CAJ | 학술논문

背景年龄相关性白内障及其手术后优势眼的变化与患者视觉质量呈明显相关,但白内障术后患者优势眼的变化与视力改变的关系研究较少. 目的观察年龄相关性白内障及白内障手术对老年人优势眼的影响.方法采用系列病例观察研究方法.收集2011年12月至2012年4月在温州医科大学附属眼视光医院就诊的年龄相关性白内障患者87例,患者行白内障超声乳化摘出联合IOL植入术.患者按标准对数视力表最佳矫正远视力分组,双眼间视力差别≥2行者为A组,双眼间视力差别≤1行者为B组,分别于术前及术后1d、1周、1个月、3个月用卡洞法或拇指法检测患者优势眼的分布及变化情况,以MecNmar检验对术眼手术前后优势眼分布的差异进行统计学分析. 结果患者术前LogMAR最佳矫正远视力中位数(M)值为0.40(0.00 ～ 1.40),术后为0.00(-0.08～0.30),差异有统计学意义(Z=-9.481,P=0.000).A组42例患者中术前右眼为优势眼者24例,左眼18例;33例(占78.57％)患者白内障较轻的眼为优势眼,9例(占21.43％)白内障较重眼为优势眼;患者术后右眼为优势眼者31例,左眼者11例;42例患者中13例发生优势眼转变,其中10例由左眼变为右眼,3例由右眼变为左眼,4例优势眼不稳定.B组45例患者中,术前右眼为优势眼者27例,左眼优势眼者18例;患者中4例优势眼发生转变,3例由左眼变为右眼,1例由右眼变为左眼,5例优势眼不稳定.两组患者手术前、手术后优势眼的分布差异均无统计学意义(A组:P=0.092;B组:P=0.727). 结论年龄相关性白内障导致的屈光介质混浊可对优势眼产生影响,白内障术后屈光介质透明性改变会导致优势眼的转换.
배경 년령상관성백내장급기수술후우세안적변화여환자시각질량정명현상관,단백내장술후환자우세안적변화여시력개변적관계연구교소. 목적 관찰년령상관성백내장급백내장수술대노년인우세안적영향.방법 채용계렬병례관찰연구방법.수집2011년12월지2012년4월재온주의과대학부속안시광의원취진적년령상관성백내장환자87례,환자행백내장초성유화적출연합IOL식입술.환자안표준대수시력표최가교정원시력분조,쌍안간시력차별≥2행자위A조,쌍안간시력차별≤1행자위B조,분별우술전급술후1d、1주、1개월、3개월용잡동법혹무지법검측환자우세안적분포급변화정황,이MecNmar검험대술안수술전후우세안분포적차이진행통계학분석. 결과 환자술전LogMAR최가교정원시력중위수(M)치위0.40(0.00 ～ 1.40),술후위0.00(-0.08～0.30),차이유통계학의의(Z=-9.481,P=0.000).A조42례환자중술전우안위우세안자24례,좌안18례;33례(점78.57％)환자백내장교경적안위우세안,9례(점21.43％)백내장교중안위우세안;환자술후우안위우세안자31례,좌안자11례;42례환자중13례발생우세안전변,기중10례유좌안변위우안,3례유우안변위좌안,4례우세안불은정.B조45례환자중,술전우안위우세안자27례,좌안우세안자18례;환자중4례우세안발생전변,3례유좌안변위우안,1례유우안변위좌안,5례우세안불은정.량조환자수술전、수술후우세안적분포차이균무통계학의의(A조:P=0.092;B조:P=0.727). 결론 년령상관성백내장도치적굴광개질혼탁가대우세안산생영향,백내장술후굴광개질투명성개변회도치우세안적전환.
Background The alteration of dominance eye is associated with visual quality in patients with age-related cataract or after cataract-surgery.However,the study on the relationship of dominance eye shift with vision following cataract-surgery is lack.Objective This study was to observe the influence of age-related cataract and cataract surgery on ocular dominance in the elderly.Methods A serial cases-observational study was designed.Eighty-seven patients with age-related cataract were collected from December 2011 to April 2012 in Affiliated Eye Hospital of Wenzhou Medical University,and phacoemulsification combined with intraocular lens (IOL) implantation was performed in all the patients.The patients were grouped into binocular vision difference (best corrected distance vision) ≥2 lines group (42 patients) and ≤ 1 line group (45 patients) on the standard logarithmic visual acuity chart.The frequency and shift of dominant eye were determined by card-hole method or thumb method before operation and 1 day,1 week,1 month and 3 months after operation.The difference in the frequencies of dominant eye between before and after operation was analyzed with MecNmar test.Results The median of best corrected distance vision (LogMAR) was 0.40 (0.00-1.40) in preoperation and 0.00 (-0.08-0.30) in postoperation,with significant difference between them (Z=-9.481,P =0.000).In the binocular vision difference ≥ 2 lines group,the dominant eyes were 24 in the right eyes and 18 in the left eyes.The milder cataractous eyes were identified as dominant eyes in 33 (78.57％) patients and heavier cataractous eyes were determined as dominant eyes in 9 (21.43％) patients before operation.However,the right eye was evidenced as dominant eye in 31 patients and the left eye was in 11 patients after operation.In the 42 patients,dominant eye shifted from the left eyes to the right eyes in 10 patients and from the right eyes to the left eyes in 3 patients,and 4 patients presented an unstable change binocularly.In 45 patients of the binocular vision difference ≤ 1 line group,the dominant eyes were the right eyes in 27 patients and the left eyes in 18 eyes in preoperation ; while after operation,dominant eye altered form the left eyes to the right eyes in 3 patients and form the right eyes to the left eyes in 1 patient,and unstable change occurred in 5 patients.There were no significant differences in the frequency of dominant eyes between before and after operation both the two groups (group A:P =0.092 ; group B:P =0.727).Conclusions Age-related cataract impact on eye dominance.Dominance eye may occur alteration binocularly following cataract surgery,which is one of causes of visual discomfort.