白内障术前后视物清晰程度对主导眼影响临床观察

Clinical observation of influence of visual acuity changing after cataract operation to dominant eye

目的通过对白内障患者手术前后主导眼的测量，观察主导眼是否会随视物清晰程度的改变而发生转换？方法选取74例双眼裸眼视力对数视力表相差≥两行，且矫正效果差、对双眼中的裸眼视力较低眼行超声乳化手术的老年性白内障患者，在术前、术后第1天、第3天及术后1周时进行裸眼视力及主导眼的测量。并对其中25例术后1个月行对侧眼手术的患者再次行手术前后主导眼的测量：结果所有74例患者术前主导眼均为视力较好眼；术后第1天42例患者术眼裸眼视力≥对侧眼，其中有34例手术眼变为主导眼；术后第3天62例术眼裸眼视力≥对侧眼，其中59例手术眼变为主导眼；而术后1周时66例患者术眼裸眼视力≥对侧眼，其中60例手术眼变为主导眼。随访到25例1个月后再次行对侧眼的白内障手术，术前均未出现主导眼转换，其中14例患者的主导眼术后再次发生转换。结论主导眼在双眼间的转换客观存在，双眼视物的清晰程度会影响主导眼的选择，进行主导眼测量时要考虑到视力矫正对其产生的影响。

Objective To observe whether dominant ocular would change with the visual acuity increasing through measuring the dominant ocular of cataract patients before and after operation. Methods A total of 74 cataract old-aged patients whose naked vision gap of both eyes was bigger than two lines were chosen, naked vision and dominant eye of low vision eye were measured before operation, 1 day, 3 days, and 1 week after operation; 25 patients were measured again 1 month later. Results All the 74 patients＇ dominant eyes were higher vision eye before operation, 42 patients＇ naked vision of operation eye were higher than the other eye ones 1 day after operation, 34 dominant eyes changes to operation eyes; 62 patients＇ naked vision of operation eye were higher than the other eye ones 3 days after operation, 59 dominant eyes changes to operation eyes; 66 patients＇ naked vision of operation eye were higher than the other eye ones 1 week after operation, 60 dominant eyes changes to operation eyes; 25 patients were operated for the other eye 1 month later, 14 dominant eyes of them changed again. Conelusions Dominant eye changing is objectively existed, and the clear degree of vision of both eyes could impact the choosing of dominant eye. We should take account for the influence of rectification when measuring dominant eye.