目的：探讨κ角和α角对多焦点人工晶状体(mIOLs)植入后患者视觉质量的影响。

方法：回顾性队列研究。纳入接受超声乳化白内障吸除联合mIOLs植入术的患者46例46眼。使用iTrace测量术前κ角、α角，术后波前像差，分别分析其与角膜、眼内及全眼视觉质量之间的相关性。

结果：在3 mm瞳孔大小时，κ角的大小与眼内和全眼调制传递函数(MTF)呈负相关； κ角的大小与3 mm瞳孔时眼内和全眼的散光、三叶、高阶像差(HOAs)呈正相关。在3 mm瞳孔时，α角的大小与全眼MTF和全眼Strehl比呈负相关。α角的大小与5 mm瞳孔时的角膜彗差、3 mm和5 mm瞳孔时的眼内散光以及3 mm瞳孔时的全眼球差(SA)呈正相关。多元线性回归分析显示，在候选自变量(κ角、α角、散光、SA、彗差、三叶草和HOAs)中，散光是改变3 mm和5 mm瞳孔时角膜MTF的唯一独立因素； 散光和HOA成为改变3 mm和5 mm瞳孔时眼内MTF以及3 mm瞳孔时全眼MTF的独立因素； 散光、SA和HOAs成为改变5mm瞳孔时全眼MTF的独立因素。

结论：随着术前κ角或α角的增大，接受mIOL植入的患者往往会出现较大的眼内散光和HOA，导致视觉质量差，尤其是瞳孔较小的患者。

METHODS: Retrospective cases series. A total of 46 patients(46 eyes)who underwent phacoemulsification were subsumed. The correlation between Preoperative angles kappa and alpha, wave-front aberrations and objective visual quality of cornea, internal, and total eye after surgery were analyzed using iTrace.

RESULTS: The magnitude of angle kappa was negatively correlated with internal and total modulation transfer function(MTF)at 3 mm; the magnitude of angle kappa was positively correlated with astigmatism, trefoil, higher-order aberrations(HOAs)of both internal and total eye at 3 mm. The magnitude of angle alpha was negatively correlated with total MTF and total Strehl ratio at 3 mm. The magnitude of angle alpha was positively correlated with corneal coma at 5 mm, internal astigmatism at both 3 mm and 5 mm, and total spherical aberration(SA)at 3 mm. Multivariate linear regression analysis showed that, among candidate independent variables(kappa, alpha, astigmatism, SA, coma, trefoil, and HOAs), astigmatism is the only independent factor for altering corneal MTF at 3 mm and 5 mm; astigmatism and HOAs emerged as independent factors for altering internal MTF at 3 mm and 5 mm, and total MTF at 3 mm; astigmatism, SA and HOAs emerged as independent factors for altering total MTF at 5 mm.

CONCLUSION: With greater preoperative angle kappa or angle alpha, patients who accept mIOL implantation tend to have larger internal astigmatism and HOAs, which resulting in poor visual quality, especially those with small pupil size.