白内障患者的视功能及生存质量评价

Evaluation on visual function and quality of life of patients with cataract

目的：评价重庆市复明工程白内障患者手术前后的主观视功能、生存质量。方法：通过流动白内障筛查选择接受手术的患者,应用世界卫生组织和美国眼科研究所为发展中国家所开发的生存质量（quality of life,QOL）量表、视功能（vision function,VF）量表在术前及术后3个月对患者进行问卷调查。由复明工程组织对患者进行免费白内障囊外摘除术联合后房型人工晶体植入术。结果：最终334名患者完成术前及术后3个月的调查。受调查患者平均年龄为（70.45±9.78）岁。手术前后VF、QOL比较差异均有统计学意义,手术后较手术前评分增高（P〈0.001）。严重盲（severe blindness,SB）组患者VF提高值分别高于视力损伤（vision impairment,VI）组和单眼盲（unilateral blindness,UL）组,差别均有统计意义（PVI=0.008,PUL=0.042）;SB组患者QOL提高值分别高于VI组和UL组,差别均有统计意义（P〈0.001）。不同年龄组VF提高值比较差异无统计学意义（F=0.397,P=0.755）,小于60岁年龄组和大于等于81岁年龄组的QOL提高值均高于60-69岁年龄组,差别均有统计意义（P〈60=0.038,P≥81=0.009）。结论：“重庆市百万贫困白内障复明工程”术后患者主观视功能和生存质量较术前提高,该项目手术效果良好,应该继续实施此类利民工程,同时也应该加强防盲手术过程的质量控制,并重视术后长期随访。

Objectlve：To assess the changes in visual function（VF） and quality of life （QOL） among patients following Blindness Prevention Surgery Program in a rural area of Chongqing. Methods：The prospective study selected cataract patients via mobile eye screening camps. VF and QOL questionnaires were completed prior and at 3 months after the surgery. Cataract surgery with posterior chamber intraocular lens （IOL） implantation was performed on patients by a blindness prevention surgery group. Results ：Three hundred and thirty four patients were enrolled with a mean age of 70.45 ± 9.78. The mean preoperative VF score was 20.00 ±36.67 and the mean postoperative VF was 70.00 ± 30.00（P〈0.001 ）. The mean preoperative QOL score was 65.06± 44.44 and the mean postoperative was 94.44 ± 27.78（P〈0.001）. The elevated VF scores in severe blindness group were higher than those in vision impairment group and unilateral blindness group （PVI=0.008,PUL=0.042）. The elevated QOL scores in severe blindness group were higher than those in vision impairment group and unilateral blindness group（P〈0.001）. No significant difference was found in the elevated VF scores between four age groups（F=0.397,P=0.755） ;but the elevated QOL score were lower in 60-69 age group than in 〈 60 year-old group and ≥ 81 year-old group（P〈60=0.038,P≥81=0.009）. Conclusion：The VF and QOL score of cataract patients increased significantly following surgery, suggesting that the surgery is an effective method for improving the QOL of cataract patients in rural areas. Blindness Prevention Surgery Program should be continued in Chongqing and the postoperative follow-up should be conducted carefully.