目的 观察外伤性白内障患者植入零球差非球面人工品状体(IOL)术后的视觉质量.方法 前瞻性临床研究.2009年6月至2012年6月依据入选标准连续选取郑州大学第一附属医院眼科收治的角膜穿孔伤所致的外伤性白内障患者96例(96只眼).根据所选择的植入品状体类型不同分为试验组48例(48只眼):白内障术中植入零球差非球面IOL;对照组48例(48只眼):白内障术中植入传统球面IOL.术后1、3、6个月对比观察两组患者的裸眼视力、最佳矫正视力、立体视觉、对比敏感度,并对患者生存质量满意度进行问卷调查.两组患者术前一般情况、术后视力、对比敏感度及立体视觉的比较均采用t检验,散光度和生活满意度采用秩和检验进行组间比较.结果 术后1、3、6个月试验组裸眼视力(0.56 ±0.22,0.68±0.13,0.84 ±0.15)与对照组(0.51 ±0.17,0.61 ±0.20,0.81 ±0.17)相比,差异无统计学意义(t=1.371,1.283,0.711,P＞0.05);试验组最佳矫正视力(0.62 ±0.13,0.74 ±0.21,0.87 ±0.10)与对照组(0.57 ±0.25,0.69±0.22,0.84 ±0.15)相比,差异无统计学意义(f =0.865,1.380,1.386,P＞0.05);术后6个月试验组与对照组远近立体视觉相比差异均无统计学意义,分别为:远立体视:123.5±7.8,126.9±5.9(t =0.638,P＞0.05);近立体视:90.5 ±7.8,95.2±3.5(t=1.364,P＞0.05);术后6个月试验组各空间频率对比敏感度(3 c/d∶1.52 ±0.18,6 c/d∶1.68 ±0.19,12 c/d∶1.29 ±0.14,18 c/d∶1.04 ±0.20)均高于对照组(3 c/d∶1.49±0.27,6 c/d∶1.57±0.21,12 c/d∶1.14±0.20,18 c/d∶0.85 ±0.14),特别是眩光对比敏感度(试验组:3 c/d∶1.40±0.15,6 c/d∶1.52±0.22,12 c/d∶1.21 ±0.18,18 c/d∶0.91 ±0.14;对照组:3 c/d∶1.13±0.13,6 c/d∶1.13 ±0.28,12 c/d∶0.92 ±0.13,18 c/d∶0.54 ±0.16),试验组明显优于对照组,两组相比差异均有统计学意义(无眩光3 c/d∶t =2.829,6 c/d∶t =4.092,12 c/d∶t =3.055,18 c/d∶t =2.093;眩光3 c/d:t=2.650,6 c/d∶t =3.105,12 c/d∶t =3.395,18 c/d∶t =2.215;P均＜0.05);问卷调查显示:生存质量总体满意度方面,试验组(72.9％)明显高于对照组(54.1％),差异有统计学意义(t=3.016,P＜0.05).结论 零球差非球面IOL应用于外伤性白内障患者,其术后的视觉质量优于传统的球面IOL.对于角膜瘢痕较小且位于周边部、视网膜功能良好的外伤性白内障患者植入零球差非球面IOL,可以利用其光学特性,将眼外伤对视功能造成的损害降低至最低限度.
目的 觀察外傷性白內障患者植入零毬差非毬麵人工品狀體(IOL)術後的視覺質量.方法 前瞻性臨床研究.2009年6月至2012年6月依據入選標準連續選取鄭州大學第一附屬醫院眼科收治的角膜穿孔傷所緻的外傷性白內障患者96例(96隻眼).根據所選擇的植入品狀體類型不同分為試驗組48例(48隻眼):白內障術中植入零毬差非毬麵IOL;對照組48例(48隻眼):白內障術中植入傳統毬麵IOL.術後1、3、6箇月對比觀察兩組患者的裸眼視力、最佳矯正視力、立體視覺、對比敏感度,併對患者生存質量滿意度進行問捲調查.兩組患者術前一般情況、術後視力、對比敏感度及立體視覺的比較均採用t檢驗,散光度和生活滿意度採用秩和檢驗進行組間比較.結果 術後1、3、6箇月試驗組裸眼視力(0.56 ±0.22,0.68±0.13,0.84 ±0.15)與對照組(0.51 ±0.17,0.61 ±0.20,0.81 ±0.17)相比,差異無統計學意義(t=1.371,1.283,0.711,P＞0.05);試驗組最佳矯正視力(0.62 ±0.13,0.74 ±0.21,0.87 ±0.10)與對照組(0.57 ±0.25,0.69±0.22,0.84 ±0.15)相比,差異無統計學意義(f =0.865,1.380,1.386,P＞0.05);術後6箇月試驗組與對照組遠近立體視覺相比差異均無統計學意義,分彆為:遠立體視:123.5±7.8,126.9±5.9(t =0.638,P＞0.05);近立體視:90.5 ±7.8,95.2±3.5(t=1.364,P＞0.05);術後6箇月試驗組各空間頻率對比敏感度(3 c/d∶1.52 ±0.18,6 c/d∶1.68 ±0.19,12 c/d∶1.29 ±0.14,18 c/d∶1.04 ±0.20)均高于對照組(3 c/d∶1.49±0.27,6 c/d∶1.57±0.21,12 c/d∶1.14±0.20,18 c/d∶0.85 ±0.14),特彆是眩光對比敏感度(試驗組:3 c/d∶1.40±0.15,6 c/d∶1.52±0.22,12 c/d∶1.21 ±0.18,18 c/d∶0.91 ±0.14;對照組:3 c/d∶1.13±0.13,6 c/d∶1.13 ±0.28,12 c/d∶0.92 ±0.13,18 c/d∶0.54 ±0.16),試驗組明顯優于對照組,兩組相比差異均有統計學意義(無眩光3 c/d∶t =2.829,6 c/d∶t =4.092,12 c/d∶t =3.055,18 c/d∶t =2.093;眩光3 c/d:t=2.650,6 c/d∶t =3.105,12 c/d∶t =3.395,18 c/d∶t =2.215;P均＜0.05);問捲調查顯示:生存質量總體滿意度方麵,試驗組(72.9％)明顯高于對照組(54.1％),差異有統計學意義(t=3.016,P＜0.05).結論 零毬差非毬麵IOL應用于外傷性白內障患者,其術後的視覺質量優于傳統的毬麵IOL.對于角膜瘢痕較小且位于週邊部、視網膜功能良好的外傷性白內障患者植入零毬差非毬麵IOL,可以利用其光學特性,將眼外傷對視功能造成的損害降低至最低限度.
목적 관찰외상성백내장환자식입령구차비구면인공품상체(IOL)술후적시각질량.방법 전첨성림상연구.2009년6월지2012년6월의거입선표준련속선취정주대학제일부속의원안과수치적각막천공상소치적외상성백내장환자96례(96지안).근거소선택적식입품상체류형불동분위시험조48례(48지안):백내장술중식입령구차비구면IOL;대조조48례(48지안):백내장술중식입전통구면IOL.술후1、3、6개월대비관찰량조환자적라안시력、최가교정시력、입체시각、대비민감도,병대환자생존질량만의도진행문권조사.량조환자술전일반정황、술후시력、대비민감도급입체시각적비교균채용t검험,산광도화생활만의도채용질화검험진행조간비교.결과 술후1、3、6개월시험조라안시력(0.56 ±0.22,0.68±0.13,0.84 ±0.15)여대조조(0.51 ±0.17,0.61 ±0.20,0.81 ±0.17)상비,차이무통계학의의(t=1.371,1.283,0.711,P＞0.05);시험조최가교정시력(0.62 ±0.13,0.74 ±0.21,0.87 ±0.10)여대조조(0.57 ±0.25,0.69±0.22,0.84 ±0.15)상비,차이무통계학의의(f =0.865,1.380,1.386,P＞0.05);술후6개월시험조여대조조원근입체시각상비차이균무통계학의의,분별위:원입체시:123.5±7.8,126.9±5.9(t =0.638,P＞0.05);근입체시:90.5 ±7.8,95.2±3.5(t=1.364,P＞0.05);술후6개월시험조각공간빈솔대비민감도(3 c/d∶1.52 ±0.18,6 c/d∶1.68 ±0.19,12 c/d∶1.29 ±0.14,18 c/d∶1.04 ±0.20)균고우대조조(3 c/d∶1.49±0.27,6 c/d∶1.57±0.21,12 c/d∶1.14±0.20,18 c/d∶0.85 ±0.14),특별시현광대비민감도(시험조:3 c/d∶1.40±0.15,6 c/d∶1.52±0.22,12 c/d∶1.21 ±0.18,18 c/d∶0.91 ±0.14;대조조:3 c/d∶1.13±0.13,6 c/d∶1.13 ±0.28,12 c/d∶0.92 ±0.13,18 c/d∶0.54 ±0.16),시험조명현우우대조조,량조상비차이균유통계학의의(무현광3 c/d∶t =2.829,6 c/d∶t =4.092,12 c/d∶t =3.055,18 c/d∶t =2.093;현광3 c/d:t=2.650,6 c/d∶t =3.105,12 c/d∶t =3.395,18 c/d∶t =2.215;P균＜0.05);문권조사현시:생존질량총체만의도방면,시험조(72.9％)명현고우대조조(54.1％),차이유통계학의의(t=3.016,P＜0.05).결론 령구차비구면IOL응용우외상성백내장환자,기술후적시각질량우우전통적구면IOL.대우각막반흔교소차위우주변부、시망막공능량호적외상성백내장환자식입령구차비구면IOL,가이이용기광학특성,장안외상대시공능조성적손해강저지최저한도.
Objective To observe the visual quality of aspherical intraocular lens (IOL) implantation in traumatic cataract patients.Methods Prospective clinical study.96 traumatic cataract patients (96 eyes) suffered from penetrating corneal trauma chosen from the first affiliated hospital of Zhengzhou university during June 2009 to June 2012.They were divided into two groups based on the different type of intraocular lens.The experimental group (48 eyes) was implanted with aspherical IOL and the control group (48 eyes) was implanted with traditional sphere IOL.Uncorrected visual acuity (UCVA),best corrected visual acuity (BCVA),contrast sensitivity (CS) and stereoscopic vision were observed at 1 month,3 months,and 6 months after surgery.At the same time,questionnaire survey about the satisfaction of patients was also performed.The t test was used to compare the preoprative general condition,postoperative visual acuity,contrast sensitivity and stereoscopic vision of the two groups,and the rank sum test was used to compare the astigmatism and the satisfaction of patients.Results There was no significant difference in UCVA (t =1.37,1.28,0.71,P ＞ 0.05) between the experimental group (0.56 ± 0.22,0.68 ± 0.13,0.84 ± 0.15) and the coutrol group (0.51 ± 0.17,0.61 ± 0.20,0.81 ± 0.17) at three time points.There was no significant difference in BCVA (t =0.87,1.38,1.39,P ＞ 0.05) between the experimental group (0.62 ± 0.13,0.74 ± 0.21,0.87 ± 0.10) and the control group (0.57 ± 0.25,0.69 ±0.22,0.84 ± 0.15).The same result happened in stereoscopic vision at 6 months after surgery (far stereopsis:123.5 ± 7.8 vs 126.9 ± 5.9,t =0.64,P ＞ 0.05 ; near stereopsis:90.5 ± 7.8 vs 95.2 ± 3.5 ; t =1.36,P ＞ 0.05) between experimental group and control group.The contrast sensitivity of the experimental group in every stage (3 c/d ∶ 1.52 ± 0.18,6 c/d ∶ 1.68 ± 0.19,12 c/d ∶ 1.29 ± 0.14,18 c/d ∶ 1.04 ± 0.20)was superior to the control group (3 c/d ∶ 1.49 ± 0.27,6 c/d ∶ 1.57 ± 0.21,12 c/d ∶ 1.14 ± 0.20,18 c/d ∶0.85 ± 0.14),especially on the glare sensitivity (the experimental group∶3 c/d∶l.40 ± 0.15,6 c/d∶ 1.52 ±0.22,12 c/d∶1.21 ±0.18,18 c/d∶0.91 ±0.14,the control group∶3 c/d∶1.13 ±0.13,6 c/d∶l.13 ±0.28,12 c/d∶0.92 ± 0.13,18 c/d ∶0.54 ± 0.16)Compared two groups of difference have statistical significance (free from glare ∶3 c/d ∶ t =2.829,6 c/d ∶ t =4.092,12 c/d ∶ t =3.055,18 c/d ∶ t =2.093 ; glare ∶ 3 c/d ∶ t =2.650,6 c/d∶t =3.105,12 c/d∶t =3.395,18 c/d∶t =2.215 ;P ＜0.05).Questionnaire survey showed the experimental group (72.9％) was statistically significantly higher(t=3.016,P ＜ 0.05) than that in the control group(54.1％) on the satisfaction of patients.Conclusions The visual quality with implantation of aspherical IOL in traumatic cataract patients is superior to traditional sphere IOL.Aspherical IOL is more appropriate for the patients with small and peripheral corneal scar.It can reduce the visual function damage to minimum caused bv trauma.
