摘要
目的观察外伤性白内障患者植入零球差非球面人工晶状体(IOL)术后的视觉质量。方法前瞻性临床研究。2009年6月至2012年6月依据入选标准连续选取郑州大学第一附属医院眼科收治的角膜穿孔伤所致的外伤性白内障患者96例(96只眼)。根据所选择的植入晶状体类型不同分为试验组48例(48只眼):白内障术中植人零球差非球面IOL;对照组48例(48只眼):白内障术中植入传统球面IOL。术后1、3、6个月对比观察两组患者的裸眼视力、最佳矫正视力、立体视觉、对比敏感度,并对患者生存质量满意度进行问卷调查。两组患者术前一般情况、术后视力、对比敏感度及立体视觉的比较均采用t检验,散光度和生活满意度采用秩和检验进行组间比较。结果术后1、3、6个月试验组裸眼视力(0.56±0.22,0.68±0.13,0.84±0.15)与对照组(0.51±0.17,0.61±0.20,0.81±0.17)相比,差异无统计学意义(t=1.371,1.283,0.711,P〉0.05);试验组最佳矫正视力(0.62±0.13.0.74±0.21,0.87±0.10)与对照组(0.57±0.25,0.69±0.22,0.84±0.15)相比,差异无统计学意义(t=0.865,1.380,1.386,P〉0.05);术后6个月试验组与对照组远近立体视觉相比差异均无统计学意义,分别为:远立体视:123.5±7.8,126.9-4-5.9(t=0.638,P〉0.05);近立体视:90.5±7.8,95.2±3.5(t=1.364,P〉0.05);术后6个月试验组各空间频率对比敏感度(3e/d:1.524-0.18,6c/d:1.68±0.19,12e/d:1.29±0.14,18c/d:1.04±0.20)均高于对照组(3e/d:1.49±0.27,6c/d:1.57±0.21.12c/d:1.14±0.20,18c/d:0.85±0.14),特别是眩光对比敏感度(试验组:3c/d:1.40±0.15,6c/d:1.52±0.22,12c/d:1.21±0.18,18e/d:0.91±0.14;对照组:3c/d:1.13±0.13,6e/d:1.13±0.28,12c/d:0.92±0.13,18e/d:0.54±0.16),试验组明显优于对照组,两组相比差异均有统计学意义(无眩光3c/d:t=2.829,6c/d:t=4.092,12c/d:t=3.055,18c/d:t=2.093;眩光3c/d:t:2.650,6e/d:t=3.105,12e/d:t=3.395,18e/d:t:2.215;P均〈0.05);问卷调查显示:生存质量总体满意度方面,试验组(72.9%)明显高于对照组(54.1%),差异有统计学意义(t=3.016,P〈0.05)。结论零球差非球面IOL应用于外伤性白内障患者,其术后的视觉质量优于传统的球面IOL。对于角膜瘢痕较小且位于周边部、视网膜功能良好的外伤性白内障患者植入零球差非球面IOL,可以利用其光学特性,将眼外伤对视功能造成的损害降低至最低限度。
Objective implantation in traumatic cataract To observe the visual quality of aspherical intraocular lens (IOL) patients. Methods Prospective clinical study. 96 traumatie cataract patients (96 eyes ) suffered from penetrating corneal trauma chosen from the first affiliated hospital of Zhengzhou university during June 2009 to June 2012. They were divided into two groups based on the different type of intraocular lens. The experimental group (48 eyes) was implanted with aspherical IOL and the control group (48 eyes) was implanted with traditional sphere IOL. Uncorrected visual acuity (UCVA),best corrected visual acuity (BCVA) , contrast sensitivity (CS) and stereoscopic vision were observed at 1 month, 3 months, and 6 months after surgery. At the same time, questionnaire survey about the satisfaction of patients was also performed. The t test was used to compare the preoprative general condition, postoperative visual acuity, contrast sensitivity and stereoscopic vision of the two groups, and the rank sum test was used to compare the astigmatism and the satisfaction of patients. Results There was no significant difference in UCVA ( t = 1.37, 1.28,0. 71, P 〉 0. 05 ) between the experimental group ( 0. 56 + 0. 22, 0.68 +- O. 13,0.84 +- 0.15 ) and the control group ( 0.51 + 0. 17,0.61 +- 0.20,0.81 +_ 0.17 ) at three time points. There was no significant difference in BCVA ( t = 0. 87, 1.38, 1.39, P 〉 0. 05 ) between the experimental group(0.62 +-0.13,0.74 + 0.21,0. 87 + 0. 10) and the control group (0. 57 +_ 0. 25,0.69 +_ 0.22,0. 84 -+ 0. 15). The same result happened in stereoscopic vision at 6 months after surgery (far stereopsis: 123.5 +_ 7.8 vs 126. 9 +_ 5, 9, t = 0.64, P 〉 O. 05 ; near stereopsis: 90. 5 +- 7.8 vs 95.2 +_ 3, 5 ; t = 1.36, P 〉 0. 05) between experimental group and control group. The contrast sensitivity of the experimental group in every stage(3 c/d: 1.52 +-O. 18,6 c/d: 1.68 +_ 0.19,12 c/d:1.29 +-0. 14,18 c/d: 1.04 +_ 0.20) was superior to the control group (3 c/d : 1.49 + 0. 27,6 c/d : I. 57 + O. 21,12 c/d : 1.14 + 0. 20, 18 c/d : O. 85 +_0. 14) , especially on the glare sensitivity(the experimental group:3 c/d:1.40 +-0. 15,6 e/d:l. 52 +_ 0. 22,12 c/d:l. 21 +0. 18,18 c/d:0. 91 -+0. 14,the control group:3 c/d:l. 13 -+0. 13,6 c/d:l. 13 _+0. 28, 12 c/d:0.92 +-0. 13,18 c/d:0. 54 +_ 0. 16)Compared two groups of difference have statistical significance ( free from glare :3 c/d : t = 2. 829,6 c/d : t = 4. 092,12 c/d : t = 3. 055, 18 c/d : t = 2. 093 ; glare : 3 c/d : t = 2. 650,6 e/d : t = 3. 105,12 c/d : t = 3. 395,18 c/d : t = 2. 215 ; P 〈 0.05 ). Questionnaire survey showed the experimental group (72. 9% ) was statistically significantly higher( t = 3. 016, P 〈 0. 05) than that in the control group(54. 1% ) on the satisfaction of patients. Conclusions The visual quality with implantation of aspherieal IOL in traumatic cataract patients is superior to traditional sphere IOL. Aspherical IOL is more appropriate for the patients with small and peripheral corneal sear. It can reduce the visual function damage to minimum caused by trauma.
出处
《中华眼科杂志》
CAS
CSCD
北大核心
2013年第12期1118-1123,共6页
Chinese Journal of Ophthalmology
关键词
眼损伤
穿透性
白内障
晶体
人工
对比敏感度
视敏度
Eye injuries, penetrating
Cataract
Lenses, intraocular
Contrast sensitivity
Visual acuity vision
Visual quality