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目的 :研究白内障患者在超声乳化联合人工晶状体植入术后客观波阵面像差的改变及与人工晶状体的关系。方法 :连续选取北京大学眼科中心行超声乳化联合人工晶状体植入术的白内障患者 79例 111只眼 ,术前 1天和术后 2周分别由同一技术员进行客观波阵面像差检查 ,得到 6阶 2 7项Zernike系数 (Z1～Z2 7) ,1～ 6阶的均方根 (RMS1～ 6 ) ,总体均方根(RMSg)和高阶均方根 (RMSh)。结果 :Z4 ,Z9,Z12和Z2 4手术前后有显著性差异 (P <0 0 5 ) ;RMS1～ 6、RMSg、RMSh术后较术前均显著性下降 (P <0 0 0 1)。折叠人工晶状体的类型 (三片 ,一片 )与术后RMS3(r =- 0 319)、RMS4 (r =- 0 4 75 )、RMS5 (r =- 0 30 4 )和RMSh(r =- 0 4 0 8)有显著相关性 (P均 <0 0 5 )。结论 :白内障术后各阶像差较术前均显著性减小 ,光学成像质量提高 ;具特征性的改变是三叶草形的像差和四阶球差 ;三片式折叠人工晶状体眼的高阶像差小于一片式折叠人工晶状体眼。
Objective: To study the changes of objective wavefront aberrations and the relationship with intraocular lens after phacoemulsification and intraocular lens implantation in cataract patients. Methods: A total of 111 eyes of 79 patients with cataract who underwent phacoemulsification combined with intraocular lens implantation at Peking University Eye Center were selected. The objective wavefront aberrations were examined by the same technician at 1 day before surgery and 2 weeks after surgery, respectively, and 6 Order 27 Zernike coefficients (Z1 ~ Z2 7), root mean square (RMS1 ~ 6) of 1 ~ 6th order, total root mean square (RMSg) and high order root mean square (RMSh). Results: There was a significant difference between before and after operation of Z4, Z9, Z12 and Z2 4 (P <0 05). RMS1 ~ 6, RMSg and RMSh after operation were significantly lower than those before operation (P <0.01). The type of foldable intraocular lens (three slices, one slice) was significantly correlated with RMS3 (r = - 0 319), RMS4 (r = - 0 4 75), RMS5 (r = - 0 30 4) and RMSh 0 8) (P <0.05). CONCLUSION: The aberrations of all stages after cataract surgery are significantly reduced compared with those before surgery, and the quality of optical imaging is improved. The characteristic changes are the clover-shaped aberrations and the fourth-order spherical aberration. The higher order of the three-fold foldable intraocular lens The aberration is less than a foldable intraocular lens.