潜在视功能检测仪预测白内障术后视力的临床研究

Clinical study for postoperative visual acuity in cataract patients with the potential acuity meter

目的评价3种潜在视功能检测仪（PAM）对白内障术后视力的预测能力。方法为PAM预测白内障术后视力的一致性研究。分析了施行超声乳化联合人工晶状体植入术的150只眼，所有眼按晶状体核硬度分为两组，A组核硬度为Ⅰ-Ⅲ级（90只眼），B组核硬度为Ⅳ或Ⅴ级（60只眼），术前分别采用南开大学现代光学研究所、天津迈达生态公司和天津医科大学眼科中心合作研制的PAM（仪器A）、美国MARCO公司生产的PAM-1000型PAM（仪器B）及HAAG-STREIT900型干涉条纹视力仪Lotmar Visometer（仪器C）进行视力检查，并将检查结果与术后2个月最佳矫正视力进行对比。结果仪器A预测视力与术后视力之间具有良好正直线相关（r=0．774，0．516；P〈0．01）。在预测视力与术后视力不符合的眼中，假阴性52只眼，假阳性3只眼，预测结果趋向于低估。随着白内障程度的加深，3种仪器预测符合率下降。仪器B及仪器C的检查符合率为64．0％和62．7％。结论仪器A对白内障术后视力的预测能力优于国外同类产品。

Objective To study a new domestic potential acuity meter （PAM） for predicting visual acuity （PVA） in patients with cataracts and to compare the results to that measured by PAM-1000 and Lotmar. Methods One hundred and fifty cataract eyes were enrolled in this study. PVA was evaluated with three different dioptometers before the surgery and compared to actual best corrected visual acuity （BCVA） obtained two months after the surgery. Results PVA obtained from domestic PAM correlated well with BCVA. In 56 eyes with non-identical results between PVA and BCVA, 52 eyes were false-negative and 3 eyes were false-positive, indicating that PAM tended to underestimate postoperative BCVA. In severe cataract patients, the correlation between PVA obtained from these three dioptometers and postoperative BCVA was decreased. The identical rates （as compared with postoperative BCVA） for the results obtained from PAM-1000 and Lotmar were 64. 0% and 62. 7%, respectively. Condusions Domestic PAM is relatively reliable for predicting postoperative visual acuity. It is a valuable method in the examination of PVA before the cataract surgery.