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[摘要]
目的：探讨个性化植入非球面人工晶状体使全眼球差接近+0.1μm方法的可行性。
方法：对行白内障超声乳化人工晶状体植入术的患者74例82眼随机分为试验组和对照组，术前均应用Pentacam测量角膜球差，试验组以术后全眼球差尽量接近+0.1μm为原则植入TecnisZCB00、Hoya60AD、ADAPT-AO三种不同的非球面人工晶状体，对照组均植入ADAPT-AO非球面人工晶状体。术后3mo测量裸眼视力、最佳矫正视力、角膜球差和全眼球差。
结果：术后3mo两组患者间裸眼视力、最佳矫正视力对比差异无统计学意义(t=0.817、0.343，P>0.05)； 术前和术后的角膜球差对比两组均无统计学意义(t=0.688、0.592，P>0.05)； 试验组和对照组术后3mo全眼球差对比有统计学意义(t=5.408， P<0.05)； 试验组不同人工晶状体组间全眼球差术前预测值和术后实际值比较均无统计学意义(t=1.943、2.033、0.032，P>0.05)； 全眼球差预测偏差值与术前角膜球差呈正相关(r=0.834，P<0.05)。
结论：根据患者的角膜球差个性化地植入非球面人工晶状体可以达到有效降低全眼球差的目的，具有可行性。
[Key word]
[Abstract]
AIM: To analysis the feasibility of selectively targeting +0.1μm total spherical aberration by personalized aspheric intraocular lens implantation.
METHODS:Seventy-four cases(82 eyes)were randomly divided into experimental and control group, the corneal spherical aberration with 6mm pupil diameter was measured with Pentacam before surgery. Patients in experimental group received TecnisZCB00, Hoya60AD and ADAPT-AO, three different aspheric intraocular lenses, and the principle as the total spherical aberration close to +0.1μm. Patients in control group received ADAPT-AO aspheric intraocular lens. The uncorrected visual acuity, best corrected visual acuity, corneal spherical aberration and total spherical aberration were measured after 3mo.
RESULTS:There was no statistically significant difference in the uncorrected visual acuity, best corrected visual acuity between the two groups(t=0.817, 0.343, P>0.05). The comparison of corneal spherical aberration of the two groups showed no statistical significance before and after surgery(t=0.688, 0.592, P>0.05). The difference of total ocular aberrations were statistically significant between two groups(t=5.408,P<0.05). In the experimental group, there were no significant difference in total ocular aberrations among the different intraocular lens group between preoperative predictive value and postoperative value(t=1.943, 2.033, 0.032, P>0.05). The prediction error of total ocular aberrations were positively correlated with the preoperative corneal spherical aberration(r=0.834, P<0.05).
CONCLUSION:The personalized aspheric intraocular lens implantation based on preoperative corneal spherical aberration is feasible. This method can reduce postoperative total ocular aberrations and make the aberrations close to the predictive value.
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