偏心和倾斜对不同屈光度的单焦点人工晶状体光学性能影响的实验研究

Experimental study on the influence of decentration and tilt on the optical properties of monofocal intraocular lens with different diopter

摘要

目的 探讨居中时不同屈光度的非球面单焦点人工晶状体(intraocular lens，IOL)的光学特性及不同程度偏心和倾斜对不同屈光度的IOL光学质量的影响。方法 采用体外光学质量测试系统OptiSpheric IOL R&D评价+10 m^-1、+20 m^-1和+30 m^-1 3种屈光度的非球面单焦点IOL AcrySof IQ SN60WF的光学质量。测量并比较3.0 mm和4.5 mm孔径下，IOL在居中、不同程度偏心和倾斜时，远焦点处的50 lp/mm和100 lp/mm空间频率下的MTF值、MTF曲线和美国空军(the United States airforce，USAF)分辨率测试图。结果 IOL的屈光度越高，居中时MTF值和USAF分辨率越高，偏心和倾斜时下降幅度越大。偏心和倾斜程度越大，3种屈光度IOL的MTF值和USAF分辨率越低。在2种孔径下各IOL在50 lp/mm和100 lp/mm空间频率下的MTF值均从偏心0.3 mm时开始下降。+10 m^-1 IOL在3.0 mm孔径下，倾斜5°时50 lp/mm空间频率下的MTF值开始下降，而在4.5 mm孔径、2种空间频率下，倾斜3° MTF值就开始下降。+20 m^-1和+30 m^-1 IOL在2种孔径下，MTF值均从倾斜3°开始下降。相同位置条件下，3.0 mm孔径下测量的IOL的MTF值和USAF分辨率较4.5 mm孔径下更高。结论 非球面单焦点IOL SN60WF的屈光度越高，居中时光学质量越好，偏心和倾斜时光学质量下降幅度越大。3种屈光度IOL发生0.30 mm偏心和5°及以上倾斜时，光学质量均较居中时下降，同时小孔径下测量IOL的光学质量优于大孔径。

Abstract

Objective To investigate the optical properties of aspheric monofocal intraocular lenses (IOLs) with different diopeters under centered and the effects of different degrees of decentration and tilt on the optical quality of IOLs with different diopeters. Methods OptiSpheric IOL R&D, an in vitro optical quality testing system, was used to evaluate the optical quality of aspheric monofocal IOL AcrySof IQ SN60WF with three different diopeters of +10 m^-1, +20 m^-1 and +30 m^-1. The modulation transfer function (MTF) values at spatial frequencies of 50 lp/mm and 100 lp/mm, the MTF curve and the United States airforce (USAF) resolution test chart were measured and compared for the IOLs under centered, different degrees of decentration, and tilt at apertures of 3.0 mm and 4.5 mm. Results The higher diopeter of the IOL, the higher the of MTF values and the higher of USAF resolution under the centered position, and the faster decreases of the MTF values and USAF resolution when decentered and tilted. The greater the degree of decentration and tilt, the greater the decrease of MTF value and USAF resolution of the three diopeter IOLs. At 2 aperture sizes, MTF values at spatial frequencies of 50 lp/mm and 100 lp/mm of IOLs decreased by 0.3 mm from the centered position when they were decentered. The MTF values at 50 lp/mm spatial frequency for the +10 m^-1 IOL at an aperture of 3.0 mm started to decrease at a tilt of 5°, whereas at an aperture of 4.5 mm and 2 spatial frequencies, the MTF values started to decrease at a tilt of 3°. The MTF values of +20 m^-1 and +30 m^-1 IOLs started decreasing from a tilt of 3° at both apertures. MTF values and USAF resolution of the IOLs measured at 3.0 mm aperture were higher than at 4.5 mm aperture at the same positional conditions. Conclusion The higher the diopeter of aspheric monofocal IOL SN60WF, the better the optical quality when centered, and the faster the optical quality decreased when decentered and tilted. Optical quality decreased at 0.30 mm decentration and tilts of 5° and above for the IOLs compared to when centered. Additionally, the optical quality of IOLs measured at small apertures is superior to that of large apertures.

关键词

人工晶状体 / 体外测试 / 光学质量 / 偏心 / 倾斜

Key words

Intraocular lens / In vitro test / Optical quality / Decentration / Tilt

参考文献

[1] 钱玖林， 廖萱， 唐玉玲， 等 . 非球面人工晶状体偏心和倾斜以及视觉质量的对比研究[J]. 中华眼科杂志， 2022, 58(7): 521-528. doi: 10.3760/cma.j.cn112142-20211103-00518

[2] QIAN Jiulin , LIAO Xuan , TANG Yuling , et al. Comparative study of decentration, tilt and visual quality after implantation of aspherical intraocular lenses[J]. Chinese Journal of Ophthalmology, 2022, 58(7): 521-528. doi: 10.3760/cma.j.cn112142-20211103-00518

[3] 唐玉玲， 廖萱， 谭青青， 等 . CASIA2对扩瞳前后晶状体和人工晶状体偏心和倾斜测量的重复性[J]. 中华实验眼科杂志， 2022, 40(5): 440-447. doi: 10.3760/cma.j.cn115989-20210526-00323

[4] TANG Yuling , LIAO Xuan , TAN Qingqing , et al. Repeatability of CASIA2 for measuring the tilt and decentration of crystalline lens and intraocular lens under non-mydriatic and mydriatic conditions[J]. Chinese Journal of Experimental Ophthalmology, 2022, 40(5): 440-447. doi: 10.3760/cma.j.cn115989-20210526-00323

[5] Lawu T , Mukai K , Matsushima H , et al. Effects of decentration and tilt on the optical performance of 6 aspheric intraocular lens designs in a model eye[J]. J Cataract Refract Surg, 2019, 45(5): 662-668. doi: 10.1016/j.jcrs.2018.10.049

[6] 黄子彦， 段国平 . 不同类型人工晶状体植入术后倾斜和偏心影响视觉质量的研究现状[J]. 山东大学耳鼻喉眼学报， 2022, 36(6): 26-31. doi: 10.6040/j.issn.1673-3770.0.2021.544

[7] HUANG Ziyan , DUAN Guoping . Effects of tilt and decentration on visual quality after various intraocular lens implantations[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(6): 26-31. doi: 10.6040/j.issn.1673-3770.0.2021.544

[8] 兰长骏， 唐玉玲， 廖萱 . 人工晶状体的偏心和倾斜[J]. 中华眼科杂志， 2021, 57(7): 552-556. doi: 10.3760/cma.j.cn112142-20210223-00096

[9] LAN Changjun , TANG Yuling , LIAO Xuan . Chinese Journal of Ophthalmology, 2021, 57(7): 552-556. doi: 10.3760/cma.j.cn112142-20210223-00096

[10] Chen XY , Wang YC , Zhao TY , et al. Tilt and decentration with various intraocular lenses: a narrative review[J]. World J Clin Cases, 2022, 10(12): 3639-3646. doi: 10.12998/wjcc.v10.i12.3639

[11] Łabuz G , Auffarth GU , Knorz MC , et al. Trifocality achieved through polypseudophakia: optical quality and light loss compared with a single trifocal intraocular lens[J]. J Refract Surg, 2020, 36(9): 570-577. doi: 10.3928/1081597X-20200715-01

[12] Mayer C , Son HS , abuz G , et al. In vitro optical quality assessment of a monofocal IOL sutured to an artificial iris[J]. J Cataract Refract Surg, 2020, 46(8): 1184-1188. doi: 10.1097/j.jcrs.0000000000000287

[13] Song SH , Song IS , Oh SJ , et al. Optical bench simulation for intraocular lenses using field-tracing technology[J]. PLoS One, 2021, 16(12): e0250543. doi: 10.1371/journal.pone.0250543

[14] Liu XM , Xie LX , Huang YS . Effects of decentration and tilt at different orientations on the optical performance of a rotationally asymmetric multifocal intraocular lens[J]. J Cataract Refract Surg, 2019, 45(4): 507-514. doi: 10.1016/j.jcrs.2018.10.045

[15] Son HS , abuz G , Khoramnia R , et al. Laboratory analysis and ray visualization of diffractive optics with enhanced intermediate vision[J]. BMC Ophthalmol, 2021, 21(1): 197. doi: 10.1186/s12886-021-01958-8

[16] 潘若琳， 廖萱， 兰长骏 . 体外光学质量测试系统对IOL光学质量评估应用的研究进展[J]. 中华实验眼科杂志， 2024, 42(3): 290-296. doi: 10.3760/cma.j.cn115989-20221107-00521

[17] PAN Ruolin , LIAO Xuan , LAN Changjun . Research progress in the application of in vitro optical quality test system for the assessment of IOL optical quality[J]. Chinese Journal of Experimental Ophthalmology, 2024, 42(3): 290-296. doi: 10.3760/cma.j.cn115989-20221107-00521

[18] Beiko GHH , Haigis W , Steinmueller A . Distribution of corneal spherical aberration in a comprehensive ophthalmology practice and whether keratometry can predict aberration values[J]. J Cataract Refract Surg, 2007, 33(5): 848-858. doi: 10.1016/j.jcrs.2007.01.035

[19] 南莉， 汤欣， 刘永基 . 球面与非球面人工晶状体焦深研究[J]. 中华眼科杂志， 2012, 48(2): 137-141. doi: 10.3760/cma.j.issn.0412-4081.2012.02.009

[20] NAN Li , TANG Xin , LIU Yongji . Depth of focus in spherical and aspheric intraocular lenses[J]. Chinese Journal of Ophthalmology, 2012, 48(2): 137-141. doi: 10.3760/cma.j.issn.0412-4081.2012.02.009

[21] Gu XX , Chen XY , Yang GY , et al. Determinants of intraocular lens tilt and decentration after cataract surgery[J]. Ann Transl Med, 2020, 8(15): 921. doi: 10.21037/atm-20-1008

[22] 唐玉玲， 廖萱， 谭青青， 等 . 扫频OCT CASIA2测量白内障患者术前晶状体与术后人工晶状体偏心和倾斜的相关性[J]. 中华眼视光学与视觉科学杂志， 2022, 24(6): 434-440. doi: 10.3760/cma.j.cn115909-20210928-00399

[23] TANG Yuling , LIAO Xuan , TAN Qingqing , et al. Correlation of decentration and tilt between crystalline lens and intraocular lens measured by swept-source ocular coherence tomography CASIA2[J]. Chinese Journal of Optometry Ophthalmology and Visual Science, 2022, 24(6): 434-440. doi: 10.3760/cma.j.cn115909-20210928-00399

[24] 谢丽暄， 廖萱， 兰长骏， 等 . 基于体外光学质量测试设备的非球面人工晶状体光学性能评价[J]. 中华实验眼科杂志， 2024, 42(3): 240-247. doi: 10.3760/cma.j.cn115989-20230821-00075

[25] XIE Lixuan , LIAO Xuan , LAN Changjun , et al. Evaluation of optical performance of aspherical intraocular lens in vitro by optical bench[J]. Chinese Journal of Experimental Ophthalmology, 2024, 42(3): 240-247. doi: 10.3760/cma.j.cn115989-20230821-00075

[26] Pakulienė G , Žimarinaitė K , Nedželskienė I , et al. Anterior segment optical coherence tomography imaging and ocular biometry in cataract patients with open angle glaucoma comorbidity[J]. BMC Ophthalmol, 2021, 21(1): 127. doi: 10.1186/s12886-021-01874-x

[27] Chen YX , Meng JQ , Cheng KW , et al. Influence of IOL weight on long-term IOL stability in highly myopic eyes[J]. Front Med (Lausanne), 2022, 9: 835475. doi: 10.3389/fmed.2022.835475

[28] International Organization for Standardization . Ophthalmic implants-Intraocular lenses-Part 2: Optical properties and test methods; ISO 11979-2:2014[S/OL]. https://www.iso.org/standard/55682.html.

[29] Borkenstein AF , Borkenstein EM , Luedtke H , et al. Optical bench analysis of 2 depth of focus intraocular lenses[J]. Biomed Hub, 2021, 6(3): 77-85. doi: 10.1159/000519139

[30] Son HS , Labuz G , Khoramnia R , et al. Ray propagation imaging and optical quality evaluation of different intraocular lens models[J]. PLoS One, 2020, 15(2): e0228342. doi: 10.1371/journal.pone.0228342

[31] Son HS , Tandogan T , Liebing S , et al. In vitro optical quality measurements of three intraocular lens models having identical platform[J]. BMC Ophthalmol, 2017, 17(1): 108. doi: 10.1186/s12886-017-0460-0

[32] 曹广梁， 刘晓敏， 樊峥， 等 . 体外光学质量测试设备评价IOL的光学性能[J]. 中华眼视光学与视觉科学杂志， 2022, 24(12): 894-901. doi: 10.3760/cma.j.cn115909-20211118-00449

[33] CAO Guangliang , LIU Xiaomin , FAN Zheng , et al. Evaluation of optical performance of IOL in vitro by optical bench[J]. Chinese Journal of Optometry Ophthalmology and Visual Science, 2022, 24(12): 894-901. doi: 10.3760/cma.j.cn115909-20211118-00449

[34] Shen ZR , Lin YC , Zhu YN , et al. Clinical comparison of patient outcomes following implantation of trifocal or bifocal intraocular lenses: a systematic review and meta-analysis[J]. Sci Rep, 2017, 7: 45337. doi: 10.1038/srep45337

[35] Ortiz C , Esteve-Taboada JJ , Belda-Salmerón L , et al. Effect of decentration on the optical quality of two intraocular lenses[J]. Optom Vis Sci, 2016, 93(12): 1552-1559. doi: 10.1097/OPX.0000000000001004

[36] Walline JJ , Lindsley KB , Swarup Vedula S , et al. Interventions to slow progression of myopia in children[J]. Cochrane Database Syst Rev, 2020, 1(1): CD004916. doi: 10.1002/14651858.CD004916.pub4

[37] Pérez-García J , Varea A , Ares J , et al. Evaluation of the optical performance for aspheric intraocular lenses in relation with tilt and decentrer errors[J]. PLoS One, 2020, 15(5): e0232546. doi: 10.1371/journal.pone.0232546

[38] 袁博 . 实验室眼模型中IOL发生位置变化的彗差和视觉质量分析[D]. 天津: 天津医科大学, 2018

[39] Tandogan T , Son HS , Choi CY , et al. Laboratory evaluation of the influence of decentration and pupil size on the optical performance of a monofocal, bifocal, and trifocal intraocular lens[J]. J Refract Surg, 2017, 33(12): 808-812. doi: 10.3928/1081597X-20171004-02

基金资助

四川省医学科研课题(S21011)

爱尔眼科医院集团临床研究所科研基金项目(AIG2306D01)