计算机随机点立体视检查图检测白内障术后患者立体视觉相关因素的分析

Stereopsis evaluation in post-operative patients using computerized randot test system

目的应用计算机立体视检查系统研究随机点大小和密度对白内障超声乳化术后患者立体视功能的测定，探讨白内障超声乳化术后患者立体视功能。方法应用计算机随机点立体视检查图（random-dot stereogram，RDS）对78例双眼白内障超声乳化并Acrysof单焦人工晶状体（美国ALCON公司型号SN60WF，非球面组）或Restor＋3D多焦人工晶状体（美国ALCON公司型号SN6ADl，非球面渐进衍射型多焦点组）植入术后患者进行立体视功能测定，分别按3种不同密度和4种不同随机点大小的检查并比较其差异，同时结合植人人工晶状体的类型不同予以进一步分析。结果（1）多焦组的裸眼中距离视力和裸眼近距离视力均显著好于单焦组。（2）当随机点的大小固定而密度不同时，患者立体视锐度检查结果没有统计学差异。（3）当随机点密度相同而大小不同时，患者立体视锐度检查结果的差异存在统计学意义。（4）多焦组立体视锐度显著优于单焦组。结论计算机随机点立体视图是一种可靠的测量立体视功能的方法，可以用于白内障患者术后立体视觉功能的检测。立体视觉功能可能牵涉到复杂的神经学机制，视力可能并不是决定白内障术后患者立体视觉功能优劣的最主要因素。

Objective To determine the stereoacuity in post-operative patients using a cus- tom-built computerized randot test system. Methods Seventy-eight patients who received phacoemulsi- fication were recruited in this study. Forty-two patients were implanted with Acrysof monofocal intra- ocular lens （IOL） and 36 patients were implanted with Restor multi-focal IOL. The stereoacuity were evaluated using a custom-built computerized randot test system. The size and the density of the dots could be modified. Results 1） The intermediate visual acuity and the near visual acuity in multi-focal IOL group were significantly better than those in monofocal IOL group. 2） There were no significant differences in stereoacuity using randot charts with different density of the dots, while the size of the dots kept unchanged. 3） There were significant differences in stereoacuity using ran- dot charts with different sizes of the dots, while the density of the dots kept unchanged. 4） The ste- reoacuity in multi-focal IOL group was significantly better than that in monofocal IOL group. Con- clusion It appears that the custom-built computerized randot test system is a reliable method for ste- reoacuity evaluation in post-operative patients. The function of stereopsis may be related to complex neurological mechanism. Visual acuity may not be the key factor determining the stereoacuity.