比较超声乳化白内障吸除联合两种不同非球面人工晶状体植入术后人工晶状体偏心和倾斜程度的异同。

收集2016年9月至2017年10月就诊于首都医科大学宣武医院眼科和北京水利医院眼科，诊断为老年性白内障并行白内障超声乳化吸除联合人工晶状体植入术的患者25例(32只眼)的病例资料进行临床研究。就诊于首都医科大学宣武医院眼科的患者，术中囊袋内植入美国麦德MATRIX Acrylic 404型人工晶状体的患者14例(15只眼)。其中，男性5例(5只眼)，女性9例(10只眼)，单眼病例14例，双眼病例1例，年龄48～78岁，平均年龄在(69.20±8.35)岁，该组作为第1组；同期收集的就诊于北京水利医院眼科的患者，术中囊袋内植入德国蔡司CT ASPHINA 603P型人工晶状体的患者11例(18只眼)。其中，男性7例(13只眼)，女性4例(5只眼)，单眼病例4例，双眼病例7例，年龄56～79岁，平均年龄在(70.60±8.28)岁，该组作为第2组。术后3个月对两组患者行跟踪随访，使用德国Oculas公司生产的三维眼前节分析仪Pentacam采集90°和180°两个位置角度上眼前节图像，用AutoCad图像分析软件，测量人工晶状体的倾斜角度和偏心距离，对所得数据采用独立样本t检验进行组间比较。

全部患者手术顺利，均未出现前囊放射状撕裂及后囊膜破裂等并发症，且人工晶状体均植入囊袋内。第1组和第2组患者术后不同类型人工晶状体水平方向的偏心距离，分别为(0.22±0.15)mm和(0.18±0.09)mm。经过独立样本t检验，其差异无统计学意义(t＝1.13，P>0.05)；第1组和第2组患者术后不同类型人工晶状体垂直方向的偏心距离，分别为(0.14±0.09)mm和(0.16±0.10)mm。经过独立样本t检验，差异无统计学意义(t＝0.38，P>0.05)。第1组和第2组患者术后不同类型人工晶状体水平方向的倾斜角度，分别为(2.57±1.25)°和(2.77±1.48)°。经过独立样本t检验，差异无统计学意义(t＝0.50，P>0.05)；第1组和第2组患者术后不同类型人工晶状体垂直方向的倾斜角度，分别为(1.85±0.87)°和(1.88±1.16)°。经过独立样本t检验，差异无统计学意义(t＝0.07，P>0.05)。

两襻的疏水性丙烯酸酯人工晶状体与三襻式的亲水性丙烯酸酯人工晶状体在囊袋内植入后均体现了良好的稳定性，人工晶状体的偏心量及倾斜角度无统计学差异。

To compare the eccentricity and tilt of intraocular lens after phacoemulsification combined with two different aspheric intraocular lens implantation.

From September 2016 to October 2017, 25 cases (32 eyes) of senile cataract with phacoemulsification and intraocular lens implantation were studied in the Department of ophthalmology, Xuanwu Hospital, Capital Medical University, and the Department of ophthalmology, Beijing Water Conservancy Hospital. Fourteen patients (15 eyes) received intraoperative implantation of Matrix Acrylic 404 intraocular lens (IOL) in the capsule bag of Xuanwu Hospital, Capital Medical University. Among them, there were 5 males (5 eyes), 9 females (10 eyes), 14 monocular cases and 1 binocular case, aged 48-78 years, with an average age of (69.20±8.35) years. This group was the first group. Eleven patients (18 eyes) who were admitted to ophthalmology department of Beijing Water Conservancy Hospital during the same period were implanted with French Zeiss CT ASPHINA 603P intraocular lens. Among them, there were 7 males (13 eyes), 4 females (5 eyes), 4 monocular cases and 7 binocular cases, ranging in age from 56 to 79 years, with an average age of (70.60±8.28) years. This group was the second group. Three months after operation, the two groups were followed up. Pentacam, a three-dimensional anterior segment analyzer manufactured by Oculas, Germany, was used to collect images of the anterior segment at 90 degrees and 180 degrees. The tilt angle and eccentricity distance of intraocular lens were measured by AutoCad image analysis software. The data were compared by independent sample t test.

All the patients were operated smoothly without any complications such as radial tear of anterior capsule and rupture of posterior capsule, and intraocular lenses were implanted into the capsule. The horizontal eccentric distances of different types of intraocular lenses in group 1 and group 2 were (0.22±0.15) mm and (0.18±0.09) mm, respectively. There was no significant difference between the two groups (t=1.13, P>0.05). The vertical eccentric distances of different types of intraocular lenses in group 1 and group 2 were (0.14±0.09) mm and (0.16±0.10) mm, respectively. After independent sample t test, there was no significant difference (t=0.38, P>0.05). The horizontal tilt angles of different types of intraocular lenses in group 1 and group 2 were (2.57±1.25)degree and (2.77±1.48)degree, respectively. There was no significant difference between the two groups (t=0.50, P>0.05). The tilt angles of different types of intraocular lenses in the first group and the second group were (1.85±0.87)degree and (1.88±1.16)degree, respectively. After independent sample t test, there was no significant difference (t= 0.07, P>0.05).

These results indicated these two different types of IOL were both showed perfect stability by implanted in the capsular bag in the cataract surgery, there was no significant difference between these two types of IOL on decentration and tilt.