CAJ | 학술논문

目的评价高度近视伴后巩膜葡萄肿的白内障患者行白内障超声乳化摘除联合人工晶状体(intraocular lens,IOL)植入术后的视觉质量,并分析其原因.方法本研究根据患者术前屈光状态以及有无后巩膜葡萄肿分为三组:A组为高度近视伴有后巩膜葡萄肿的白内障患者;B组为高度近视无后巩膜葡萄肿的白内障患者;C组为正视眼的白内障患者.于手术后3d观察A、B、C三组裸眼远视力(uncorrected distance visual acuity,UCDVA)和最佳矫正远视力(best-corrected distance visual acuity,BCDVA),术后6mo观察A组视力与眼轴的关系、A、B、C三组UCDVA和BCDVA、对比敏感度、眼底检查及患者术后满意度调查.结果在本实验收集的472例患者(545眼)中,A组患者74例(91眼);B、C组各199例(227眼).术后3d及6mo,B、C组的UCDVA及BCDVA均优于A组,差异有统计学意义(均P<0.05);术后3d,C组的裸眼远视力及最佳矫正远视力优于B组,差异有统计学意义(P<0.05);术后6mo患者UCDVA及BCDVA在B、C两组间的差异无统计学意义.A组和B组在4种状态5种空间频率下的对比敏感度的差异均有统计学意义(均P<0.05),C组的对比敏感度高于A、B组,B组的对比敏感度要高于A组,差异有统计学意义(均P<0.05).经统计学检验,高度近视伴后巩膜葡萄肿白内障患者超声乳化术后视力与眼轴长短之间呈负相关性.A、B组患者术后视觉质量满意度高于C组,差异有统计学意义(均P<0.05),但A、B组间患者术后质量满意度无明显差异.结论高度近视伴后巩膜葡萄肿的白内障患者行白内障超声乳化摘除联合IOL植入术后的视觉质量较高度近视不伴有后巩膜葡萄肿的白内障及正视眼的白内障患者差,这与高度近视眼底病变有直接关系.
목적 평개고도근시반후공막포도종적백내장환자행백내장초성유화적제연합인공정상체(intraocular lens,IOL)식입술후적시각질량,병분석기원인.방법 본연구근거환자술전굴광상태이급유무후공막포도종분위삼조:A조위고도근시반유후공막포도종적백내장환자;B조위고도근시무후공막포도종적백내장환자;C조위정시안적백내장환자.우수술후3d관찰A、B、C삼조라안원시력(uncorrected distance visual acuity,UCDVA)화최가교정원시력(best-corrected distance visual acuity,BCDVA),술후6mo관찰A조시력여안축적관계、A、B、C삼조UCDVA화BCDVA、대비민감도、안저검사급환자술후만의도조사.결과 재본실험수집적472례환자(545안)중,A조환자74례(91안);B、C조각199례(227안).술후3d급6mo,B、C조적UCDVA급BCDVA균우우A조,차이유통계학의의(균P<0.05);술후3d,C조적라안원시력급최가교정원시력우우B조,차이유통계학의의(P<0.05);술후6mo환자UCDVA급BCDVA재B、C량조간적차이무통계학의의.A조화B조재4충상태5충공간빈솔하적대비민감도적차이균유통계학의의(균P<0.05),C조적대비민감도고우A、B조,B조적대비민감도요고우A조,차이유통계학의의(균P<0.05).경통계학검험,고도근시반후공막포도종백내장환자초성유화술후시력여안축장단지간정부상관성.A、B조환자술후시각질량만의도고우C조,차이유통계학의의(균P<0.05),단A、B조간환자술후질량만의도무명현차이.결론 고도근시반후공막포도종적백내장환자행백내장초성유화적제연합IOL식입술후적시각질량교고도근시불반유후공막포도종적백내장급정시안적백내장환자차,저여고도근시안저병변유직접관계.
AIM: To evaluate the visual quality of cataract patients of high myopia with posterior staphyloma after phacoemulsification and intraocular lens(IOL) implantation, and analyze the reasons.staphyloma(Group A) and cataract patients of high myopia without posterior staphyloma(Group B)and cataract patients of emmetropia(Group C) .Postoperative visual function, including uncorrected distance visual acuity (UCDVA) and best-corrected distance visual acuity(BCDVA) were evaluated 3 days and 6 months postoperatively. Contrast sensitivity, fundoscopy and patients' self satisfaction in the 3 groups were also compared. The relationship of vision and the axial length was also evaluated in Group A.Group B and C. The Group B and C had statistically significant better UCDVA and BCDVA than Group A from 3 days postoperatively to the final follow-up (both P<0.05). Group C had statistically significant better UCDVA and BCDVA than Group B at 3 days postoperatively (P<0.05). There were no statistically significant differences in UCDVA or BCDVA between Group B and C at 6 months postoperatively. The Group C had statistically significantly better contrast sensitivity than Group A and B; Group B had statistically significantly better contrast sensitivity than Group A (all P<0.05). After statistical test, it was testified that there was negative correlation between axis length of eye and postoperative vision in cataract patients of high myopia with posterior staphyloma. Patients in Group A and B reported being more satisfied than those in Group C(both P<0.05), but there were no significant differences between Group A and B.posterior staphyloma after phacoemulsification and IOL implantation is worse than that of high myopia without posterior staphyloma and emmetropia. It is directly related to the posterior segment pathological changes in high myopia.