中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2010年
11期
1212-1214
,共3页
才瑜%潘英姿%聂红平%杨松霖
纔瑜%潘英姿%聶紅平%楊鬆霖
재유%반영자%섭홍평%양송림
西藏%老年性白内障%视力改善影响因素
西藏%老年性白內障%視力改善影響因素
서장%노년성백내장%시력개선영향인소
Tibet%Senile cataract%Impact factors for visual acuity improvement
目的 分析影响西藏地区老年性白内障术后视力改善的因素.方法 对西藏地区接受白内障手术的老年性白内障278例,分析年龄、核分级、术式(超声乳化术和小切口白内障囊外摘除术)、人工晶状体度数、角膜水肿部位等对术后视力改善的影响.视力采用LogMAR视力.统计方法分别采用单因素和多因素线性回归方法.结果 (1)单因素分析:术式:超声乳化术组术后较术前视力改善(平均视力差) 0.92±0.48,小切口白内障囊外摘除术组平均视力差0.83±0.46,两种手术方式对视力改善的影响,差异没有统计学意义(P＞0.05).年龄:70-、80-年龄组分别与40-、50-、60-年龄组差异有统计学意义(P＜0.05).角膜水肿部位:弥漫性水肿(平均视力差0.52±0.42)较中央部位水肿(平均视力差0.70±0.44))对视力改善影响更大,差异有统计学意义(P＜0.05).(2)多因素线性回归分析:年龄、角膜水肿部位均对视力改善有影响,差异有统计学意义(P＜0.05).结论 (1)超声乳化术和小切口白内障囊外摘除术两种手术方式对视力提高程度无明显差异,因此在西藏地区可以根据当地条件,包括经济状况和医师具备的手术水平,来选择术式,以使患者获得最佳有用视力.(2)年龄为白内障术后视力改善的影响因素之一,随年龄增加视力改善减少,而西藏地区就医条件有限,故在西藏地区更应重视白内障的普查,强调早期发现和早期手术.(3)在角膜水肿分级无明显差异的基础上,弥漫性水肿较中央部水肿对视力改善影响更大,因此在术中应谨慎操作,尽量避免角膜内皮广泛的损伤.
目的 分析影響西藏地區老年性白內障術後視力改善的因素.方法 對西藏地區接受白內障手術的老年性白內障278例,分析年齡、覈分級、術式(超聲乳化術和小切口白內障囊外摘除術)、人工晶狀體度數、角膜水腫部位等對術後視力改善的影響.視力採用LogMAR視力.統計方法分彆採用單因素和多因素線性迴歸方法.結果 (1)單因素分析:術式:超聲乳化術組術後較術前視力改善(平均視力差) 0.92±0.48,小切口白內障囊外摘除術組平均視力差0.83±0.46,兩種手術方式對視力改善的影響,差異沒有統計學意義(P＞0.05).年齡:70-、80-年齡組分彆與40-、50-、60-年齡組差異有統計學意義(P＜0.05).角膜水腫部位:瀰漫性水腫(平均視力差0.52±0.42)較中央部位水腫(平均視力差0.70±0.44))對視力改善影響更大,差異有統計學意義(P＜0.05).(2)多因素線性迴歸分析:年齡、角膜水腫部位均對視力改善有影響,差異有統計學意義(P＜0.05).結論 (1)超聲乳化術和小切口白內障囊外摘除術兩種手術方式對視力提高程度無明顯差異,因此在西藏地區可以根據噹地條件,包括經濟狀況和醫師具備的手術水平,來選擇術式,以使患者穫得最佳有用視力.(2)年齡為白內障術後視力改善的影響因素之一,隨年齡增加視力改善減少,而西藏地區就醫條件有限,故在西藏地區更應重視白內障的普查,彊調早期髮現和早期手術.(3)在角膜水腫分級無明顯差異的基礎上,瀰漫性水腫較中央部水腫對視力改善影響更大,因此在術中應謹慎操作,儘量避免角膜內皮廣汎的損傷.
목적 분석영향서장지구노년성백내장술후시력개선적인소.방법 대서장지구접수백내장수술적노년성백내장278례,분석년령、핵분급、술식(초성유화술화소절구백내장낭외적제술)、인공정상체도수、각막수종부위등대술후시력개선적영향.시력채용LogMAR시력.통계방법분별채용단인소화다인소선성회귀방법.결과 (1)단인소분석:술식:초성유화술조술후교술전시력개선(평균시력차) 0.92±0.48,소절구백내장낭외적제술조평균시력차0.83±0.46,량충수술방식대시력개선적영향,차이몰유통계학의의(P＞0.05).년령:70-、80-년령조분별여40-、50-、60-년령조차이유통계학의의(P＜0.05).각막수종부위:미만성수종(평균시력차0.52±0.42)교중앙부위수종(평균시력차0.70±0.44))대시력개선영향경대,차이유통계학의의(P＜0.05).(2)다인소선성회귀분석:년령、각막수종부위균대시력개선유영향,차이유통계학의의(P＜0.05).결론 (1)초성유화술화소절구백내장낭외적제술량충수술방식대시력제고정도무명현차이,인차재서장지구가이근거당지조건,포괄경제상황화의사구비적수술수평,래선택술식,이사환자획득최가유용시력.(2)년령위백내장술후시력개선적영향인소지일,수년령증가시력개선감소,이서장지구취의조건유한,고재서장지구경응중시백내장적보사,강조조기발현화조기수술.(3)재각막수종분급무명현차이적기출상,미만성수종교중앙부수종대시력개선영향경대,인차재술중응근신조작,진량피면각막내피엄범적손상.
Objective To analyze impact factors for visual acuity improvement of senile cataract surgery in Tibet prospectively. Methods Of 278 cases were included. To study relations of visual acuity improvement between pre- and post-cataract surgery with patient age, nucleus classification, small incision cataract surgery (SICS) or Phacoemulsification (PHACO) and corneal edema. LogMAR chart was used in visual acuity analysis. Results 1. Univariate analysis: There was no significant difference between PHACO group and SICS group on visual acuity improvement (PHACO 0.92± 0.48, SICS 0.83± 0.46, P ＞0.05). Age group for 70- and 80- years-old had less improvement on visual acuity (P ＜0.05). Diffuse corneal edema had much more influence than central corneal edema on visual acuity improvement (0.52± 0.42, 0.70± 0.44, diffuse vs central, respectively). 2. Multivariate analysis: There were significant differences in age and location of corneal edema on visual acuity improvement (P ＜0.05). Conclusions There is no significant difference on visual acuity improvement between PHACO and SICS. Ophthalmologist can choose either PHACO or SICS for better rehabilitation of visual acuity, depending on area economics, his own experience and so on in Tibet. Visual acuity improvement in cataract surgery is significantly affected by the age of the patients. Since medication is deficient in Tebit, screening of cataract in Tibet is very important for detecting and treating cataract as early as possible. Diffuse corneal edema has much more influence than central edema on visual acuity improvement when corneal edema degrees are not different. It's important to avoid corneal endothelium damage in cataract surgery.
