Pentacam和KR-1W像差仪在白内障手术前、后对角膜前、后表面高阶像差测量的应用研究
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摘要
目的探讨利用Pentacam和KR-1W像差仪测量超声乳化白内障联合IOL植入术手术前后角膜前、后表面高阶像差的变化,比较两种仪器测量角膜前表面像差的差异。方法收集年龄相关性白内障患者60例98眼行超声乳化联合IOL植入术,利用Pentacam系统于术前和术后1个月测量角膜前、后表面高阶像差,同时利用KR-1W像差仪测量角膜前表面高阶像差,记录总高阶像差、球差、彗差、三叶草、四叶草以及总三阶、四阶像差的测量值,观察手术前、后角膜前、后表面像差的变化。结果术前测量结果:Pentacam测量各类像差值均比KR-1W偏大,其中总高阶像差、球差、四叶草差和总四阶像差之间差异有统计学意义(P分别为0.001、0.001、0.002和0.003)。术后测量结果:两种仪器测量角膜前表面像差均比术前增加,其中Pentacam测量术后角膜前表面总高阶像差、彗差、三叶草差、三阶和四阶像差与术前差异有统计学意义(P分别为0.001、0.014、0.005、0.003和0.001);KR-1W测量术后角膜前表面总高阶像差、三叶草差、三阶和四阶像差与术前差异有统计学意义(P分别为0.004、0.019、0.023和0.001)。Pentacam测量角膜后表面总高阶像差、彗差、三叶草差、四叶草差、三阶和四阶像差术后均比术前轻度增加,但差异无统计学上的意义(P均> 0.05)。结论小切口超声乳化白内障吸除联合IOL植入术后角膜前、后表面高阶像差均有不同程度增加(除外球差),可能影响术后视觉质量,Pentacam测量角膜前表面像差值比KR-1W测量值偏大。
Objective To investigate the changes of higher-order aberrations on the anterior and posterior corneal surfaces before and after phacoemulsification combined with intraocular lens(IOL)implantation by Pentacam and KR-1W aberrometer, and compare the difference between the two instruments Methods Ninety-eight eyes of 60 age-related cataract patients underwent small incision phacoemulsification combined with IOL implantation were collected. The higher-order aberrations of anterior and posterior corneal surfaces were measured by Pentacam before surgery and 1 month later.The higher-order aberrations of anterior corneal surface were measured by KR-1 W. The total higher-order aberrations, spherical aberrations and coma were recorded. The changes of corneal surface aberrations before and after operation were observed. Results Before cataract surgery, all kinds of aberrations measured by Pentacam were larger than those measured by KR-1 W. There were significant differences in total higher-order aberrations, spherical aberrations and total fourth-order aberrations(P 0.001, 0.001, 0.002 and 0.003, respectively). Postoperative corneal surface aberrations measured by Pentacam were significantly higher than those before surgery(P 0.001, 0.014, 0.005, 0.003 and 0.001 respectively). The total higher-order aberration, trefoil aberration, third-order aberration and fourth-order aberration of anterior corneal surface were significantly different from those before operation(P 0.004, 0.019, 0.023 and 0.001, respectively). Finally, Pentacam measured the posterior corneal surface total higher-order aberration, coma, trefoil aberration, third-order and fourth-order aberration after surgery were slightly increased, but the difference was not statistically significant(P > 0.05). Conclusion The high-order aberrations on the anterior and posterior corneal surfaces after small incision phacoemulsification combined with IOL implantation increased in varying degrees(except for spherical aberrations), which may affect the visual quality. The aberrations measured by Pentacam were larger than those measured by KR-1W.
Objective To investigate the changes of higher-order aberrations on the anterior and posterior corneal surfaces before and after phacoemulsification combined with intraocular lens(IOL)implantation by Pentacam and KR-1W aberrometer, and compare the difference between the two instruments Methods Ninety-eight eyes of 60 age-related cataract patients underwent small incision phacoemulsification combined with IOL implantation were collected. The higher-order aberrations of anterior and posterior corneal surfaces were measured by Pentacam before surgery and 1 month later.The higher-order aberrations of anterior corneal surface were measured by KR-1 W. The total higher-order aberrations, spherical aberrations and coma were recorded. The changes of corneal surface aberrations before and after operation were observed. Results Before cataract surgery, all kinds of aberrations measured by Pentacam were larger than those measured by KR-1 W. There were significant differences in total higher-order aberrations, spherical aberrations and total fourth-order aberrations(P 0.001, 0.001, 0.002 and 0.003, respectively). Postoperative corneal surface aberrations measured by Pentacam were significantly higher than those before surgery(P 0.001, 0.014, 0.005, 0.003 and 0.001 respectively). The total higher-order aberration, trefoil aberration, third-order aberration and fourth-order aberration of anterior corneal surface were significantly different from those before operation(P 0.004, 0.019, 0.023 and 0.001, respectively). Finally, Pentacam measured the posterior corneal surface total higher-order aberration, coma, trefoil aberration, third-order and fourth-order aberration after surgery were slightly increased, but the difference was not statistically significant(P > 0.05). Conclusion The high-order aberrations on the anterior and posterior corneal surfaces after small incision phacoemulsification combined with IOL implantation increased in varying degrees(except for spherical aberrations), which may affect the visual quality. The aberrations measured by Pentacam were larger than those measured by KR-1W.
引文
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[10]张帅,汤欣,张一凡,et al.Pentacam与i Trace像差仪在白内障患者角膜像差测量中的应用.眼科研究.2010,28(10):984-8.
[11]von Sonnleithner C,Pilger D,Homburg D,et al.Corneal higher-order aberrations after phacoemulsification:a comparison of 3 different incision sizes.Eur JOphthalmol.2017,27(4):402-6.
[12]HW R,VK W,DL S,et al.Refractive outcomes after limbal relaxing incisions or femtosecond laser arcuate keratotomy to manage corneal astigmatism at the time of cataract surgery.J Cataract Refract Surg.2018,44(8):955-63.
[13]Razmjoo H,Koosha N,Vaezi MH,et al.Corneal astigmatism change and wavefront aberration evaluation after cataract surgery:"Single"versus"paired opposite"clear corneal incisions.Adv Biomed Res.2014,19(3):163.
[14]常平骏,喻芳,王丹丹,et al.不同长度角膜缘切口对白内障超声乳化术后角膜前后表面高阶像差影响对比.中国实用眼科杂志.2013,31(10):1263-7.
[15]王娟,汤欣,张帅,et al.超声乳化白内障吸除术后角膜前后表面高阶像差的变化.中华眼科杂志.2008,44(12):1066-71.
[16]Ye H,Zhang K,Yang J,et al.Changes of corneal higher-order aberrations after cataract surgery.Optom Vis Sci.2014,91(10):1244-50.
[2]Beiko GH.Personalized correction of spherical aberration in cataract surgery.JCataract Refract Surg.2007,33(8):1455-60.
[3]Nochez Y,Majzoub S,Pisella PJ.Effect of residual ocular spherical aberration on objective and subjective quality of vision in pseudophakic eyes.J Cataract Refract Surg.2011,37(6):1076-81.
[4]蒋伟蓉,陈瑶,谭浅等.年龄相关性白内障的高阶像差及光学质量.中华眼视光学与视觉科学杂志.2018,3:150-5.
[5]Amorim-de-Sousa A,Vieira AC,Gonzalez-Meijome JM,et al.Age-Related Variations in Corneal Asphericity and Long-Term Changes.Eye Contact Lens.2018.
[6]Whang WJ,Piao J,Yoo YS,et al.The efficiency of aspheric intraocular lens according to biometric measurements.PLo S One.2017,12(10):e0182606.
[7]倪宁,张凤妍,杜珊珊等.不同球面像差的人工晶状体植入术后视觉质量的对比研究.中华眼外伤职业病杂志.2017,39(4):245-8.
[8]Schrecker J,Langenbucher A,Seitz B,et al.First results with a new intraocular lens design for the individual correction of spherical aberration.J Cataract Refract Surg.2018.
[9]邢晓杰,汤欣,宋慧.KR-1W波前像差仪测量人工晶状体眼像差可重复性研究.中国实用眼科杂志.2011,29(11):1127-30.
[10]张帅,汤欣,张一凡,et al.Pentacam与i Trace像差仪在白内障患者角膜像差测量中的应用.眼科研究.2010,28(10):984-8.
[11]von Sonnleithner C,Pilger D,Homburg D,et al.Corneal higher-order aberrations after phacoemulsification:a comparison of 3 different incision sizes.Eur JOphthalmol.2017,27(4):402-6.
[12]HW R,VK W,DL S,et al.Refractive outcomes after limbal relaxing incisions or femtosecond laser arcuate keratotomy to manage corneal astigmatism at the time of cataract surgery.J Cataract Refract Surg.2018,44(8):955-63.
[13]Razmjoo H,Koosha N,Vaezi MH,et al.Corneal astigmatism change and wavefront aberration evaluation after cataract surgery:"Single"versus"paired opposite"clear corneal incisions.Adv Biomed Res.2014,19(3):163.
[14]常平骏,喻芳,王丹丹,et al.不同长度角膜缘切口对白内障超声乳化术后角膜前后表面高阶像差影响对比.中国实用眼科杂志.2013,31(10):1263-7.
[15]王娟,汤欣,张帅,et al.超声乳化白内障吸除术后角膜前后表面高阶像差的变化.中华眼科杂志.2008,44(12):1066-71.
[16]Ye H,Zhang K,Yang J,et al.Changes of corneal higher-order aberrations after cataract surgery.Optom Vis Sci.2014,91(10):1244-50.