高度近视合并白内障患者手术前后视觉相关生活质量评估研究

Study of evaluation of vision-related life quality before and after the surgery for the patients with high myopia complicated with cataract

目的 评估高度近视合并白内障患者行白内障超声乳化摘除联合人工晶体植入手术前后视力及视觉相关的生活质量。方法 选取2014年8月~2015年12月于本院就诊并行白内障超声乳化摘除联合人工晶体植入术的高度近视合并白内障患者68例（68眼）,使用标准对数视力表及25项美国国家眼科研究所视觉功能问卷调查（NEI-VFQ-25）对患者手术前及术后3个月时的视力及视觉相关的生活质量进行评价分析。结果 高度近视合并白内障患者手术后3个月时远视力（0.63±0.18）、近视力（0.51±0.13）,与手术前远视力（1.21±0.26）、近视力（1.08±0.30）比较,差异均有高度统计学意义（P〈0.01）。高度近视合并白内障患者手术后的视觉相关的生活质量,包括一般健康状态、总体视觉情况、近距离工作、远距离工作、社交功能、精神健康状态、社会角色限制、独立性、驾驶、色彩视觉和周边视野等评分均较术前明显提高,差异均有统计学意义（P〈0.05）,而术前与术后3个月时眼痛指标评分差异无统计学意义（P〉0.05）。高度近视合并白内障患者中单眼盲与单眼低视力患者的术后NEIVFQ-25评分总分均明显提高,与术前评分比较,差异均有高度统计学意义（t=-11.34、-12.37,P〈0.01）。结论白内障超声乳化摘除联合人工晶状体植入术能够明显改善高度近视合并白内障患者的远近视力及视觉相关的生活质量。

Objective To evaluate the life quality related to vision and visual acuity before and after the surgery of phacoemulsifieation cataract excision combined with intraocular implantation in the patients with high myopia compli- cated with cataract. Methods A total of 68 cases （68 eyes） with high myopia complicated with cataract who were diag- nosed in our hospital and were given phacoemulsification cataract excision combined with intraocular implantation from August 2014 to December 2015 were selected. Standard logarithmic visual acuity chart and NEI-VFQ-25 were applied for evaluation and analysis of life quality related to vision and visual acuity before the surgery and 3 months after the surgery. Results 3 months after the surgery in the patients with high myopia complicated with cataract, the distant vi- sion was （0.63±0.18）, and the near vision was （0.51±0.13）. Compared with the distant vision of （1.21±0.26） and near vi- sion of （1.08±0.30） before the surgery, the differences were both statistically significant （P〈0.01）. The life quality relat- ed to vision after the surgery in the patients with high myopia complicated with cataract, including the scores of general health condition, general vision, near work, distant work, social function, mental health, social role limitation, depen- dence, driving, color vision, surrounding vision and other aspects, were significantly improved compared with those be- fore the surgery, and the differences were statistically significant （P〈0.05）, but the score of eye pain before the surgery and 3 months after the surgery was not significantly different（P〉0.05）. Among the patients with high myopia complicat- ed with cataract, postoperative NEI-VFQ-25 total scores in the patients with unilateral blindness and low monocular vision were significantly improved, and the differences were statistically significant compared with the scores before the surgery（t=-11.34, -12.37,P〈0.01）. Conclusion Phacoemulsification cataract excision combined with intraocular implan- tation is able to significantly improve the near and distant vision and life quality related to vision in the patients with high myopia complicated with cataract.