摘要
背景Bigbag人工晶状体（IOL）由于特殊设计有利于支撑高度近视患者白内障术后的玻璃体及视网膜，保证了周边视网膜的可视化，便于高度近视患者的眼底检查。但是其凹凸式设计，是否在囊袋稳定的基础上具有减少像差的优势尚不清楚。目的观察高度近视白内障眼植入不同类型的IOL术后眼高阶像差的变化。方法采用回顾性病例观察研究设计，分析行超声乳化白内障手术的高度近视患者39例39眼，分为BigbagIOL植入组19眼及AR40eIOL植入组20眼。行上方透明角膜缘隧道切口，连续环形撕囊直径≥5mm，采用phaco—chop术进行白内障超声乳化术，2个组术眼分别将BigbagIOL和AR40eIOL植于囊袋内。术后2个月散瞳检查术眼IOL位置、后囊膜皱褶及眼底并发症，并在绝对暗室内观察瞳孔直径〉4．5mm时的全眼像差及眼内各高阶像差，并对2个组间的结果进行比较。用角膜地形图仪对角膜表面进行检查。结果2个组术后IOL位置居中，在2个月的随访过程中未发现任何并发症。术后2个月在4．5mm瞳孔直径下，BigbagIOL植入组与AR40eIOL眼的全眼高阶像差的均方根值（RMS）、慧差的差异均有统计学意义（t=-3．296、-3．322，P〈0．05），而球差和三叶草像差的差异均无统计学意义（t=-1．256、-0．573，P〉0．05）；2个组间眼内仅慧差的差异有统计学意义（t=-2．004，P〈0．05），而RMS、球差和三叶草像差的差异均无统计学意义（t=-1．073、0．380、0．288，P〉0．05）。结论高度近视患者植入BigbagIOL具有术后预留度数准确、术后视觉质量较好等优点，与植入AR40eIOL眼相比，高阶像差各成分差异以彗差为主，且差异主要来自眼内。
Background Bigbag intraocular lens （IOL）, due to its special conducive design to support vitreous and retina after cataract surgery in high myopia, and ensure the visualization of peripheral retinal, is closely concerned. But whether its concave design has the advantage in reducing aberrations on the basis of stability or not is worth to be studied. Objective This study was to evaluate the high order aberrations（HOA） of phacoemulsification and the Bigbag IOL implantation ~n patients with myopia and cataract. Methods A retrospective case-observational study was designed. Total 39 eyes of 39 cases with cataract and high myopia were enrolled in this study. The patients were divided into Bigbag IOL group and AR40e [OL group. Phaco-chop technique and IOL implantation were performed in April to June,2010 in Tianjin Eye Hospital. Two months after surgery,the operated eyes were clinical examined and the aberrations were detected including Root-Mean-Square （RMS）, coma, spherical and Trefoil. Postoperative RMS values of HOA components of the whole and interior optic with iTrace were compared. Results The operation was smoothly with the correct IOL position after two months. No complication was found. Under the 4. 5 mm pupil diameters, the whole ocular HOA RMS values and coma were significantly different between Bigbag IOL group and AR40e IOL group（t =-3. 296,-3. 322 ,P〈O. 05） ,but no significant differences were seen in spherical andTrefoil aberrations（ t = - 1. 256, -0. 573, P〉0. 05 ）. Regarding to the interior optic with iTrace aberration, only the coma showed the significant difference between Bigbag IOL group and AR40e IOL group（ t = -2. 004 ,P〈0. 05 ） , and there were no significant differences in RMS, spherical and Trefoil aberrations（ t =- 1. 073,0. 380,0. 288, P〉0. 05 ）. Conclusions The Bigbag IOL,a design for high myopia,is safe and effective after implant for the high myopia with cataract. It offers more exact obligate degree and better visual quality. The chief total and inter
出处
《中华实验眼科杂志》
CAS
CSCD
北大核心
2012年第3期266-269,共4页
Chinese Journal Of Experimental Ophthalmology
