| 目的：与以往球面型人工晶体相比，评价一种前表面经过非球面处理的非球面型人工晶体能否通过改善老年患者白内障超声乳化联合人工晶体植入术后的波阵面像差以提高术后视觉质量。
方法：连续收集于北京大学眼科中心就诊并要求接受白内障手术的患者72人115只眼，年龄在49到84岁之间（63.9±9.9岁）。随机选择三种不同类型人工晶体TecnisZ9001，CeeOn Edge 911 或Sensar AR40e（均由AMO公司制造）。术前1天及术后1周、1个月、3个月和6个月由相同技术人员进行相关检查，包括视力、眼压、对比敏感度和主客观波阵面像差等。结果主要记录最佳矫正视力，对比敏感度水平，主客观Z40 Zernike系数，第4阶均方根RMS4和总高阶像差均方根RMSh，同时进行主观视觉质量量表的评估获得评分。记录并分析结果。
结果：球面像差与年龄存在正相关性（相关系数r＝0.582，P值<0.05）。术前术后3组患者间最佳矫正视力没有显著性差异（P值>0.05）。TecnisZ9001组患者Z40 Zernike系数、RMS4以及RMSh的值均低于CeeOn Edge911组和Sensar AR40e组（P值>0.05），其5个不同水平空间频率的对比敏感度高于另外2组。并且TecnisZ9001组患者术后主观视觉质量得分也高于另外2组（P value<0.05）。
结论：随着年龄的增长，人眼的球面像差也随之增加。与以往的球面型人工晶体不同，非球面型人工晶体可以通过降低老年患者的球面像差来提高白内障术后的视觉质量。
Purpose: To evaluate whether the aspherical intraocular lens (IOL) with a modified aspherical anterior surface provides better quality of vision than a conventional spherical IOL for the senile cataract patients after phacoemusification and IOL implantation.
Methods: Consecutively 115 eyes were selected from 72 senile cataract patients who had performed phacoemulsification and IOL implantation in Peking University Eye Center, aged from 49 to 84(63.9±9.9 years old).Each was randomly assigned to receive TecnisZ9001 IOL or CeeOnEdge 911 and or Sensar AR40e (both made by AMO). One day before operation, one week, a month, 3months and six months after operation, the eyes underwent several tests by same technicians, including visual acuity, optometry, contrast sensitivity test and wavefront aberration examination. The parameters included best corrective visual acuity, the values of contrast sensitivity, Z40 Zernike coefficient, root mean square of the 4th order (RMS4) and higher-order root mean square (RMSh). Visual functional questionnaires were finished and the scores were saved. Then statistical analyzing need to be done.
Results: Spherical wavefront aberration has positive correlation with the age (r=0.582, P value<0.05). There is no significant difference of BCVA between each two of the three groups before or after the operation (P value>0.05). The patients with Tecnis IOL get lower Z40 Zernike coefficient, RMS4 and the RMSh than these items in the CeeOn 911 group and Sensar AR40e group(P value<0.05), and higher contrast sensitivity at the 5 level of spatial frequency. Furthermore, the visual function scores are higher then the other two spherical IOL group(P value<0.05).
Conclusion: The older, the higher spherical wavefront of the eye. Different from the conventional spherical IOL, a kind of aspherical IOL can provide better quality of vision by reducing the spherical wavefront after the cataract surgery.
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