晶状体超声乳化＋人工晶状体植入术围术期主导眼的变化

Changes of ocular dominance following phacoemulsification and intraocular lens implantation

目的探究晶状体超声乳化+人工晶状体(Phaco+IOL)植入术围术期主导眼转变情况。方法前瞻性研究。将行Phaco+IOL植入术的患者64例(95眼)分为A组(单眼手术) 33例和B组(双眼手术,术后第2周行第2眼手术) 31例。利用卡洞法判断主导眼别。结果右主导眼比例为60. 9%。术后1周,23例(A组8例、B组15例)发生主导眼转变(35. 9%),41例未转变(64. 1%)。术后1个月,B组7例再次发生主导眼转变,主导眼别回到术前状态。围术期主导眼最小分辨角的对数(log MAR)最佳矫正远视力(BCDVA)优于非主导眼(P <0. 05)。结论 Phaco+IOL植入术后主导眼别可发生转变和连续转变,转变与双眼矫正视力状态相关。成人一旦双眼矫正视力优劣状态发生逆转,主导眼仍具可塑性。

Objective To investigate whether ocular dominance may change following the surgel？^- of phacoemulsification and intraocular lens implantation. Methods This prospective study included patients scheduled to undergo phacoemulsification. The patients were divided into two groups （group A, 33 patients, monocular surgetry; group B, 31 patients, binocular surgery, the second eyes were operated in the second week）. Ocular dominance was assessed using the hole-in-the-card test. Results A total of 95 eyes of 64 patients were included in the study. The incidence of right-eye dominance was 60.9%. One week postoperatively, 23 patients （8 cases in group A, 15 cases in group B） had a change in ocular dominance （35.9%）, while 41 patients had no change （64. 1% ）. One month postoperatively, 7 patients in group B had a change again in ocular dominance and the dominant eyes changed back to preoperative ones. Best corrected distance visual acuity （BCDVA） of dominant eyes were significantly better than non dominant eyes in the perioperative period （P 〈 0.05 ）. Conclusions The ocular dominance may change and change back after surgery and is related to the status of visual acuity. Once the clear degree of vision of both eyes reversed, the eye dominance was still plastic even after the key period of visual development.