目的：观察不同角膜球差患者植入相同非球面IOL后的视力及对比敏感度，探讨白内障术后不同全眼球差对视觉质量的影响。

方法：前瞻性病例系列研究。收集在我院就诊拟行手术治疗的年龄相关性白内障患者39例46眼。依据术前角膜球差将患眼分为3组。角膜球差≤0.2μm者为A组，～0.3μm者为B组，>0.3μm者为C组。所有患者均行白内障超声乳化吸除联合ArcySof IQ非球面IOL植入术。术后3mo观察患者的裸眼视力(uncorrected visual acuity， UCVA)、最佳矫正视力(best-corrected visual acuity， BCVA)、对比敏感度及6.0mm瞳孔直径下的全眼高阶像差。采用方差分析对获得的数据进行统计学分析。

结果：术后3mo，3组患者的裸眼视力、最佳矫正视力差异无统计学意义(P=0.287，0.115)。对比敏感度在不同亮度背景下、不同空间频率差异均无统计学意义(P>0.05)。术后6.0mm瞳孔直径全眼总高阶像差均方根A组与B组小于C组，差异有统计学意义(P=0.000)。3组间球差差异有统计学意义(P=0.000)，彗差及三叶草差异无统计学意义(P=0.788，0.590)。

结论：不同角膜球差患者植入相同非球面IOL后的视力及对比敏感度相似。白内障术后全眼球差的少量差异对视觉质量无明显影响。

AIM: To compare the visual acuity and contrast sensitivity of eyes with different corneal spherical aberration implanted with the same aspherical IOL and evaluate the effect of different ocular spherical aberration on visual performance after phacoemulsification.

METHODS: It was a prospective case series study. Forty-six eyes of thirty-nine age-related cataract patients in our department were included. The patients were divided into 3 groups according to the value of preoperative corneal spherical aberration. Eyes with corneal spherical aberration≤0.2μm were assigned to group A, those with corneal spherical aberration >0.2μm and ≤0.3μm to group B, and those with corneal spherical aberration ≥0.3μm to group C. All patients underwent phacoemulcification and recieved AcrySof IQ aspheric IOL. Uncorrected visual acuity(UCVA), best-corrected visual acuity(BCVA), contrast sensitivity, and total ocular higher-order aberrations for a 6.0mm pupil were recorded 3mo postoperatively. ANOVA were used to analyze the data.

RESULTS: There were no significant differences in UCVA and BCVA between the 3 groups(P=0.287, 0.115). Contrast sensitivity was no statistically significant difference between the 3 groups at any spatial frequency under photopic、mesopic, and mesopic with glare conditions(P>0.05). With a 6.0mm pupil diameter, root mean square values for total ocular higher-order aberrations were lower in groups A and B than that in group C(P=0.000). The difference of total ocular spherical aberration was statistically significant between the 3 groups(P=0.000).Coma and trefoil were similar between the groups(P=0.788,0.590), with no statistically significant differences.

CONCLUSION: Implantation of the same aspherical IOL in eyes with different corneal spherical aberration results in similar visual acuity and contrast sensitivity. Small differences of ocular spherical aberration after phacoemulsification have no effect on visual performance.

河北省卫生厅科研基金项目(No.20120216)