目的：观察有晶状体眼的人工晶状体植入术(ICL)术后在不同瞳孔直径状态下晶状体拱高的变化及视觉质量相关分析。

方法：回顾性病例研究。选取2018-01/2019-01在上海爱尔眼科医院行V4c型ICL植入手术顺利并按期随访满足测量要求的患者43例86眼。术前，术后1wk，1、3mo行常规参数和iTrace检测，Visante-OCT行3mm和5mm瞳孔下的晶状体拱高测量。

结果：术后1wk，1、3mo在3mm瞳孔下的拱高为586.06±24.49、560.16±21.31、508.19±21.17μm，5mm瞳孔下的拱高分别是698.13±20.98、667.69±20.16、613.28±19.79μm(F_时间=40.160，P_时间<0.001； F_组间=56.835，P_组间<0.001)。3次的大、小瞳下的拱高差值分别为112.06±8.91、107.53±6.94、101.01±10.64μm(F=16.875，P>0.05)。术后全眼总高阶像差和RMS值明显降低，与术前相比有显著性差异(F=29.847、85.019，均P<0.001)； 术后3次均值之间无差异。MTF值和SR值术后较术前明显升高(F=47.653、33.264，均P<0.001)，术后3次均值间无差异。术后3mo，在≥5mm瞳孔下总高阶像差的RMS值较≤3mm时明显增加，球差和三叶草差的增加显著(t=21.812、17.136，均P<0.001)，彗差RMS值无明显差异(t=2.028，P>0.05)； ≥5mm瞳孔下的MTF值在5、10、15、20、25、30c/d的空间频率下均较≤3mm时明显降低(t=15.138、9.147、7.018、4.693、3.814、3.075，均P<0.05)。

结论：ICL术后瞳孔活动对拱高波动造成的影响约110μm。建议术后拱高低值在300μm以上，仅供参考。ICL植入术后能显著降低全眼总高阶像差和像差的均方根值，明显提升MTF和SR值。ICL术后瞳孔大小对视觉质量有明显影响，大瞳状态下球差和三叶草差增大，MTF值普遍降低。

METHODS: Retrospective case study. Selected 43 patients(86 eyes)who implanted V4c ICL surgery successfully at Shanghai Aier Eye Hospital and followed up regularly to meet the measurement requirements from January 2018 to January 2019, Routine parameters and iTrace were checked before and 1wk, 1mo, and 3mo after surgery. Visante-OCT was used to measure the vault height under the pupils of 3mm and 5mm.

RESULTS: The vault height under the 3mm pupil at 1wk, 1mo and 3mo after surgery were(586.06±24.49, 560.16±21.31, 508.19±21.17)μm, the values under the 5mm pupil were(698.13±20.98, 667.69±20.16, 613.28±19.79)μm(F_Time=40.160,P_Time<0.001; F_Groups=56.835,P_Groups<0.001). The wave of vaule under the different pupils was(112.06±8.91, 107.53±6.94,101.01±10.64)μm(F=16.875, P>0.05). The total high-order aberration(HOA)and RMS of the whole eye after ICL were significantly reduced(F=29.847, 85.019; P<0.001). The MTF and SR value were significantly higher than before surgery(F=47.653, 33.264; P<0.001), and there was no statistical difference after ICL. At 3mo after surgery, the RMS and MTF values at 3mm and 5mm pupils were compared. The RMS value of the total HOA under the pupil of 5mm is significantly higher than that at 3mm, and the increase of spherical and trefoil aberration is significant(t=21.812, 17.136; P<0.001). No significant difference in coma value(t=2.028, P>0.05). The MTF at 5mm pupils were significantly lower than those at 3mm at spatial frequencies of 5, 10, 15, 20, 25, 30c/d(t=15.138, 9.147, 7.018, 4.693, 3.814 and 3.075, all P<0.05).

CONCLUSION: The impact of pupil movement on vault height fluctuation is about 110μm. It is recommended that the minimum vault height should be above 300μm. It can significantly reduce the root mean square value of total high-order aberration and aberration of the whole eye, and significantly increase the MTF and SR values after ICL surgery. The pupil size has a significant effect on visual quality after ICL. The spherical aberration and trefoil aberration increase under the condition of large pupil, and the MTF value generally decreases.