CAJ | 학술논문

目的：探讨双眼高度近视合并白内障患者白内障术后屈光状态与日常视觉活动质量的关系。方法选择我院双眼白内障进行超声乳化吸出联合人工晶状体植入术的双眼高度近视合并白内障60例(120眼),按术后屈光度分为-1.0~-2.0 D 组(A 组)、-2.25~-3.0 D 组(B组)、-3.25~-4.0D 组(C 组)3组,每组20例(40眼)。术后3个月时对患者进行《日常视觉活动量表》调查。结果对手术效果满意者 A 组11例,B 组8例及 C 组13例,组间差异无统计学意义(χ2=4.23,P=0.38)。3组术后生活自理能力、精神状态及兴趣爱好调查差异无统计学意义(χ2=0, P=1)；术后视觉质量中的夜间视物(χ2=3.39,P=0.415)、看电视(χ2=4.20,P=0.38)组间差异无统计学意义。而阅读书写能力则 A 组差于 B 组、C 组(χ2=10.62,P=0.005；χ2=16.25,P=0.0015；χ2=4.64,P=0.2),精细分辨力则 C 组优于 A 组、B 组(χ2=5.26,P=0.072；χ2=19.54,P<0.001；χ2=9.09,P=0.011)。3组术后戴镜情况差异有统计学差异(χ2=29.67,P<0.001),术后看远戴镜率A 组40%,B 组95%和C组100%；而看近戴镜率则A组75%,B组40%,C组30%。结论双眼高度近视合并白内障患者施行白内障手术,能为患者提供更好的视觉及生活质量；若术前无戴镜习惯,且无近距离工作要求者,可预留较少的近视度；而能接受术后配戴中低度数的远视力矫正镜,且有近距离工作要求者,可预留较高的近视度。
목적：탐토쌍안고도근시합병백내장환자백내장술후굴광상태여일상시각활동질량적관계。방법선택아원쌍안백내장진행초성유화흡출연합인공정상체식입술적쌍안고도근시합병백내장60례(120안),안술후굴광도분위-1.0~-2.0 D 조(A 조)、-2.25~-3.0 D 조(B조)、-3.25~-4.0D 조(C 조)3조,매조20례(40안)。술후3개월시대환자진행《일상시각활동량표》조사。결과대수술효과만의자 A 조11례,B 조8례급 C 조13례,조간차이무통계학의의(χ2=4.23,P=0.38)。3조술후생활자리능력、정신상태급흥취애호조사차이무통계학의의(χ2=0, P=1)；술후시각질량중적야간시물(χ2=3.39,P=0.415)、간전시(χ2=4.20,P=0.38)조간차이무통계학의의。이열독서사능력칙 A 조차우 B 조、C 조(χ2=10.62,P=0.005；χ2=16.25,P=0.0015；χ2=4.64,P=0.2),정세분변력칙 C 조우우 A 조、B 조(χ2=5.26,P=0.072；χ2=19.54,P<0.001；χ2=9.09,P=0.011)。3조술후대경정황차이유통계학차이(χ2=29.67,P<0.001),술후간원대경솔A 조40%,B 조95%화C조100%；이간근대경솔칙A조75%,B조40%,C조30%。결론쌍안고도근시합병백내장환자시행백내장수술,능위환자제공경호적시각급생활질량；약술전무대경습관,차무근거리공작요구자,가예류교소적근시도；이능접수술후배대중저도수적원시력교정경,차유근거리공작요구자,가예류교고적근시도。
Objective To evaluate postoperative daily visual activity of highly myopes after cataract surgery. Methods Data of studied 120 eyes of 60 cases with cataract surgery and high myopia who underwent cataract surgery in our hospital were retrospectively analyzed. The patients were divided into three groups based on postoperative diopters:group A ( -1. 0 ~ -2. 0D), group B ( -2. 25 ~ -3. 0D) and group C ( -3. 25~ -4. 0D). The questionnaires of Activities of Daily Vision Scale (ADVS) were collected to assess the vision three months after the cataract surgery. Results The numbers of patients who satisfied with the surgery were 11 in group A, 8 in group B, and 13 in group C, and the difference were not statistically significant among three groups (χ2 =4. 23,P=0. 38). No statistically significant difference was observed among three groups in postoperative life self-care ability, mental state and interest survey (χ2 =4. 23,P=0. 38). Depending on the postoperative visual qualities, there were no statistically significant differences in night vision (χ2 =3. 39,P=0. 415) and the vision for watching TV among three groups (χ2 =4. 20,P=0. 38). But for reading and writing capabilities, the vision of patients in group A was poorer than that of patients in group B and C (χ2 =10. 62,P=0. 005;χ2 =16. 25,P=0. 0015;χ2 =4. 64,P=0. 2). Patients in group C had better fine resolution than those in group A and B (χ2 =5. 26,P =0. 072;χ2 =19. 54,P<0. 001;χ2 =9. 09,P=0. 011). There was statistically significant difference in wearing glasses among three groups (χ2 =29. 67,P<0. 001). For distant vision, the wearing rate were 40% in group A, 95% in group B and 100% in group C. For near vision, the wearing rate were 75% in group A, 40% in group B and 30% in group C. Conclusion Cataract surgery in highly myopic eyes can improve qualities of vision and life. For patients who are not used to wearing glasses and working at near distant, it ’ s appropriated to reserve a minor degree of myopia. Conversely, for patients who require to work at near distant and can receive wearing moderate or low hyperopia mirror, higher degree of myopia can be reserved.