摘要目的:观察年龄相关性白内障患者术前角膜球差的分布情况及其相关因素。方法:采用横断面研究方法，对2014年12月至2015年12月于山西省眼科医院就诊的40岁以上年龄相关性白内障患者1 319例1 319眼术前角膜球面像差进行测量，分析年龄相关性白内障患者术前角膜球面像差分布。所有患眼均采用Pentacam HR眼前节分析仪测量平均角膜曲率(Km)值、平均角膜后表面曲率(Km)值、角膜散光值、角膜后表面散光值和角膜厚度；采用Zernike分析计算以角膜顶点为中心6 mm直径范围内的角膜球面像差值；计算角膜球面像差的分布情况及其与各眼球因素之间的相关性、不同类型非球面人工晶状体矫正角膜球差的比率。结果:患者平均年龄为(68.00±11.12)岁，平均角膜球面像差值为(0.34±0.17)μm，波动范围为－0.38～0.99 μm。其中角膜球面像差<0 μm者22眼，占1.67%；角膜球面像差为0～0.4 μm者842眼，占63.84%；角膜球面像差>0.4 μm者455眼，占34.50%。角膜球面像差与患者年龄呈弱正相关( r＝0.398， P<0.001)；与受检眼角膜Km值、角膜后表面Km值、角膜厚度均呈极弱相关( r＝0.129， P<0.001； r＝0.240， P<0.001； r＝－0.068， P<0.05)；与角膜散光或角膜后表面散光之间尚不能认为有相关性( r＝－0.025， P＝0.365； r＝－0.008， P＝0.771)。年龄可能影响角膜球面像差。以残余球面像差(0.10±0.05)μm为目标采用不同类型非球面人工晶状体(0、－0.20和－0.27 μm)可矫正710眼，占53.83%。 结论:年龄相关性白内障患者术前平均角膜球面像差较既往报道值(＋0.27 μm)偏大。术前应根据患者个性化的角膜球面像差选择适合的非球面IOL。

abstractsObjective:To investigate the distribution of the spherical aberration in age-related cataractous eyes using the Pentacam HR.Methods:A cross-sectional study was performed in Shanxi Eye Hospital from December 2014 to December 2015.The preoperative corneal spherical aberration of 1 319 eyes of 1 319 patients with age-related cataract over 40-years-old was analyzed.The mean average keratometry (Km value), and corneal posterior surface Km corneal astigmatism, posterior corneal astigmatism, and corneal thickness were measured with.Pentacam, and the Zernike coefficients of corneal spherical aberration were calculated.A correlation between spherical aberration and corneal parameters was evaluated by Pearson correlation analysis.The proportion of eyes qualifying for spherically neutral or negatively aspheric intraocular lens targeted residual spherical aberration level was evaluated.This study protocol was approved by Ethics Committee of Shanxi Eye Hospital and complied with Declaration of Helsinki.Results:The average age of all patients was (68.00±11.12) years old with an average spherical aberration (0.34±0.17)μm.The spherical aberration was lower than 0 μm in 22 eyes (1.67%), 0~0.4 μm in 842 eyes (63.84%), and greater than 0.4 μm in 455 eyes (34.50%). There was a weak positive correlation between spherical aberration and age ( r=0.398, P<0.001). There were very weak correlations between spherical aberration and corneal Km, posterior corneal surface Km, corneal thickness ( r=0.129, P<0.001; r=0.240, P<0.001; r=-0.068, P<0.05). No significant correlations were found between spherical aberration and corneal astigmatism or posterior corneal astigmatism ( r=-0.025, P=0.365; r=-0.008, P=0.771). Seven hundred and ten eyes (53.83%) could be qualified for implantation of negatively or neutrally aspheric intraocular lens based on postoperative targets of (0.10±0.05)μm residual spherical aberration. Conclusions:Corneal spherical aberration in Chinese patients is greater than that in other populations (+ 0.27 μm) in literature and shows individual differences.The appropriate aspheric intraocular lens should be selected according to individual corneal spherical aberration before cataract operation.