[关键词]
[摘要]
随着白内障手术技术和人工晶状体(intraocular lens,IOL)的不断发展,IOL植入术后视觉质量的评估成为了研究热点,而像差正是影响视觉质量的重要因素。IOL经过了60多年的发展,在光学设计上做出了很大改进,由于传统的球面IOL具有正球差,不能矫正正常人角膜存在的正球差,因此改良为具有负球差、零球差的非球面IOL,前者可矫正角膜正球差、提高对比敏感度、改善视觉质量,但如果光学位置不匹配,将形成对视觉效果影响更大的其他高阶像差; 后者虽然对偏中心和偏位有很好的耐受性,但仍不能抵消来自角膜的正像差。非恒定像差IOL的问世为白内障医生解决这一问题提供了新途径。本文拟对像差的概念、不同种类非球面IOL的设计原理及优缺点、非恒定像差非球面IOL的临床应用效果观察等方面进行阐述。
[Key word]
[Abstract]
With the continuous development of cataract surgery and intraocular lens(IOL), the evaluation of visual quality after IOL implantation has become a research hotspot, and aberration is an important factor that affecting visual quality. After more than 60y of development, IOL has made great improvement in optical design. Due to the fact that conventional spherical IOL has a positive spherical aberration and cannot correct the positive spherical aberration existing in the normal human cornea, it is improved to an aspherical IOL having a negative spherical aberration and a zero spherical aberration. The former can correct the cornea positive spherical aberration, improve the contrast sensitivity and improve visual quality. However, if the optical position does not match, the formation of other higher-order aberrations will have greater impact on visual effects. Although the latter is well tolerated to tilt and decentration, it still cannot compensate for the positive aberration from the cornea. The advent of the non-constant aberration IOL provides a new way for cataract surgeons to solve this problem. In this paper, the concept of aberration, the design principle and advantages and disadvantages of different kinds of aspheric IOL, as well as the observation of clinical application effect of non-constant aberration aspheric IOL are discussed.
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