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ENGLISH ABSTRACT
年龄相关性白内障患者术前角膜球面像差分析
刘文洁
刘杰为
王琪
王晶晶
贾志杰
王兵
李筱荣
作者及单位信息
·
DOI： 10.3760/cma.j.cn115989-20200325-00201
Analysis of the corneal spherical aberration of age-related cataractous eyes
Liu Wenjie
Liu Jiewei
Wang Qi
Wang Jingjing
Jia Zhijie
Wang Bing
Li Xiaorong
Authors Info & Affiliations
Liu Wenjie
Tianjin Medical University Eye Hospital, Tianjin 300384, China (is working at Shanxi Eye Hospital, Taiyuan 03001, China)
Liu Jiewei
Shanxi Eye Hospital, Taiyuan 030001, China
Wang Qi
Shanxi Eye Hospital, Taiyuan 030001, China
Wang Jingjing
Shanxi Eye Hospital, Taiyuan 030001, China
Jia Zhijie
Shanxi Eye Hospital, Taiyuan 030001, China
Wang Bing
Shanxi Eye Hospital, Taiyuan 030001, China
Li Xiaorong
Tianjin Medical University Eye Hospital, Tianjin 300384, China
·
DOI： 10.3760/cma.j.cn115989-20200325-00201
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摘要

目的观察年龄相关性白内障患者术前角膜球差的分布情况及其相关因素。

方法采用横断面研究方法，对2014年12月至2015年12月于山西省眼科医院就诊的40岁以上年龄相关性白内障患者1 319例1 319眼术前角膜球面像差进行测量，分析年龄相关性白内障患者术前角膜球面像差分布。所有患眼均采用Pentacam HR眼前节分析仪测量平均角膜曲率(Km)值、平均角膜后表面曲率(Km)值、角膜散光值、角膜后表面散光值和角膜厚度；采用Zernike分析计算以角膜顶点为中心6 mm直径范围内的角膜球面像差值；计算角膜球面像差的分布情况及其与各眼球因素之间的相关性、不同类型非球面人工晶状体矫正角膜球差的比率。

结果患者平均年龄为(68.00±11.12)岁，平均角膜球面像差值为(0.34±0.17)μm，波动范围为－0.38～0.99 μm。其中角膜球面像差<0 μm者22眼，占1.67%；角膜球面像差为0～0.4 μm者842眼，占63.84%；角膜球面像差>0.4 μm者455眼，占34.50%。角膜球面像差与患者年龄呈弱正相关( r＝0.398， P<0.001)；与受检眼角膜Km值、角膜后表面Km值、角膜厚度均呈极弱相关( r＝0.129， P<0.001； r＝0.240， P<0.001； r＝－0.068， P<0.05)；与角膜散光或角膜后表面散光之间尚不能认为有相关性( r＝－0.025， P＝0.365； r＝－0.008， P＝0.771)。年龄可能影响角膜球面像差。以残余球面像差(0.10±0.05)μm为目标采用不同类型非球面人工晶状体(0、－0.20和－0.27 μm)可矫正710眼，占53.83%。

结论年龄相关性白内障患者术前平均角膜球面像差较既往报道值(＋0.27 μm)偏大。术前应根据患者个性化的角膜球面像差选择适合的非球面IOL。

生物测量/眼;角膜球面像差;白内障;非球面人工晶状体
ABSTRACT

ObjectiveTo investigate the distribution of the spherical aberration in age-related cataractous eyes using the Pentacam HR.

MethodsA cross-sectional study was performed in Shanxi Eye Hospital from December 2014 to December 2015.The preoperative corneal spherical aberration of 1 319 eyes of 1 319 patients with age-related cataract over 40-years-old was analyzed.The mean average keratometry (Km value), and corneal posterior surface Km corneal astigmatism, posterior corneal astigmatism, and corneal thickness were measured with.Pentacam, and the Zernike coefficients of corneal spherical aberration were calculated.A correlation between spherical aberration and corneal parameters was evaluated by Pearson correlation analysis.The proportion of eyes qualifying for spherically neutral or negatively aspheric intraocular lens targeted residual spherical aberration level was evaluated.This study protocol was approved by Ethics Committee of Shanxi Eye Hospital and complied with Declaration of Helsinki.

ResultsThe average age of all patients was (68.00±11.12) years old with an average spherical aberration (0.34±0.17)μm.The spherical aberration was lower than 0 μm in 22 eyes (1.67%), 0~0.4 μm in 842 eyes (63.84%), and greater than 0.4 μm in 455 eyes (34.50%). There was a weak positive correlation between spherical aberration and age ( r=0.398, P<0.001). There were very weak correlations between spherical aberration and corneal Km, posterior corneal surface Km, corneal thickness ( r=0.129, P<0.001; r=0.240, P<0.001; r=-0.068, P<0.05). No significant correlations were found between spherical aberration and corneal astigmatism or posterior corneal astigmatism ( r=-0.025, P=0.365; r=-0.008, P=0.771). Seven hundred and ten eyes (53.83%) could be qualified for implantation of negatively or neutrally aspheric intraocular lens based on postoperative targets of (0.10±0.05)μm residual spherical aberration.

ConclusionsCorneal spherical aberration in Chinese patients is greater than that in other populations (+ 0.27 μm) in literature and shows individual differences.The appropriate aspheric intraocular lens should be selected according to individual corneal spherical aberration before cataract operation.

Biometry/ocular;Corneal spherical aberration;Cataract;Aspherical intraocular lens
Li Xiaorong, Email: nc.defudabe.umtgnoroaixil
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引用本文

刘文洁,刘杰为,王琪,等. 年龄相关性白内障患者术前角膜球面像差分析[J]. 中华实验眼科杂志,2020,38(04)：336-341.

DOI:10.3760/cma.j.cn115989-20200325-00201

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由球面人工晶状体(intraocular lens，IOL)增加的全眼球面像差是导致起白内障术后各种不良视觉症状的原因之一 [ 1 ]。球面像差是轴对称性高阶像差，能被IOL所矫正，目前各种不同类型的非球面IOL广泛用于白内障手术，以达到矫正角膜球面像差，提高术后视觉质量的目的 [ 2 ]。因此了解白内障患者术前角膜球面像差的分布对于适宜的非球面IOL的选择，提高患者术后的视觉质量至关重要。目前中国年龄相关性白内障人群术前角膜球面像差的分布情况报道较少，而临床工作中发现患者间术前角膜球面像差个体变异较大，值得眼科医生关注。本研究探讨年龄相关性白内障患者术前角膜球面像差的分布及其影响因素，为临床上个性化非球面IOL的应用及未来新型非球面IOL的设计提供参考依据。
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备注信息
A
李筱荣，Email： nc.defudabe.umtgnoroaixil
B
所有作者均声明不存在任何利益冲突
C
山西省卫生健康委员会科研基金项目 (2015069)
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