单眼先天性白内障术后视功能长期随访研究
단안선천성백내장술후시공능장기수방연구
Long-term follow up of visual function after unilateral congenital cataract extraction
  • 万方数据
    中国实用眼科杂志 중국실용안과잡지
    CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
    2015年 2期 123-127 ,共5页

    李倩%李忠恩%傅特

    리천%리충은%부특

    先天性白内障%视功能 先天性白內障%視功能
    선천성백내장%시공능
    Congenital cataract%Visual function
    目的 评价单眼先天性白内障术后患儿的视功能恢复情况.方法 临床病例对照研究.对2006年1月至2008年12月在济南市第二人民医院就诊的160例单眼先天性白内障术后患儿,按手术时年龄分为3组.A组:＜1岁;B组:≥1岁且＜2岁;C组:2～6岁.随访期5年,观察患儿术后不同时间最佳矫正视力、视觉诱发电位(VEP)和双眼视功能的变化.结果 术后6个月、1、3和5年最佳矫正视力、VEP P100潜伏时和振幅均优于术后1周;术后1年上述指标优于术后6个月;术后1、3和5年上述指标差异无统计学意义,视力:术后6个月Vs术后1周:qA=60.10,qB=99.51,qC=56.09;术后1年Vs术后6个月:qA=6.71,qB=8.72,qC=9.73;术后3年Vs术后1年:qA=1.10,qB=1.30,qC=1.00;术后5年Vs术后3年:qA=0.35,qB=0.76,qC=0.25.P100潜伏时:术后6个月Vs术后1周:qA=92.31,qB=109.21,qC=83.51;术后1年Vs术后6个月:qA=45.07,qB=49.29,qC=48.17;术后3年Vs术后1年:qA=1.88,qB=1.54,qC=1.66;术后5年Vs术后3年:qA=1.20,qB=1.59,qC=1.02.振幅:术后6个月Vs术后1周:qA=140.97,qB=100.99,qC=95.81;术后1年Vs术后6个月:qA=74.66,qB=98.97,qC=76.95;术后3年Vs术后1年:qA=1.57,qB=1.79,qC=1.02;术后5年Vs术后3年:qA=1.72,qB=0.67,qC=1.59.三组术后5年与术后1周视力差值分别为0.411±0.026、0.387±0.022和0.214±0.015(qAB=4.49,qBC=53.47,qAC=47.33);P100潜伏时差值分别为(64.78±1.06) ms、(42.67±1.02) ms和(32.65±0.92) ms (qAB=93.54,qBC=59.30,qAC=150.18); P100振幅差值分别为(12.74±0.26) uV、(9.08±0.22) uV和(6.88±0.21) uV(qAB=68.55,qBC=58.65,qAC=117.00),均从A组依次减小.三组各有20 (71.43％) (20/28)、20 (33.33％) (20/60)和10 (13.89％) (10/72)例获得不同程度双眼视功能,差异有统计学意义(x2AB=3.88,x2BC=4.40,x2AC=14.81,P＜0.05).结论 单眼先天性白内障患儿视功能恢复与手术年龄有关,手术年龄越小,视功能恢复越好.单眼先天性白内障患者应尽早行手术治疗,术后进行屈光矫正及增视训练,对患者视功能的恢复和重建具有重要意义.
    목적 평개단안선천성백내장술후환인적시공능회복정황.방법 림상병례대조연구.대2006년1월지2008년12월재제남시제이인민의원취진적160례단안선천성백내장술후환인,안수술시년령분위3조.A조:＜1세;B조:≥1세차＜2세;C조:2～6세.수방기5년,관찰환인술후불동시간최가교정시력、시각유발전위(VEP)화쌍안시공능적변화.결과 술후6개월、1、3화5년최가교정시력、VEP P100잠복시화진폭균우우술후1주;술후1년상술지표우우술후6개월;술후1、3화5년상술지표차이무통계학의의,시력:술후6개월Vs술후1주:qA=60.10,qB=99.51,qC=56.09;술후1년Vs술후6개월:qA=6.71,qB=8.72,qC=9.73;술후3년Vs술후1년:qA=1.10,qB=1.30,qC=1.00;술후5년Vs술후3년:qA=0.35,qB=0.76,qC=0.25.P100잠복시:술후6개월Vs술후1주:qA=92.31,qB=109.21,qC=83.51;술후1년Vs술후6개월:qA=45.07,qB=49.29,qC=48.17;술후3년Vs술후1년:qA=1.88,qB=1.54,qC=1.66;술후5년Vs술후3년:qA=1.20,qB=1.59,qC=1.02.진폭:술후6개월Vs술후1주:qA=140.97,qB=100.99,qC=95.81;술후1년Vs술후6개월:qA=74.66,qB=98.97,qC=76.95;술후3년Vs술후1년:qA=1.57,qB=1.79,qC=1.02;술후5년Vs술후3년:qA=1.72,qB=0.67,qC=1.59.삼조술후5년여술후1주시력차치분별위0.411±0.026、0.387±0.022화0.214±0.015(qAB=4.49,qBC=53.47,qAC=47.33);P100잠복시차치분별위(64.78±1.06) ms、(42.67±1.02) ms화(32.65±0.92) ms (qAB=93.54,qBC=59.30,qAC=150.18); P100진폭차치분별위(12.74±0.26) uV、(9.08±0.22) uV화(6.88±0.21) uV(qAB=68.55,qBC=58.65,qAC=117.00),균종A조의차감소.삼조각유20 (71.43％) (20/28)、20 (33.33％) (20/60)화10 (13.89％) (10/72)례획득불동정도쌍안시공능,차이유통계학의의(x2AB=3.88,x2BC=4.40,x2AC=14.81,P＜0.05).결론 단안선천성백내장환인시공능회복여수술년령유관,수술년령월소,시공능회복월호.단안선천성백내장환자응진조행수술치료,술후진행굴광교정급증시훈련,대환자시공능적회복화중건구유중요의의.
    Objective To evaluate visual function after unilateral congenital cataract extraction in children patients.Methods One hundred and sixty children patients following unilateral congenital cataract extraction were divided into 3 groups:＜1 year old,≥1 and ＜2 years old and 2-6 years old.The changes of best corrected visual acuity (BCVA),flash visual evoked potential (F-VEP) and binocular visual function were observed at different post-operative times.The follow-up time was 5 years.Results VA,P100 latent time and amplitude at post-operative 6 months,1 year,3 and 5 years were better than those at post-operative 1 week.VA,P100 latent time and amplitude at post-operative 1 year were better than those at post-operative 6 months.Above indices at post-operative 1 year,3 and 5 years had no statistical differences.VA differences between post-operative 5years and 1 week were 0.411±0.026,0.387±0.022,and 0.214±0.015 at each study group,respectively (qAB=4.49,qBC=53.47,qAC=47.33).P100 latent time differences between post-operative 5 years and 1 week were 64.78ms±1.06ms,42.67ms±1.02ms,and 32.65ms±0.92ms at each study group,respectively (qAB=93.54,qBC=59.30,qAC=150.18).P100 amplitude differences between post-operative 5 years and 1 week were 12.74uV±0.26uV,9.08uV±0.22uV,and 6.88uV±0.21uV at each study group,respectively (qAB=68.55,qBC=58.65,qAC=ll7.00).VA,P100 latent time and amplitude differences at each study group decreased in turn from group A.There were 20(71.43％)(20/28),20(33.33％)(20/60),and 10(13.89％)(10/72) patients with different degrees of binocular visual function at each study group,respectively (x2AB=3.88,x2BC=4.40,x2AC=14.81).The differences were statistically significant.Conclusions The recovery of visual function after unilateral congenital cataract extraction in children patients is related to the operation age.And the children can obtain better visual function if they accept surgery earlier.Patients suffering from congenital cataract should be operated as early as possible.After operation,they should wear suitable spectacles for optical correction and undertake visual training,which play a significant role in visual improvement.
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