客观视觉质量分析系统对白内障患者术后视力的预测效果

Prediction on postoperative visual acuity of cataract patients by objective quality analysis system

目的:评估客观视觉质量分析系统(OQASⅡ)预测白内障患者术后视力的准确性。方法:本研究为前瞻性研究,筛选2019-06/11期间于大坪医院眼科行手术治疗的白内障患者205例259眼,根据术前最佳矫正视力(BCVA)与100%模拟对比度视力(PVA100%)的相对大小将患者分为A、B两组:A组:PVA100%差于BCVA(145眼);B组:PVA100%优于或等于BCVA(114眼)。比较两组患者术后1mo视力提升情况。结果:与术前BCVA相比,术后1mo BCVA提升达到2行或以上的,A组有112眼(77.2%),B组有93眼(81.6%),两组间视力提升2行或以上的人数比例无差异(P=0.394)。A组患者视力平均改善幅度为0.3(0.2,0.4)(LogMAR),B组患者视力平均改善幅度为0.4(0.2,0.5)(LogMAR),两组间视力提升幅度有差异(P=0.001)。A、B两组患者组内术前PVA100%与术后BCVA均无显著相关性(P=0.888、0.304)。对于术前合并眼部疾病的患者,术后视力提升幅度达到2行或以上的,A组有17眼(94.4%),B组有26眼(65.0%),两组间比较有差异(P=0.041)。有眼部合并症的患者,A组平均视力提升幅度为0.3(0.2,0.4)(LogMAR),B组为0.3(0.1,0.5)(LogMAR),两组间比较无差异(P=0.597)。结论:根据PVA100%与BCVA的相对大小不足以准确预测白内障术后视力能否明显提升。对于术前眼部有合并症的白内障患者,如果术前PVA100%差于BCVA时,术后视力明显改善的可能性较大。PVA100%对于白内障术后视力的预测价值有待进一步的研究。

AIM:To assess the accuracy of optical quality analysis systemⅡ(OQASⅡ)in predicting postoperative visual acuity of cataract patients.METHODS:Prospective study,patients underwent cataract surgery in Daping Hospital from June 2019 to November 2019 were recruited.According to predicted visual acuity 100%(PVA100%)and best corrected visual acuity(BCVA),patients were dichotomized into group A(PVA100%worse than BCVA,145 eyes)and group B(PVA100%equal to or better than BCVA,114 eyes).Visual acuity improvement was compared between the two groups 1mo after surgery.RESULTS:In group A,visual acuity of 112 eyes(77.2%)improved at least 2 lines.While in group B,93 eyes(81.6%)improved at least 2 lines.There was no significant difference in visual acuity improvement ratio between the two groups(P=0.394).The average BCVA improvement of group A was 0.3(0.2,0.4)LogMAR,and that of group B was 0.4(0.2,0.5)LogMAR,revealed statistically significant differences(P=0.001).No significant correlation was found between preoperative PVA100%and postoperative BCVA in both of the two groups(P=0.888,0.304).In patients combined with preoperative ocular comorbidity,17 eyes(94.4%)in group A and 26 eyes(65.0%)in group B improved at least 2 lines with significant difference between the two groups(P=0.041).BCVA improved 0.3(0.2,0.4)LogMAR in group A and 0.3(0.1,0.5)LogMAR in group B,there was no significant difference between the two groups(P=0.597).CONCLUSION:The binary classification method based on the value of preoperative PVA100%and BCVA failed to accurately predict who shall benefit more from cataract surgery.In patients diagnosed with preoperative ocular comorbidity,BCVA is likely to be significantly improved if preoperative PVA100%were worse than BCVA.More data are needed to determine the clinical value of PVA100%.