| Objective: To study the change of corneal high order aberration(HOAs) before and after the 2.75 mm clear corneal incision(CCI) phacoemulsification and intraocular lenses(IOL) implantation, the comparison of corneal, internal and ocular HOAs in pseudophakia with spherical IOL and aspheric IOL implantation, and the comparison of corneal, internal and ocular HOAs in pseudophakia with monofocal intraocular lenses(SIOL) and multifocal intraocular lens(MIOL) implantation, in order to provide theory basis for individual selection of aspheric IOL.Methods: A prospective non-random controlled clinical study was conducted on 142 age-related cataract patients(200 eyes). HOAs from the a n t e r i o r s u r f a c e o f c o r n e a w e r e m e a s u r e d b e f o r e a n d a f t e r phacoemulsification. AMO Sensor AR40, AMO Tecnis ZA9003,Bausch & Lomb Sof Port AO,Alcon SN60 WF IQ and Alcon SN6AD1 Re STOR were implanted after phacoemulsification through 2.75 mm CCI(orientation 10:30). Patients were examined in Preoperative and postoperative 3 months. HOAs included the total high order aberration(t HOA), spherical aberration(SA), coma and trefoil. Root-mean-square(RMS) values of HOAs were obtained at 4mm and 6mm pupil diameters(PD) using Topcon KR-1W in the pre- and postoperative. The Paired-t test was used to assess the data.A prospective non-random controlled clinical study was conducted on 112 age-related cataract patients(160 eyes). 116 eyes were subjected to phacoemulsification cataract surgery and divided into 4 groups. Four groups were implanted respectively spherical IOLs and different types of aspheric IOLs based on the wishes of the patients. The IOLs included AMO Sensor AR40(group AR40, 40 eyes of 26 patients), AMO Tecnis ZA9003(group ZA9003, 40 eyes of 31 patients), Bausch & Lomb Sof Port AO(group AO, 40 eyes of 28 patients). Alcon SN60 WF IQ(group IQ, 40 eyes of 27 patients) The corneal, ocular and internal HOAs were measured 3 months after phacoemulsification. The HOAs included t HOA, SA, coma and trefoil. RMS values of HOAs were obtained at 4mm PD and 6mm PD 3 months postoperative. The single factor variance analysis was used to analyze the data, and the pairwise comparison was performed with LSD method.It was a prospective non-random controlled clinical study. 80 eyes were subjected to phacoemulsification cataract surgery and divided into 2 groups. Two groups were implanted Alcon SN60 WF IQ SIOL(group IQ, 40 eyes of 27 patients) and Alcon SN6AD1 Re STOR MIOL(group Re STOR, 40 eyes of 30 patients) based on the wishes of the patients. The corneal,internal and ocular HOAs were measured 3 months after phacoemulsification. The HOAs included t HOA, SA, coma and trefoil. RMS values of HOAs were obtained at 4mm PD and 6mm PD 3 months postoperative. The independent samples t test was used to analyze the data.Result: The mean corneal SA before the cataract surgery was(0.05±0.03) μm(4mm PD) and(0.25±0.07) μm(6mm PD). Corneal t HOA from a mean of(0.17±0.07) μm preoperatively to(0.27±0.09) μm 3 months postoperatively at 4mm PD(t=-16.30, P=0.00) and(0.48±0.14) μm preoperatively to(0.73±0.21) μm 3 months postoperatively at 6mm PD(t=-18.06, P=0.00), the increase of postoperative corneal t HOA was statistically significant. Corneal SA from a mean of(0.05±0.03) μm preoperatively to(0.05±0.03) μm 3 months postoperatively at 4mm PD(t=-0.89, P=0.38) and(0.25±0.07) μm preoperatively to(0.26±0.07) μm 3 months postoperatively at 6mm PD(t=-1.64, P=0.10), there was no statistically significant difference in corneal SA between pre- and postoperative. Corneal coma from a mean of(0.10±0.06) μm preoperatively to(0.11±0.06) μm 3 months postoperatively at 4mm PD(t=-1.74, P=0.08) and(0.26±0.13) μm preoperatively to(0.27±0.14) μm 3 months postoperatively at 6mm PD(t=-1.08, P=0.28), there was no statistically significant difference in corneal coma between pre- and postoperative. Corneal trefiol from a mean of(0.10±0.06) μm preoperatively to(0.21±0.09) μm 3 months postoperatively at 4mm PD(t=-16.41, P=0.00) and(0.20±0.11) μm preoperatively to(0.49±0.20) μm 3 months postoperatively at 6mm PD(t=-21.29, P=0.00), the increase of postoperative corneal trefoil was statistically significant.The UCDVA and BCDVA had no statistical significant difference among the four groups. Postoperative ocular t HOA at 4mm PD(F=6.28, P=0.00): In group AR40:(0.29±0.10) μm, group ZA9003:(0.28±0.09) μm, group AO:(0.24±0.08) μm, group IQ:(0.22±0.08) μm, there were statistically significant differences between group AR40 and group AO, group AR40 and group IQ, group ZA9003 and group IQ. Postoperative ocular t HOA at 6mm PD(F=12.03, P=0.00): In group AR40:(0.98±0.30) μm, group ZA9003:(0.82±0.16) μm, group AO:(0.75±0.13) μm, group IQ:(0.71±0.23) μm, there were statistically significant differences between group AR40 and group ZA9003, group AR40 and group AO, group AR40 and group IQ, group ZA9003 and group IQ. Postoperative ocular SA at 4mm PD(F=50.09, P=0.00): In group AR40:(0.06±0.04) μm, group ZA9003:(-0.02±0.04) μm, group AO:(0.06±0.03) μm, group IQ:(0.01±0.03) μm, there were statistically significant differences between group AR40 and group ZA9003, group AR40 and group IQ, group ZA9003 and group AO, group ZA9003 and group IQ, group AO and group IQ. Postoperative ocular SA at 6mm PD(F=143.30, P=0.00): In group AR40:(0.37±0.10) μm, group ZA9003:(-0.06±0.15) μm, group AO:(0.32±0.10) μm, group IQ:(0.06±0.08) μm, there were statistically significant differences among the 4 groups. Postoperative internal t HOA at 6mm PD(F=11.34, P=0.00): In group AR40:(0.47±0.15) μm, group ZA9003:(0.53±0.11) μm, group AO:(0.36±0.15) μm, group IQ:(0.43±0.13) μm, there were statistically significant differences between group AR40 and group AO, group ZA9003 and group AO, group ZA9003 and group IQ, group AO and group IQ. Postoperative internal SA at 4mm PD(F=43.23, P=0.00): In group AR40:(0.00±0.04) μm, group ZA9003:(-0.06±0.03) μm, group AO:(0.00±0.02) μm, group IQ:(-0.04±0.03) μm, there were statistically significant differences between group AR40 and group ZA9003, group AR40 and group IQ, group ZA9003 and group AO, group ZA9003 and group IQ,group AO and group IQ. Postoperative internal SA at 6mm PD(F=316.85, P=0.00): In group AR40 :(0.11±0.06)μm, group ZA9003:(-0.31±0.10) μm, group AO:(0.03±0.06) μm, group IQ:(-0.23±0.06) μm, there were statistically significant differences among the 4 groups. Postoperative internal coma at 4mm PD(F=3.49, P=0.02): In group AR40:(0.07±0.04) μm, group ZA9003:(0.09±0.06) μm, group AO:(0.05±0.03) μm, group IQ:(0.08±0.06) μm, there were statistically significant differences between group ZA9003 and group AO, group AO and group IQ. Postoperative internal coma at 6mm PD(F=3.61, P=0.02): In group AR40:(0.19±0.10) μm, group ZA9003:(0.26±0.20) μm, group AO:(0.15±0.10) μm, group IQ:(0.21±0.14) μm, there were statistically significant difference between group ZA9003 and group AO.The UCDVA ã€BCDVA and best corrected near visual acuity(BCNVA) had no statistical significant difference between the two groups,but the uncorrected near visual acuity(UCNVA) had statistical significant difference. Postoperative ocular SA at 6mm PD(t=-4.36, p=0.00): In group IQ:(0.06±0.08) μm, group Re STOR :(0.15±0.11) μm, there was statistically significant difference between the two groups. Postoperative internal t HOA at 6mm PD(t=3.86, p=0.00): In group IQ:(0.43±0.13) μm, group Re STOR :(0.34±0.08) μm, there was statistically significant difference between the two groups. Postoperative internal SA at 6mm PD(t=-6.99, p=0.00): In group IQ:(-0.23±0.06) μm, group Re STOR :(-0.13±0.07) μm, there was statistically significant difference between the two groups. Postoperative internal coma at 4mm PD(t=3.05, p=0.00): In group IQ:(0.08±0.06) μm, group Re STOR:(0.05±0.03) μm, there was statistically significant difference between the two groups. Postoperative internal coma at 6mm PD(t=2.62, p=0.01): In group IQ:(0.21±0.14) μm, group Re STOR:(0.14±0.07) μm, there was statistically significant difference between the two groups.Conclusion: The mean corneal SA of age-related cataract patients was(0.25±0.07) μm at 6mm PD.There were no statistically significant difference in corneal SA and coma after 2.75 mm CCI phacoemulsification, this result provide theory basis for individual selection of aspheric IOL.But the increase of postoperative corneal HOA and trefoil were statistically significant.Postoperative internal SA at 6mm PD: In group AR40 :(0.11±0.06)μm, group ZA9003:(-0.31±0.10) μm, group AO:(0.03±0.06) μm, group IQ:(-0.23±0.06) μm, group Re STOR:(-0.23±0.06) μm, were similar to the design value of SA, this result also provide theory basis for individual selection of aspheric IOL.The ocular tHOA and SA were induced in IQ, ZA9003, AO aspherical IOL significantly less than AR40 spherical IOL at 4mm PD and 6mm PD. On the improvement of ocular SA, IQ IOL had more significant SA than other IOLs at 4mm PD, but was same as ZA9003 IOL at 6mm PD. |
