屈光协力与tecnis一片式人工晶体讲者幻灯

更安全、更敏锐的术后视——屈光协力与新 is一片式人工晶FDAFDA360屈光协多种晶体光学技术、材质、设计等因素影响视觉质量，包括360 TMFSpeaker’sKit©2009AbbottMedicalOptics,屈光协屈光协 更敏锐的视+-年轻人+-年轻人眼的球差在19岁时为零光线完 到视网膜上，产生一个高质量的影像和良好的功能性视Notdrawnto*GuiraoA,etal.JOptSocAmA.2000;17:1697-**HolzerM.PresentedatDOC,老年人能力，从而导致功能性视力下降*†*GuiraoA,et.al.JOptSocAmA.2000;17:1697-†GlasserACampbellMCW.VisionRes.1998;38:209-

Notdrawn 年轻人MicronsMicrons(OcularsphericalaberrationSA(>25SA(>25mean(SDSA(<25mean(SD- 顶尖视力出现在19岁时，此时对比敏感度度和视觉质量为 *ArtalP,etal.PresentedatESCRS†GlasserA,etal.VisionRes.年轻人21- - Figure5.Thenegativecorrelationbetweentherangeof Usingthe1.0nearvisionoptotypeandZ12(sphericalaberrationfora4.0mmpupil(r=-*NishiT,etal.JCataractRefractSurg.以0球差为目IS®人工晶体采用独一无二的扁长形设计，以零球差为IS®是第一个也是唯一一个获得FDA批准的波前设计人工晶体，可将球差降低到0.0†,近似于19岁的人眼

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Spherical IS®FoldablePosteriorChamberIntraocularLens.AbbottMedicalOptics†ThedataasitappearsherefollowstheOSAstandardandhasbeenchangedfromtheoriginaldatatoreflectadifferenceinsign(+or-)thatexistsbetweentheWASCAmeasurementandtheOSAstandard.IS®IOL提供高质量的视IS®IOL无球差残 有球差残留的人工晶体 条件下(5mm瞳孔)比球面人工晶体有更好的视力.†*Traditionalspherical†Dataonfile.AbbottMedicalOptics临床意义对 IS®人工晶体对于老年 有着意义深远的安全利益,对于 的行人都是如此” IS®人工晶体提高了功能性视力，这将改善患者在低光照条件下生活场景中的安全性”*Package IS®FoldablePosteriorChamberIntraocularLens.AbbottMedicalOptics经过证实 IS®光学技 减少球面相差提高夜间模拟驾驶安全性*Package IS®FoldablePosteriorChamberIntraocularLens.AbbottMedicalOptics残余球差降低了视觉质量单焦点人工晶体的残余球差（4mm AcrySof®IQIOLB&LLI61AO SphericalPointSpreadAverageCornealLens--TotalResidual*ImagessimulatedusingZernikeTool,createdbyGeorgeDai,点扩散函数（PSF）指单一的、集中的光线通过一个透镜投射后的形状。PSF用来描述因光学系统*Dataonfile.AbbottMedicalOpticsMTF的显著改在一项研究中 is在100c/mm时的MTFAcrysofIQAO*Dataonfile.AbbottMedicalOpticsIS®Z9000，AcrySof®IQ和人工晶体的临床比较比较非球面人工晶体术后的球差和对比敏感度SofPort®AOIOLAO),AcrySofIQIOL(IQ), IS®Z9000IOL 测量术前和术后BCVA光(85cd/m2)和暗光(3cd/m2)对比敏感度，并发症术后数据收集于术后3†ChuR.PresentedatESCRS比较每种人工晶体术后的角膜球差：6mm瞳孔

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Log*在3cpd空间频率下 IS®和AO(P<0.001) IS®和IQ(P=0.037);IQ和AO(P=0.04)间具有显著地统计学差异；在18cpd时ECNIS®IOL著好于AO†ChuR.PresentedatESCRS对比敏感度具有显著差异：明光条件下MeanMeanContrast

Log IS®和AO(P=0.002)；IQ和AO(P=0.026),具有显著的统计学差异.在18cpd时,IS®IOL明显好于AO(P=0.031).†ChuR.PresentedatESCRS研究结果IS®IOL比SofPort®AO或AcrySof®IQ更低的球差(P<.001versusIQ)在暗光条件下,3cpdIS®IOL比SofPort®AOAcrySof®IQ18cpdSofPort®明光条件下,3cpd和18cpd时， 感度比SofPort®AO更好†ChuR.PresentedatESCRSTheclinicalstudyconductedin2002andsummarizedinthelabelingdidnotdemonstrateastatisticallysignificantimprovementincontrastsensitivity.However,morerecentstudies,suchastheoneshownhere,haveshownstatisticallysignificantimprovementsincontras functionwiththe IS®IOL.1919 何谓色差1.SchwiegerlingJ,SurveyofOphthalmology,September-October我们如何测量色差晶体色 影响光学部材质的色差可 数表NegishiK,etal.ArchOphthalmol材质比数越高越好：色差更低，光学性能更好%%0AMO

1.ZhaoH.,MainsterM.JCRS.20072.NegishiK,etal.ArchOphthalmol 数的临床显著30cpd（当于1.0）时，料的对比敏感Alcon材料要增加ZhaoH.MainsterM.JCRS.球差和色差的联合矫–多项研究表明联合矫 片式和AcrySofIQIOL的

色差联合矫 MTF值的提高*ZhaoH,PiersPA,MainsterMA.TheadditiveeffectsofdifferentopticalDdentasphericIOLs.Presentedat:27thCongressoftheESCRS;2009Sep4-8;Paris,France..温度的改变使得水 在非纯系的聚合化而形成的间隙中AMOAcrysof模注法与温度敏感性的结合使得Acrysof*Miyata,etal.JCataractRefractSurg.闪辉：丙烯酸材质的比VanderMoorenM,etal.PresentedatARVO灯泡和聚光照相灯泡和聚光照相光锥/裂孔径光透明容器与*VanderMoorenM,etal.PresentedatARVO所以临，功能性的显*VanderMoorenM,etal.PresentedatARVO闪辉的临床意一份关于闪辉对于视功能的影响的研究显示，Acrysof(MA30BAandMA60BA)**GunencU,etal.JCataractRefractSurg.†ChristiansenG,etal.JCataractRefractSurg.AcrylicVS疏水性丙烯酸材质总疏水性疏水性丙烯酸材一种人工晶体植入材高度的生物相容低的含水半硬度材中高度的屈光指比亲水性材料更高的抗张强闪辉发生可能无需水H x x

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or 43.310.911 91.5%的患者未矫正视力达到20/4010020/40*FDAGridforposterior辉ImportantSafetyInformation IS®Caution:Federallawrestrictsthisdevicetosalebyorontheorderofa islensesareindicatedforthevisualcorrectionofaphakiainadultpatientsinwhomacataractouslenshasbeenremovedbyextracapsularcataractextraction.Thesedevicesareintendedtobeplacedinthecapsularbag.Warnings:PhysiciansconsideringlensimplantationunderanyoftheconditionsdescribedintheDirectionsforUselabelingshouldweighthepotentialrisk/benefitratiopriortoimplantingaPrecautions:Donotresterilizeorautoclave.Useonlysterileirrigatingsolutionssuchasbalancedsaltsolutionorsterilenormalsaline.Donotstoreindirectsunlightorover45 AdverseEvents:Adverseeventsoccurredatratesbetween1.6%and3.3%duringtheclinicaltrialsforisIOLsortheir“parent”IOLs.Theseeventsincludedmacularedema,endophthalmitis,anteriorlenstissueongrowth,lensdislocation,hypopyon,cornealedema,iritis,hyphema, andsecondarysurgicalAttention:ReferencetheDirectionsforUseforacomple istingofindications,warnings,andAbela-FormanekC,etal.Uvealand patibilityofhydrophilicacrylic,hydrophobicacrylic,siliconeintraocularlenses.JCataractRefractSurg.2002;28(1):50-ArtalP,AlcónE,VillegasE.Sphericalaberrationinyoungsubjectswithhighvisualacuity.Presentedat:XXIVCongressoftheEuropeanSocietyofCataractandRefractiveSurgeons,September9-13,2006.London,AsplundR,EidervikLindbladB.Thedevelopmentofsleepin sundergoingcataractsurgery.ArchGerontolGeriatr.2002;35(2):179-187.AsplundR,LindbladBE.Sleepandsleepiness1and9monthsaftercataractsurgery.ArchGerontolGeriatr.BalasubramaniamC,GoodfellowJ,PriceN,KirkpatrickN.OpacificationoftheHydroviewH60Mintraocularlens:totalpatientrecall.JCataractRefractSurg.2006;32(6):944-948.BisolT,RezendeRA,GuedesJ,DantasAM.Effectofbluestainingofexpandablehydrophilicintraocularlensesoncontras sitivityandglarevision.JCataractRefractSurg.2004;30(8):1732-1735.BuchenSY,CunananCM,GwonA,etal.Assessingintraocularlenscalcificationinananimalmodel.JRefractSurg.2001;27:1473-CajochenC,JudC,Mun .EveningexposuretobluelightstimulatestheexpressionoftheclockgenePER2inhumans.EurJNeurosci.2006:PP-1-5.CharmanWN.Age,lenstransmittanceandthepossibleeffectsoflightonmelatoninsuppression.OphthalmolPhysiolOpt.2003;23(2):181-187.ChristiansenG,DurcanFJ,OlsonRJ,ChristiansenK.GlisteningsintheAcrySofintraocularlens:Pilotstudy.CataractRefractSurg.2001;27:728-ChuR. ingZeroSphericalAberrationWithOptimalLensSelectionAndPseudophakicManagement.PresentedattheESCRS,2007.DogruM,TetsumotoK,TagamiY,etal.OpticalandatomicforcemicroscopyofanexplantedAcrySofintraocularlenswithglistenings.JCataractRefractSurg.2000;26:571-575.GlasserA,CampbellMC.Presbyopiaandtheopticalchangesinthehumancrystallinelenswithage.VisionRes.1998;38(2):209-229.GregoriNZ,SpencerTS,MamalisN,OlsonRJ.Invitrocomparisonofglisteningformationamonghydrophobicacrylicintraocularlenses(1).JCataractRefractSurg.2002;28(7):1262-1268.GuiraoA,GonzalezC,RedondoM,etal.Averageopticalperformanceofthehumaneyeasafunctionofageinanormalpopulation.InvestOphthalmolVisSci.1999;40(1):203-213.GunencU,OnerFH,TongalS,FerlielM.EffectsonvisualfunctionofglisteningsandfoldingmarksinAcrySofintraocularlenses.JCataractRefractSurg.2001;27:1611-1614.HolladayJT,PiersPA,KoranyiG,etal.Anewintraocularlensdesigntoreducesphericalaberrationofpseudophakiceyes.JRefractSurg.2002;18(6):683-691.HolzerMP.Datapresentedatthe19thCongressofGermanOphthalmicSurgeons(DOC),Nuremburg,Germany,JacksonGR.Pilotstudyontheeffectofablue-blockingIOLonrod-mediated(scotopic)vision.ASCRSSymposiumonCataract,IOLandRefractiveSurgery,Washington,DC,2005.KennisH,HuygensM,CallebautF.Comparingthecontras sitivityofamodifiedprolateanteriorsurfaceIOLandoftwosphericalIOLs.BullSocBelgeOphtalmol.2004 LehrlS,GerstmeyerJ,JacobH.Bluelightimprovescognitiveperformance.JNeuralTrans.MainsterMA.Violetandbluelightblockingintraocularlenses:photoprotectionvs.photoreception.BrJOphthalmol.2006;90:784-792.MainsterMA,TurnerPL.Theimpactofbluelightonvision&health.PresentedatASCRS,2007.MarketScopeIOLReport,2007.McBrideDK,MatsonW.PreliminaryreportPIPS-50-03.Arlington,VA:PotomacInstituteforPolicyStudies;April1,2003.MiyataA,YaguchiS.Equilibriumwatercontentandglisteningsinacrylicintraocularlenses.JCataractRefractSurg.2004;30:1768-1772. .,KobialkaS.,SteinerR.,Wavelength-dependenteffectsofeveninglightexposureonsleep ureandsleepEEGpowerdensityinmen.AmJPhysiol.2006;290:1421-1428.NegishiK,OhnumnaK,HirayamaN,NodaT.Effectofchromaticaberrationon sitivityNishiT,NawaY,UedaT,etal.Effectoftotalhigher-orderaberrationson modationinpseudophakiceyes.JCataractRefractSurg.2006;32(10):1643-1649.OshikaT,KlyceSD,ApplegateRA,etal.Changesincornealwavefrontaberrationswithaging.InvestOphthalmolVisSci.1999;40:1351-1355.OwsleyC,SekulerR,SiemsenD. sitivitythroughoutadulthood.VisionRes.1983;23(7):689-OzbekZ,SaatciAO,DurakI,etal.Stainingofintraocularlenseswithvariousdyes:Astudyofdigitalimageysis.Ophthalmologica.2004;218:243-247.PackerM,FineIH,HoffmanRS.Functionalvision, sing,andcataractIntOphthalmolClin.2003;43(2):79-PiersPA,TaberneroJ,BenitoA,etal.Opticalandvisualperformancearewellcorrelatedinpseudophakiceyes.PresentedatASCRS2005.SchwiegerlingJ.Theoreticallimitstovisualperformance.SurvOphthalmology.2000;45(2):139-SchwiegerlingJ.Blue-light-absorbinglensesandtheireffectonscotopicvision.JCataractRefractScilleyK,JacksonG,CideciyanA,etal.EarlyAge-relatedMaculopathyandSelf-reportedVisualDifficultyinDailyLife.Ophthalmology.2002;109(7):1235-1242.SteinertRR.Invivoassessmentofintraocularlenscalcificationinarabbitmodel.PresentedatASCRS,ISFoldablePosteriorChambe