不同形态白内障和视觉质量的相关性研究

Correlation between different types of cataract and visual quality

目的应用晶状体混浊分级系统(lens opacity classification systemⅢ,LOCSⅢ)探究分析不同形态年龄相关性白内障对客观视觉质量产生的影响。方法前瞻性病例对照研究。在2019年5~11月期间从我院门诊选取75例(75只眼)年龄相关性白内障患者作为研究对象,利用LOCSⅢ白内障分级体系进行分组,即皮质性白内障组24例、核性白内障组28例、后囊膜下白内障23例,同时选取30例正常体检者作为对照组,比较4组的对比敏感度及高阶相差。结果与对照组相比,其他3组除最佳矫正视力(BCVA)明显下降外,在年龄、柱镜度数、球镜度数上均无明显差异。对比敏感度分析显示:3组患者的对比敏感度明显低于对照组,差异有统计学意义(P<0.05),另外视力>0.05时,后囊下型白内障的对比敏感度明显低于其他两组,且年龄越大,核性白内障的对比敏感度越低,差异均具有统计学差异(P<0.05)。高阶相差分析表明:核性白内障的全眼和眼内球差显著低于其它两组,皮质性白内障的全眼和眼内彗差显著高于其它两组,差异有统计学意义(P<0.05)。结论仅仅对白内障患者进行简单的视力检查,很难对患者的视觉质量进行了解,而通过对患眼对比敏感度和高阶相差进行检查,则可得知白内障对视觉质量产生的影响,促使患者及时采取有效的治疗措施。

Objective To explore and analyze the influence of different types of age-related cataract on objective visual quality using the Lens Opacity Classification System III(LOCSIII).Methods A total of 75 cataract patients(75 eyes)in the outpatient department of our hospital from May to November 2019 were included and divided into three groups based on the LOCSIII,including the cortical cataract group(24 cases),nuclear cataract group(28 cases)and posterior capsule cataract group(23 cases).At the same time,30 normal subjects were selected as the control group.The contrast sensitivity and higher-order aberrations of the four groups were compared.Results Compared with the control group,the cataract groups had no significant difference in age,cylindrical lens power or spherical lens power,except that the best corrected visual acuity(BCVA)was significantly poorer.The contrast sensitivity of the three cataract groups was significantly lower than that of the control group(P<0.05).When the visual acuity was more than 0.05,the contrast sensitivity of the posterior capsular cataract group was significantly lower than the other two cataract groups.And the contrast sensitivity of nuclear cataract group was lower with older age(P<0.05).Analysis of the high-order aberration showed that the global and intraocular spherical aberration of nuclear cataract patients were significantly lower than those of the other two cataract groups,and the global and intraocular coma of cortical cataract patients were significantly higher than those of the other two cataract groups,the differences were statistically significant(P<0.05).Conclusions It is difficult to understand the visual quality of cataract patients based on sole visual acuity examination.By checking the contrast sensitivity and high-order aberrations of the affected eyes,we can know the impact of cataract on visual quality and prompt patients to take effective treatment measures in time.