AIM:To observe and analyze visual quality changes of the patients with posterior capsule opacification ( PCO ) Nd:YAG laser posterior capsular dissection, including the change of the best corrected vision acuity ( BCVA ) , total high- order aberration ( tHOA ) , and the modulation transfer function ( MTF) . METHODS:In this prospective observational study, 100 cases of patients ( 100 eyes ) with posterior cataract underwent Nd:YAG laser posterior capsular dissection ( posterior capsular diameter dissected was 5mm or higher). The mean age was 65. 52±7. 01 years old. The change of the BCVA was collected. The tHOA and MTF under the 3mm and 5mm pupil diameter were assessed by iTrace respectively before and after Nd:YAG laser posterior capsular dissection. RESULTS:All the surgery went well without obvious intraoperative and postoperative complications happened. The preoperative BCVA was 0. 451 ± 0. 023 while the postoperative BCVA was 0. 763±0. 025. The difference of BCVA before and after Nd: YAG laser surgery was statistically significant (P<0. 01). At 3mm pupil diameter, the tHOA preoperative was 0. 551 ± 0. 031 while the postoperative tHOA was 0. 214± 0. 011, the differences were significance (P<0. 05). At 3mm pupil diameter while the spatial frequencies ( 5cpd, 10cpd, 15cpd, 20cpd, 25cpd, 30cpd ) respectively, the MTF tHOA value postoperative (0. 644±0. 023, 0. 49±0. 011, 0. 311±0. 015, 0.202±0. 018, 0. 056±0. 027, 0. 041±0. 011) were significantly higher than that preoperative (0. 401±0. 021, 0. 261±0. 026, 0. 179±0. 012, 0. 108±0. 014, 0. 031±0. 016, 0. 022±0. 021), and the difference has statistical significance (P<0. 05). At 5mm pupil diameter, the tHOA preoperative was 0. 752±0.028 while the postoperative tHOA was 0. 361±0. 014, the differences were significance (P<0. 01). At 5mm pupil diameter while the spatial frequencies ( 5cpd, 10cpd, 15cpd, 20cpd, 25cpd, 30cpd) respectively the MTF tHOA value postoperative (0. 426±0. 027, 0. 209±0. 018, 0. 172±0. 013, 0. 116±0. 015, 0. 049±0. 010, 0. 034±0. 014 ) were significantly higher than that preoperative (0. 234±0. 021, 0. 102±0. 019, 0. 088±0. 016, 0. 058±0. 022, 0. 021±0. 014, 0.016 ± 0. 011 ), and the difference had statistical significance (P<0. 05). CONCLUSION: Patients with posterior capsule opacification ( PCO ) Nd:YAG laser posterior capsular dissection can help improve BCVA, reduce tHOA, increase MTF tHOA values, and significantly improve visual quality of patients.%目的：观察分析白内障人工晶状体植入术后后发性白内障( posterior capsule opacification,PCO)患者行Nd：YAG激光后囊膜切开术前后视力、全眼高阶像差( total high-order aberration, tHOA )、调制传递函数( modulation transfer function,MTF)、视觉质量的变化。 方法：选取2014-06/2015-09来我院就诊的白内障人工晶状体植入术后PCO患者共100例100眼,年龄47~80(平均65.52±7.01)岁,所有患者均行Nd：YAG激光后囊膜切开术(激光孔径≥5 mm )治疗,观察激光术前后最佳矫正视力( best corrected vision acuity,BCVA)的变化,应用iTrace视觉功能分析仪分别测量分析3 mm和5 mm瞳孔直径下激光术前后全眼总高阶像差tHOA及MTF的变化。结果：所有Nd：YAG激光手术顺利,未发生明显术中、术后意外情况及并发症,BCVA：术前0.451±0.023,术后0.763±0.025,手术前后 BCVA 差异有统计学意义( P<0.01)。3 mm瞳孔直径下术前 tHOA 0.551±0.031,术后 tHOA 0.214±0.011,手术前后3 mm瞳孔直径下tHOA 差异有统计学意义(P <0.01)。3mm瞳孔直径下激光术后在5、10、15、20、25、30 c/d 6种空间频率下 MTF tHOA 值(0.644±0.023、0.497±0.011、0.311±0.015、0.202±0.018、0.056±0.027、0.041±0.011)较术前(0.401±0.021、0.261±0.026、0.179±0.012、0.108±0.014、0.031±0.016、0.022±0.021)显著提高,差异有统计学意义(P<0.05)。5mm瞳孔直径下术前 tHOA 0.752±0.028,术后 tHOA 0.361±0.014,激光术前后5 mm瞳孔直径下tHOA 差异有统计学意义( P <0.01)。5 mm瞳孔直径下激光术后在5、10、15、20、25、30 c/d 6种空间频率下 MTF tHOA 值(0.426±0.027、0.209±0.018、0.172±0.013、0.116±0.015、0.049±0.010、0.034±0.014)较术前(0.234±0.021、0.102±0.019、0.088±0.016、0.058±0.022、0.021±0.014、0.016±0.011)显著提高,差异有统计学意义(P<0.05)。 结论：PCO 患者行 Nd：YAG 激光后囊膜切开术治疗后BCVA提高、tHOA 降低、MTF值增大、患眼的视觉质量明显提高。
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