视觉质量分析系统对后发障行激光切开术后视觉质量评估

Visual quality assessment for posterior capsule opacification after Nd：YAG laser incision surgery using visual quality analysis system

目的应用双通道视觉质量分析系统研究后发性白内障行Nd：YAG激光切开术后患者眼内散射的变化，客观评价术后视觉质量。方法回顾性临床病例对照研究。对2007年5月至2013年12月在天津市眼科医院就诊的42例行白内障超声乳化＋人工晶状体植入术后患有后发性白内障纤维型Ⅱ级及Ⅱ级以下膜，明显影响视力的患者行Nd：YAG激光切开术。术前及术后2周散瞳前测量最佳矫正视力（BCVA），并将瞳孔充分散大，用裂隙灯数码相机进行眼底红光反射照相，联合Image Pro Plus6．0软件测量激光孔的大小。采用OQAS Ⅱ视觉质量分析系统测量4mm瞳孔下手术前后的客观散射指数（OSI），OQAS值（OVs），斯特列尔比（sR）和调制传递函数（MTF）。结果后发性白内障行Nd：YAG激光切开术后2周，BCVA明显提高，logMAR视力由术前平均0．541提高到术后0．137，术后OSI值（3．263±2．118），较术前（12．14±3．511）明显减小，差异有统计学意义（t=16．818，P〈0．05），术后SR、MTF以及OVs较术前均有明显提高，差异有统计学意义（P〈0．05）。结论后发性白内障行Nd：YAG激光切开术后2周，最佳矫正视力明显提高，眼内散射明显减小，术后视觉质量显著提高。

Objective To evaluate the intraocular scatter after Nd：YAG laser posterior capsuloto- my and analyze visual quality based on double-pass system. Methods A prospective comparative study. Forty-six eyes of 42 consecutive pseudophakic patients with clinically observable posterior cap- sule opacification （fibroelastic type, The Ⅱ degree and under）, who impaired the visual acuity severe- ly, and scheduled to have Nd：YAG laser posterior capsulotomy at our clinic, were included in this study. Before and two weeks after Nd：YAG laser was determined, using slit-lamp digital camera and calculate the diameter of the laser drill hole. The 4mm diameter of the pupil by OQAS system. posterior capsulotomy, fully mydriatic, the BCVA combined with the Image Pro plus6.0 software to OSI, OVs, SR, MTF value were measured at the Results Significant improvement in visual acuity was observed after Nd：YAG laser posterior capsulotomy, mean logMAR visual acuity 0.541 to 0.137. Two weeks after the procedure, significant decreases in OSI （t =16.818, P 〈0.05）, after （3.263±2.118） to before （12.148±3.511）, significantiy increased in SR, MTF, OVs value （P 〈0.05）. Conclu- sions After Nd：YAG laser posterior capsulotomy, the BCVA is improved and the intraocular scatter is decreased, the visual quality is significantly improved.