency of (cycles per degree, cpd) at the spatial frequency of 510101520 / 2530 weeks. The tilt and eccentricity of IOL are measured by Scheimpflug images. The slope, eccentricity, HOA and the MTF (HOA) value of removing low order aberration at different spatial frequencies were compared between the two groups. Multiple regression analysis was used to determine the effects of tilt and eccentricity on HOA and visual quality. Results: 1 the inclination of ZA9003 group, IQ group, AO group and AR40e group were not significantly different between the four groups in 1 week, 1 month and 3 months after operation (P0.05). The inclination of the four groups in different follow-up time, the difference was not statistically significant (P0.05); in the four groups in different follow-up time eccentric, there was no significant difference (P > 0.05). The eccentricity of the four groups at different follow-up time showed significant difference between AO group, ZA9003 group, IQ group and AR40e group (F _ (6.391) 4.265 ~ 7.692; P _ (0.021) 0.030 ~ 0.011). There was no significant difference between the ZA9003 group, IQ group and AR40e group (P0.05), 2, the optical partial tilting AR40e group (2.99 0.94) 掳, the ZA9003 group (2.98 1.15) 掳. Optical eccentric AR40e group (0.30 卤0.13) mm, ZA9003 group (0.31 卤0.14) mm. There was no significant difference in tilting and eccentricity between groups (t0. 04 ~ 0. 525, P = 0. 965 ~ 0. 600), total spherical aberration in AR40e group (0.366 卤0.163) 渭 m was significantly higher than that in ZA9003 group (0.027 卤0.032) 渭 m (t = 10. 386, P < 0. 000), MTF (HOA) value in 5mm pupil diameter in ZA9003 group was higher than that in AR40e group (P0.05). IOL tilt and eccentricity had no significant effect on HOA and MTF (HOA) values of each frequency band. Conclusion: 1 Pentacam three-dimensional anterior segment analysis system can dynamically observe and evaluate the position of IOL in the eye, one piece of soft loop IQ aspherical IOL has good bag stability similar to that of ZA9003 aspheric IOL. The intraocular eccentricity stability of four-loop aspheric IOL AO may be better than that of two-loop aspherical IOL ZA9003,IQ; _ 2. Under normal conditions, the inclination and eccentricity of spherical IOL AR40e and aspheric IOL ZA9003 after phacoemulsification combined with IOL implantation are very small. When the tilt and eccentricity of IOL are within the normal limit, it will not harm the compensation effect of aspheric IOL to spherical aberration, which is not enough to cause the decline of visual quality.
【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：2292784
[Abstract]:Aim: to measure the inclination and eccentricity of aspherical intraocular lens (intraocular lens,IOL) after implantation into the capsular bag and its effect on higher order aberration (higher-order aberration, HOA) and visual quality by using Pentacam three-dimensional anterior segment analysis system. Methods: 1. 90 patients (120 eyes) with age-related cataract underwent phacoemulsification cataract extraction, and 30 eyes of aspherical IOL Tecnis ZA9003 (30 eyes of), Acrysoft IQ (and 30 eyes of Akreos AO () and 30 eyes of spherical IOL AR40e (30 eyes) were randomly implanted with aspherical IOL Tecnis ZA9003 (30 eyes) and Akreos AO (30 eyes). The tilt and eccentricity of IOL in four groups were measured by Pentacam three-dimensional anterior segment analysis system at 1 week, 1 month and 3 months after operation. 60 eyes of 50 patients with simple senile cataract and 30 eyes were randomly implanted with spherical IOL SensarAR40e,30 of AMO Company. Ocular aspherical IOL Tecnis ZA9003. implantation From 3 to 4 months after operation, the modulation transfer function (modulation transfer function, MTF).) was measured under the pupil of 5.0mm and at the spatial frequency of (cycles per degree, cpd) at the spatial frequency of 510101520 / 2530 weeks. The tilt and eccentricity of IOL are measured by Scheimpflug images. The slope, eccentricity, HOA and the MTF (HOA) value of removing low order aberration at different spatial frequencies were compared between the two groups. Multiple regression analysis was used to determine the effects of tilt and eccentricity on HOA and visual quality. Results: 1 the inclination of ZA9003 group, IQ group, AO group and AR40e group were not significantly different between the four groups in 1 week, 1 month and 3 months after operation (P0.05). The inclination of the four groups in different follow-up time, the difference was not statistically significant (P0.05); in the four groups in different follow-up time eccentric, there was no significant difference (P > 0.05). The eccentricity of the four groups at different follow-up time showed significant difference between AO group, ZA9003 group, IQ group and AR40e group (F _ (6.391) 4.265 ~ 7.692; P _ (0.021) 0.030 ~ 0.011). There was no significant difference between the ZA9003 group, IQ group and AR40e group (P0.05), 2, the optical partial tilting AR40e group (2.99 0.94) 掳, the ZA9003 group (2.98 1.15) 掳. Optical eccentric AR40e group (0.30 卤0.13) mm, ZA9003 group (0.31 卤0.14) mm. There was no significant difference in tilting and eccentricity between groups (t0. 04 ~ 0. 525, P = 0. 965 ~ 0. 600), total spherical aberration in AR40e group (0.366 卤0.163) 渭 m was significantly higher than that in ZA9003 group (0.027 卤0.032) 渭 m (t = 10. 386, P < 0. 000), MTF (HOA) value in 5mm pupil diameter in ZA9003 group was higher than that in AR40e group (P0.05). IOL tilt and eccentricity had no significant effect on HOA and MTF (HOA) values of each frequency band. Conclusion: 1 Pentacam three-dimensional anterior segment analysis system can dynamically observe and evaluate the position of IOL in the eye, one piece of soft loop IQ aspherical IOL has good bag stability similar to that of ZA9003 aspheric IOL. The intraocular eccentricity stability of four-loop aspheric IOL AO may be better than that of two-loop aspherical IOL ZA9003,IQ; _ 2. Under normal conditions, the inclination and eccentricity of spherical IOL AR40e and aspheric IOL ZA9003 after phacoemulsification combined with IOL implantation are very small. When the tilt and eccentricity of IOL are within the normal limit, it will not harm the compensation effect of aspheric IOL to spherical aberration, which is not enough to cause the decline of visual quality.
【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 宋黎;朱思泉;;非球面人工晶状体的临床研究进展[J];国际眼科纵览;2006年01期
2 宋旭东;郭佳;;如何理解和选择非球面人工晶状体[J];眼科;2007年02期
3 吕秀芳;杨浩江;楼定华;;晶状体乳化吸出非球面人工晶状体植入术后视觉质量的临床研究[J];眼外伤职业眼病杂志(附眼科手术);2007年05期
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