摘要
目的探讨IOL Alpha角对连续视程人工晶体(extended depth-of-field intraocular lens,EDOF IOL)植入术后视觉质量的影响。方法选取行白内障超声乳化联合EDOF IOLs植入术的年龄相关性白内障患者50例(50只眼)。采用OPD-ScanⅢ像差分析仪的日-夜瞳孔测量系统,得到人工晶状体(intraocular len,IOL)植入术后Alpha角,根据光学路径差扫描仪Ⅲ(Optical Path Difference ScanⅢ,OPD ScanⅢ)测量术后IOL Alpha角大小分为3组:A组19只眼(0 mm<Alpha角≤0.2 mm),B组19只眼(0.2 mm<Alpha角≤0.4 mm),C组12只眼(Alpha角>0.4 mm)。采用OPD-ScanⅢ像差分析仪检测术前Alpha角;术后3个月检测裸眼远视力(uncorrected distance visual acuity,UDVA),OPD-ScanⅢ测量EDOF IOLs植入眼的客观视觉质量,包括眼内高阶像差(higher-order aberrations,HOA)、斯特列尔比(strehl ratio,SR)、全眼HOA、彗差(Coma)、三叶草像差(Trefoil)并进行比较分析。采用视功能指数量表-14(visual function index,VF-14)评估患者的视功能。结果术前Alpha角与IOL Alpha角差异不具有统计学意义(t=0.11,P=0.915)。经Pearson相关性分析,术前Alpha角与IOL Alpha角之间呈正相关(r=0.983,P<0.001)。IOL Alpha角三组间UDVA、眼内HOA、SR、全眼HOA、Coma、Trefoil差异都具有统计学意义(P均<0.05)。眼内HOA、SR值及Coma值组间两两比较均有统计学差异(P均<0.05);Trefoil值及全眼HOA值仅在A组与C组之间差异具有统计学意义(P=0.030,P=0.001)。VF-14问卷调查显示A、B、C组眩光或光晕的发病率分别为47.4%(9/19)、68.4%(13/19)和100%(12/12),差异具有统计学意义(χ^(2)=9.365,P=0.009)。结论IOL Alpha角可反映IOL居中性及在眼内的实际状态,其不仅影响术后患者视觉质量、反映其术后实际视觉效果,较大的IOL Alpha角还会增加术后眩光、光晕发生率,进而影响患者生活质量。
Objective To study the effect of the IOL Alpha angle on visual quality following the implantation of the EDOF IOL(ZXR00).Methods A total of 50 cases(50 eyes)that underwent phacoemulsification combined with EDOF IOL implantation were included in the study.Preoperative and IOL Alpha angle assessments were conducted using the OPD ScanⅢwavefront aber-rometer.The study eyes were then categorized into three distinct groups based on the IOL Alpha angle values ascertained:Group A(19 eyes,0 mm<Alpha angle≤0.2 mm),Group B(19 eyes,0.2 mm<Alpha angle≤0.4 mm),and Group C(12 eyes,Alpha angle>0.4 mm).UDVA was recorded three months postoperatively.The OPD ScanⅢwas employed to evaluate intraocular aberra-tions,including SR,total HOA,Coma and Trefoil.The assessment of photic phenomena were conducted utilising the Visual Func-tioning Index-14.Results The preoperative and IOL Alpha angle were no statistically significant difference(t=0.11,P=0.915).Pearson correlation analysis revealed a significant positive correlation between the preoperative and the IOL Alpha angle(r=0.983,P<0.001).The differences in UDVA,intraocular aberration,SR,total HOA,Coma and Trefoil values among the three groups were statistically significant(all P<0.05).Statistically significant differences in intraocular aberrations were observed in pairwise comparisons among groups(all P<0.05).A statistically significant difference in Trefoil values was found between Group A and Group C(P=0.030),as well as in total HOA values between these two groups(P=0.001).The results of the questionnaire survey indicated that the prevalence of glare/halos among patients in the three groups was 47.4%(9/19),68.4%(13/19)and 100%(12/12),respectively,with these differences being statistically significant(χ^(2)=9.365,P=0.009).Conclusion The IOL Alpha angle may reflect the decentration and actual position of the IOL within the eye.The IOL Alpha angle may affect the postoperative visual acuity and reflect the actual visual quality after surgery.Larger IOL Alpha angle will increase the incidence of postoperative glare/halos,which may affect the patient's quality of life.
作者
刘振
周维维
刘涵婧
张艺
朱玉广
朱艳
LIU Zhen;ZHOU Weiw ei;LIU Hanjing;ZHANG Yi;ZHU Yuguang;ZHU Yan(School of Clinical Medicine,Shandong Second Medical University,Weifang 261053,Shandong,China;Eye Center,The Affiliated Hospital of Shandong Second Medical University,Weifang 261035,Shandong,China)
出处
《山东大学耳鼻喉眼学报》
2026年第1期47-53,共7页
Journal of Otolaryngology and Ophthalmology of Shandong University
基金
山东省教育发展促进会教育科研规划课题(JCHKT2023423)
潍坊医学院教育教学改革与研究课题(2023YBD003,2023ZX024)。
