白内障摘除手术单眼视设计度数对白内障患者预后视觉质量的影响
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摘要
目的:探讨白内障摘除手术单眼视设计中不同的近附加度数对白内障患者预后视觉质量的影响。方法:选取2016-02/2017-02在我院进行白内障摘除手术的白内障患者84例168眼进行前瞻性研究,根据单眼视设计中近附加度数的不同,将入选患者分为低近附加度数组(1.25～1.75D)和高近附加度数组(2.25～2.75D)每组各42例84眼。比较两组患者的术后6mo双眼裸眼近视力、中距离视力、远视力及立体视,以及治疗前后的视功能生存质量评分。结果:低近附加度数组患者的双眼裸眼中、远视力分别为0.27±0.20、0.09±0.08,高近附加度数组患者的双眼裸眼中、远视力分别为0.29±0.25、0.10±0.07,两组相比差异均无统计学意义(P>0.05)。高近附加度数组患者的双眼裸眼近视力为0.03±0.06,显著优于低近附加度数组0.07±0.04,差异具有统计学意义(P<0.05)。治疗前两组患者视功能指数量表(VF-14)评分分别为27.93±4.52、28.24±4.91分,治疗后两组患者视功能指数量表(VF-14)评分分别为82.04±14.31、81.22±13.70分,差异均无统计学意义(P>0.05)。与治疗前相比,两组患者治疗后VF-14评分均显著增加,差异具有统计学意义(P<0.05)。低近附加度数组患者正常立体视、周边立体视及黄斑立体视所占百分比分别为47.6%、31.0%、21.4%,高近附加度数组正常立体视、周边立体视及黄斑立体视所占百分比分别为42.9%、23.8%、33.3%,两组相比差异均无统计学意义(P>0.05)。结论:白内障患者的两种近附加度数对提高单眼视设计白内障摘除手术后患者的裸眼视力、视功能生存质量及立体视均有相似的优越性。
AIM:To investigate the influence of monovision design of cataract surgery on the prognosis visual quality in cataract patients.METHODS:Totally 84 cases cataract patients( 168 eyes)who receiving cataract surgery were enrolled from February 2016 to February 2017 in our hospital to conduct a prospective study. According to the different near addition in the monovision design,patients were divided into low near addition group( 1. 25 D-1. 75 D) and high near addition group( 2. 25 D-2. 75 D),each group was 42 cases. At postoperative 6 mo,the binocular uncorrected near visual acuity,uncorrected intermediate visual acuity,uncorrected distance visual acuity and stereoscopic vision were compared between two groups. The visual function survival quality score before and after treatment were compared.RESULTS:The binocular uncorrected intermediate and distance visual acuity in the low near addition group respectively was 0. 27 ± 0. 20,0. 09 ± 0. 08,and that in the high near addition group respectively was 0. 29 ± 0. 25,0. 10 ±0. 07, which had no statistically significant difference between two groups( P > 0. 05). The binocular uncorrected near visual acuity in the high near addition group was 0. 03 ±0. 06,which was significantly better than the low near addition group 0. 07 ± 0. 04,the difference was statistically significant( P < 0. 05). Before the treatment,the visual function-14( VF-14) score in each two group respectively was 27. 93 ± 4. 52,28. 24 ± 4. 91;after the treatment,VF-14 score in each two group respectively was 82. 04 ± 14. 31,81. 22 ± 13. 70,which had no statistically significant difference between two groups( P > 0. 05). After treatment, the VF-14 score both significantly increased in the two groups( P < 0. 05). The proportion of patients with the normal stereoscopic vision,peripheral stereovision and macular stereovision in the low near addition group respectively was 47. 6%,31. 0%,21. 4%; and that in the high near addition group respectively was 42. 9%,23. 8%,33. 3%,which had no statistically significant difference between two groups( P>0. 05).CONCLUSION:Two kinds of near addition have similar advantages to cataract patients after cataract surgery on uncorrected visual acuity,the quality of visual function and stereopsis.
AIM:To investigate the influence of monovision design of cataract surgery on the prognosis visual quality in cataract patients.METHODS:Totally 84 cases cataract patients( 168 eyes)who receiving cataract surgery were enrolled from February 2016 to February 2017 in our hospital to conduct a prospective study. According to the different near addition in the monovision design,patients were divided into low near addition group( 1. 25 D-1. 75 D) and high near addition group( 2. 25 D-2. 75 D),each group was 42 cases. At postoperative 6 mo,the binocular uncorrected near visual acuity,uncorrected intermediate visual acuity,uncorrected distance visual acuity and stereoscopic vision were compared between two groups. The visual function survival quality score before and after treatment were compared.RESULTS:The binocular uncorrected intermediate and distance visual acuity in the low near addition group respectively was 0. 27 ± 0. 20,0. 09 ± 0. 08,and that in the high near addition group respectively was 0. 29 ± 0. 25,0. 10 ±0. 07, which had no statistically significant difference between two groups( P > 0. 05). The binocular uncorrected near visual acuity in the high near addition group was 0. 03 ±0. 06,which was significantly better than the low near addition group 0. 07 ± 0. 04,the difference was statistically significant( P < 0. 05). Before the treatment,the visual function-14( VF-14) score in each two group respectively was 27. 93 ± 4. 52,28. 24 ± 4. 91;after the treatment,VF-14 score in each two group respectively was 82. 04 ± 14. 31,81. 22 ± 13. 70,which had no statistically significant difference between two groups( P > 0. 05). After treatment, the VF-14 score both significantly increased in the two groups( P < 0. 05). The proportion of patients with the normal stereoscopic vision,peripheral stereovision and macular stereovision in the low near addition group respectively was 47. 6%,31. 0%,21. 4%; and that in the high near addition group respectively was 42. 9%,23. 8%,33. 3%,which had no statistically significant difference between two groups( P>0. 05).CONCLUSION:Two kinds of near addition have similar advantages to cataract patients after cataract surgery on uncorrected visual acuity,the quality of visual function and stereopsis.
引文
1陈拥军,姬亚洲,毋艳君,等.两种不同的单眼视设计在合并高度近视白内障患者中的应用.眼科新进展2016;36(11):1073-1076
2 Meier PG,Majo F,Othenin-Girard P,et al.Refractive outcomes and complications after combined copolymer phakic intraocular lens explantation and phacoemulsification with intraocular lens implantation.JCataract Refract Surg 2017;43(6):748-753
3 Casini G,Loiudice P,Lazzeri S,et al.Analysis of Choroidal Thickness Change after 25-Gauge Vitrectomy for Idiopathic Epiretinal Membrane with or without Phacoemulsification and Intraocular Lens Implantation.Ophthalmologica 2017;237(2):78-84
4 Chiu H,Dang H,Cheung C,et al.Ten-year retrospective review of outcomes following phacoemulsification with intraocular lens implantation in patients with pre-existing uveitis.Can J Ophthalmol 2017;52(2):175-180
5 Courtin R,Saad A,Grise-Dulac A,et al.Changes to Corneal Aberrations and Vision After Monovision in Patients With Hyperopia After Using a Customized Aspheric Ablation Profile to Increase Corneal Asphericity(Q-factor).J Refract Surg 2016;32(11):734-741
6 Lee SH,Jun W,London R.Optical Management Using Monovision and Yoked Prism for Acquired Strabismus and Nystagmus Secondary to a Neurodegenerative Disease.Neuroophthalmology 2015;39(3):147-151
7林慧敏,陈瑶,封利霞.屈光参差与立体视功能的相关性分析.安徽医科大学学报2016;51(10):1514-1517
8刘晓玲,尹素凤,刘彦才.视功能指数量表(VF-14)的修订及评价.国际眼科杂志2011;11(3):455-458
9 Jimenez-Roman J,Lazcano-Gomez G,Martínez-Baez K,et al.Effect of phacoemulsification on intraocular pressure in patients with primary open angle glaucoma and pseudoexfoliation glaucoma.Int JOphthalmol 2017;10(9):1374-1378
10 Xu H,Lutrin D,Wu Z.Outcomes of 23-gauge pars plana vitrectomy combined with phacoemulsification and capsulotomy without intraocular lens implantation in rhegmatogenous retinal detachment associated with choroidal detachment.Medicine 2017;96(34):e7869
11 Mohebbi M,Bashiri SA,Mohammadi SF,et al.Outcome of Singlepiece Intraocular Lens Sulcus Implantation following Posterior Capsular Rupture during Phacoemulsification.J Ophthalmic Vis Res 2017;12(3):275-280
12 Kamiya K,Takahashi M,Takahashi N,et al.Monovision by Implantation of Posterior Chamber Phakic Intraocular Lens with a Central Hole(Hole ICL)for Early Presbyopia.Sci Rep 2017;7(1):11302
13 Greenstein S.The Quest for Spectacle Independence:A Comparison of Multifocal Intraocular Lens Implants and Pseudophakic Monovision for Patients with Presbyopia.Seminars Ophthalmol 2017;32(1):111-115
14陈文静.双眼视的检查及病例分析.中国眼镜科技杂志2017;21:130-134
15穆晶,李一壮,吴强,等.两种附加度数在白内障摘除手术单眼视设计中应用的临床观察.中华眼科杂志2017;53(6):451-454
16 Nuzzi R,Monteu F,Tridico F.Implantation of a Multifocal Toric Intraocular Lens after Radial Keratotomy and Cross-Linking with Hyperopia and Astigmatism Residues:A Case Report.Case Rep Ophthalmol 2017;8(2):440-445
17吴微微,彭秀军.屈光参差与立体视觉.国际眼科杂志2014;14(1):74-76
18从金菊,宁宏.屈光性调节性内斜视屈光参差对弱视及远期立体视觉的影响.安徽医药2017;21(5):834-837
19刘长辉,魏栋栋,梁玲.屈光参差性弱视患者LASIK术后矫正视力和立体视觉的变化.国际眼科杂志2017;17(8):1519-1522
2 Meier PG,Majo F,Othenin-Girard P,et al.Refractive outcomes and complications after combined copolymer phakic intraocular lens explantation and phacoemulsification with intraocular lens implantation.JCataract Refract Surg 2017;43(6):748-753
3 Casini G,Loiudice P,Lazzeri S,et al.Analysis of Choroidal Thickness Change after 25-Gauge Vitrectomy for Idiopathic Epiretinal Membrane with or without Phacoemulsification and Intraocular Lens Implantation.Ophthalmologica 2017;237(2):78-84
4 Chiu H,Dang H,Cheung C,et al.Ten-year retrospective review of outcomes following phacoemulsification with intraocular lens implantation in patients with pre-existing uveitis.Can J Ophthalmol 2017;52(2):175-180
5 Courtin R,Saad A,Grise-Dulac A,et al.Changes to Corneal Aberrations and Vision After Monovision in Patients With Hyperopia After Using a Customized Aspheric Ablation Profile to Increase Corneal Asphericity(Q-factor).J Refract Surg 2016;32(11):734-741
6 Lee SH,Jun W,London R.Optical Management Using Monovision and Yoked Prism for Acquired Strabismus and Nystagmus Secondary to a Neurodegenerative Disease.Neuroophthalmology 2015;39(3):147-151
7林慧敏,陈瑶,封利霞.屈光参差与立体视功能的相关性分析.安徽医科大学学报2016;51(10):1514-1517
8刘晓玲,尹素凤,刘彦才.视功能指数量表(VF-14)的修订及评价.国际眼科杂志2011;11(3):455-458
9 Jimenez-Roman J,Lazcano-Gomez G,Martínez-Baez K,et al.Effect of phacoemulsification on intraocular pressure in patients with primary open angle glaucoma and pseudoexfoliation glaucoma.Int JOphthalmol 2017;10(9):1374-1378
10 Xu H,Lutrin D,Wu Z.Outcomes of 23-gauge pars plana vitrectomy combined with phacoemulsification and capsulotomy without intraocular lens implantation in rhegmatogenous retinal detachment associated with choroidal detachment.Medicine 2017;96(34):e7869
11 Mohebbi M,Bashiri SA,Mohammadi SF,et al.Outcome of Singlepiece Intraocular Lens Sulcus Implantation following Posterior Capsular Rupture during Phacoemulsification.J Ophthalmic Vis Res 2017;12(3):275-280
12 Kamiya K,Takahashi M,Takahashi N,et al.Monovision by Implantation of Posterior Chamber Phakic Intraocular Lens with a Central Hole(Hole ICL)for Early Presbyopia.Sci Rep 2017;7(1):11302
13 Greenstein S.The Quest for Spectacle Independence:A Comparison of Multifocal Intraocular Lens Implants and Pseudophakic Monovision for Patients with Presbyopia.Seminars Ophthalmol 2017;32(1):111-115
14陈文静.双眼视的检查及病例分析.中国眼镜科技杂志2017;21:130-134
15穆晶,李一壮,吴强,等.两种附加度数在白内障摘除手术单眼视设计中应用的临床观察.中华眼科杂志2017;53(6):451-454
16 Nuzzi R,Monteu F,Tridico F.Implantation of a Multifocal Toric Intraocular Lens after Radial Keratotomy and Cross-Linking with Hyperopia and Astigmatism Residues:A Case Report.Case Rep Ophthalmol 2017;8(2):440-445
17吴微微,彭秀军.屈光参差与立体视觉.国际眼科杂志2014;14(1):74-76
18从金菊,宁宏.屈光性调节性内斜视屈光参差对弱视及远期立体视觉的影响.安徽医药2017;21(5):834-837
19刘长辉,魏栋栋,梁玲.屈光参差性弱视患者LASIK术后矫正视力和立体视觉的变化.国际眼科杂志2017;17(8):1519-1522