单眼或双眼白内障手术对患者视功能相关生活质量的影响

Impact of unilateral or bilateral cataract surgery on vision health related quality of life

目的分析单眼或双眼白内障手术对患者术后视功能相关生活质量影响。方法以接受白内障超声乳化摘除联合人工晶体植入术治疗的258例白内障患者作为调查对象,平均年龄(73.16±10.79)岁。分别于手术前和手术后3个月,采用中文版低视力者生活质量量表(CLVQOL)对单眼手术患者(Ⅰ组,n=136)和双眼手术患者(Ⅱ组,n=122)进行生活质量调查,计算视功能相关生活质量(VRQOL)得分,并进行组间比较和影响因素分析。结果两组患者术前VRQOL得分、双眼加权平均最小分辨角对数(logMAR)视力、年龄、受教育时间、性别构成、全身和眼部伴发疾病情况比较,差异均无统计学意义(P>0.05);两组手术并发症发生率的差异无统计学意义(P>0.05)。术后3个月,Ⅰ组和Ⅱ组双眼加权平均logMAR视力提高值分别为(0.42±0.38)和(0.63±0.53),组间比较差异有统计学意义(P=0.040),两组间VRQOL得分提高值比较差异无统计学意义(P=0.112)。在对影响总体病例术后VRQOL得分提高的多因素分析中,手术眼别(单或双)的P值为0.054。结论在具有高伴发疾病负荷的老年患者中,双眼或单眼白内障手术均能使视功能相关生活质量显著提高,二者没有显著差异。

Objective To investigate the impact of unilateral or bilateral cataract surgery on vision health related quality of life. Methods Two hundred and fifty-eight patients with cataract undergoing phacoemulsification with intraocular lens implantation were selected, with the mean age of （73.16 ±10.79） years. The quality of life was investigated in patients undergoing unilateral cataract surgery （group I, n = 136） or bilateral cataract surgery （ group II, n = 122） with Chinese- version low vision quality-of-life questionnaire （CLVQOL） before surgery and 3 months after surgery, the scores of vision health related quality of life （VRQOL） were calculated and compared between groups, and the influential factors were analysed. Results There was no significant difference in the scores of VRQOL, weighted average logarithm of minimum angle of resolution （logMAR） visual acuity, age, time of education, gender, systemic or ocular comorbidities before operation between two groups （ P 〉 O. 05）, and there was also no significant difference in the prevalences of surgical complications between two groups （P 〉 0.05）. Three months after surgery, there were significant differences in the improvement of weighted average logMAR visual acuity between group I and group II （0.42 ~ 0.38 vs 0. 63 ± 0. 53, P = 0.04）, while there was no significant difference in the improvement of VRQOL scores between group I and group II （ P = 0. 112）. Multivariate analysis indicated that ways of surgery （ unilateral or bilateral surgery） was less important factor to the improvement of scores of VRQOL （ P = 0. 054）. Conclusion In elder patients with high preoperative disease burden, either unilateral or bilateral cataract surgery could bring improvement to vision health related quality of life, and there is no significant difference between these two ways of surgery.