±0. lllym和0.250±0. 107jim,二者差异无统计学意义。术后全眼球面像差 为0.0365±0.0654um较预测值(0. 027±0.0714um)略大,但差异无统计学意 义(P:0.299)。全眼球面像差的预测误差为_0.009±0. 092um,其中小于±0. 10 ym 的有 49 眼(81.7%),小于±0.05 nm 的有 34 眼(56.7%)。 结论 基于角膜球面像差个体化选择非球面人工晶状体可以减小术后全眼像差, 并使全眼像差更接近预设值。由于手术对角膜球面像差的影响很小,且术源性 角膜球差与预测误差不具相关性,我们认为在有效控制倾斜、偏中心及测量误 差的前提下这种个体化的方法具有可行性。 关键词:1h球面人I:晶状体球面像差个体化 II 硕士学位报告 Personalized correction of spherical aberration in cataract surgery based on corneal spherical aberration ABSTRACT Objective: To determine the effectiveness and feasibility of personalized aspheric intraocular lens (IOL) implantation based on preoperative corneal spherical aberration. Methods: Candidates for cataract surgery were offered topographical measurement by OCULUS Pentacam preoperatively. Based on the corneal spherical aberration at 6-mm optical zone, one of three aspheric IOLs was chosen so the arithmetic sum of the corneal spherical aberration and pseudophakic spherical aberration came closest to zero. The three aspheric IOLs including Akreos Adapt AO (Bausch & Lomb),AcrySof IQ SN60WF (Alcon Laboratories Inc) and Teen is ZA9003 (Advanced Medical Optics [AMO])7 which have spherical aberration as 0,-0. 20,-0. 27 u m, respectively. Postoperatively, corneal wavefront was mesasured by Pentacam again. Total ocular wavefront was also measured by Zywave aberrometer (Bausch & Lomb) . The effectiveness was assessed by compared postoperative total ocular spherical aberration with other personalized and nonpersonalize studies. The feasibility was assessed by compared predictive value and postoperative total spherical aberration. Results: Sixty eyes of 53 patients were available for analysis. The Akreos Adapt AO (Bausch & Lomb) lens was implanted in 6 eyes (10.0%),the AcrySof IQ SN60WF (Alcon Laboratories Inc) in 17 eyes (28.3%) , and the Tecnis ZA9003 (Advanced Medical Optics [AMO]) in 37 eyes (61.7%) .The preoperative and postoperative corneal spherical aberration at 6-mm diameter were 0.250 士 O.llljam and 0.250 士 0.107jam respectively. The difference was not statistically significant (P二.768) . Postoperative total ocular spherical aberration at 6-mm diameter was ABSTRACT 0.0365士0.0654|im , which was bigger than preoperative. But the difference was not statistically significant (尸=.299) . For the entire population, mean absolute predictive error measured -0.009士0.092(im; 56.7% of the absolute error was within 士0.05 mm and 81.7%, within 土0.10 mm. Conclusion: The personalized aspheric intraocular lens (IOL) implantation based on preoperative corneal spherical aberration is feasible; This method can reduce postoperative total ocular aberrations, and the aberration is closer to the predictive value. Kyewords: aspheric intraocular lens; spherical aberration; personalized 硕士学位报告 目录 M I ABSTRACT i 第一章前言 1 1.像差和球面像差 1 2.人眼的像差 2 3.角膜像差的测量(Pentacam三维眼前节分析诊断系统) 3 4.全眼像差的测量(Zywave像差仪) 5 5.非球面人工晶状体 6 6.个体化非球面人工晶状体的探索 9 第二章资料与方法 11 1.研究对象 11 2.纳入标准 11 3.排除标准 11 4.像差测量 11 5.个体化方案 12 6.手术方法 12 7.检查方法 12 8.评价指标 13 9.统计学方法 14 第三章结果 15 1.基本资料 15 2.非球面IOL的选择 15 3.手术对角膜像差的影响 16 4.全眼球差及预测误差 22 目录 第四章讨论 24