Effect of Astigmatism on Apparent Accommodation in Pseudophakic Eyes
Effect of Astigmatism on Apparent Accommodation in Pseudophakic Eyes
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DOI：
10.1097/opx.0b013e31823ededa
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发表时间：
2012-02-01
影响因子：
1.4
通讯作者：
Shimizu, Kimiya
中科院分区：
文献类型：
--
作者：
Kamiya, Kazutaka;Kawamorita, Takushi;Shimizu, Kimiya
目的。从临床角度探讨影响假晶状眼视调节的因素，从光学角度探讨角膜和屈光散光对视调节的影响。我们回顾性检查了33例超声乳化术合并单焦点人工晶状体植入术的62只眼。我们在术后3个月用调节仪定量评估表观调节幅度。采用多元回归分析评估影响表观调节的因素。我们还通过光学模拟估计了角膜散光眼的调节能力。表观调节的平均振幅为1.58 +/- 0.65 d，与此调节相关的解释变量依次为瞳孔直径（部分回归系数B = -0.293, p = 0.008）和角膜多焦性（B = 0.101, p = 0.03）。其他解释变量如年龄、性别、眼轴长度、角膜散光和屈光性散光与这种调节没有显著关系。在角膜散光为0、0.5、1.0、1.5和2.0 D的情况下，通过光学模拟估计3.0 mm瞳孔的视调节分别为1.25、1.25、1.25、0.75和0 D。对于4.0 mm的瞳孔，也得到了类似的结果。瞳孔直径较小的眼睛和角膜多焦性较大的眼睛更容易有更大的表观调节。然而，从临床和光学角度来看，角膜或屈光性散光对白内障手术后的表观调节没有显著影响，这表明散光眼在考虑这种调节时有意识地保留散光的重要性可能较小。（光学视觉科学；2012;39:148-154）
Purpose. To investigate the factors affecting apparent accommodation in pseudophakic eyes from a clinical viewpoint and the effects of corneal and refractive astigmatism on this accommodation from an optical viewpoint.Methods. We retrospectively examined 62 eyes of 33 patients who had undergone phacoemulsification with monofocal intraocular lens implantation. We quantitatively assessed the amplitude of apparent accommodation using an accommodometer 3 months after surgery. Multiple regression analysis was used to assess the factors affecting apparent accommodation. We also estimated the accommodation in eyes with corneal astigmatism by optical simulation.Results. The mean amplitude of apparent accommodation was 1.58 +/- 0.65 D. Explanatory variables relevant to this accommodation were in order of influence, pupil diameter (partial regression coefficient B = -0.293, p = 0.008), and corneal multifocality (B = 0.101, p = 0.03). Other explanatory variables such as age, gender, axial length, corneal astigmatism, and refractive astigmatism showed no significant relationship with this accommodation. The estimated apparent accommodations for a 3.0 mm pupil by optical simulation were 1.25, 1.25, 1.25, 0.75, and 0 D, in eyes with corneal astigmatism of 0, 0.5, 1.0, 1.5, and 2.0 D, respectively. Similar results were obtained for a 4.0 mm pupil.Conclusions. Eyes with smaller pupil diameter and eyes with greater corneal multifocality are more predisposed to have greater apparent accommodation. However, from clinical and optical viewpoints, corneal or refractive astigmatism does not significantly contribute to apparent accommodation after cataract surgery, suggesting that it may be of less significance that the astigmatism is consciously retained in consideration of this accommodation in astigmatic eyes. (Optom Vis Sci 2012; 89: 148-154)