鼻泪管阻塞患者内镜下泪囊鼻腔吻合术前后视觉质量变化  

Changes in Visual Quality before and after Endoscopic Dacryocystorhinostomy in Patients with Nasolacrimal Duct Obstruction

作　　者：张咏 李沙 Yong Zhang;Sha Li(Hankou Eye Hospital of Wuhan Aier,Wuhan 430024,China)

机构地区：[1]武汉爱尔眼科医院汉口医院,武汉430024

出　　处：《中华眼视光学与视觉科学杂志》2024年第5期347-352,共6页Chinese Journal Of Optometry Ophthalmology And Visual Science

基　　金：爱尔眼科医院集团临床研究所科研基金项目(AR2110D27)

摘　　要：目的:探讨内镜下泪囊鼻腔吻合术前后视觉质量的变化。方法:回顾性临床研究。连续收集2021年5月至2023年3月于武汉爱尔眼科医院汉口医院行内镜下泪囊鼻腔吻合术的鼻泪管阻塞患者67例(101眼)。分析患者术前,术后3周、2个月、3个月的泪河高度(TMH)、斯特列尔比(SR)、人眼调制传递函数(MTF)曲线中4 mm面积比(AR)以及角膜高阶像差的变化,包括角膜总高阶像差、球差、彗差、三叶草像差。TMH、SR、AR及各类角膜高阶像差分析采用混合模型Ⅲ类固定效应检验,组间两两比较采用Bofferoni校正法;手术前后TMH与SR、AR及各类角膜高阶像差的相关性分析采用Spearman分析法。结果:术前,术后3周、2个月、3个月的TMH、SR、AR、角膜总高阶像差、球差、彗差、三叶草像差比较总体差异均有统计学意义(均P<0.001),两两比较发现术后3周、2个月的SR和AR均较术前升高,术后2个月较术后3周升高,差异均有统计学意义(均P<0.001);术后3周、2个月的THM、角膜总高阶像差、球差、彗差、三叶草像差均较术前降低,术后2个月较术后3周降低,差异均有统计学意义(均P<0.05)。所有指标术后2个月与术后3个月差异均无统计学意义(均P>0.05)。手术前后各时间点TMH与SR、AR、角膜总高阶像差、球差、彗差及三叶草像差均无相关性(均P>0.05)。结论:内镜下泪囊鼻腔吻合术后患者的TMH逐渐降低,泪膜形态发生变化,患者的视觉质量明显提升。Objective:To study the alterations of visual quality before and after endoscopic dacryocystorhinostomy.Methods:This was a retrospective clinical study.Clinical data of 67 patients(101 eyes)with nasolacrimal duct obstruction who underwent endoscopic dacryocystorhinostomy at Hankou Eye Hospital of Wuhan Aier from May 2021 to March 2023 were collect continuously.Analyze the changes in tear meniscus height(TMH),strehl ratio(SR),4 mm area ratio(AR)in the human eye modulation transfer function(MTF)curve,and higher order aberrations of the corneal,including total higher order aberration,spherical aberration,coma and trefoil preoperative,3 weeks postoperative,2 months postoperative,and 3 months postoperative.TMH,SR,AR,and higher order aberrations of the corneal were analyzed using a mixed model Class III fixed effects test,and pairwise comparisons between groups were performed using the Bofferoni correction method.And the correlation analysis between TMH,SR,AR,and various high erorder corneal aberrations preoperative and postoperative was performed using Spearman analysis.Results:There were significant differences in TMH,SR,AR,total higher order aberration,spherical aberration,coma and trefoil preoperative and postoperative(all P<0.001).The SR and AR at 3 weeks and 2 months postoperatively increased compared to preoperative levels,and at 2 months postoperatively they increased significantly compared to 3 weeks postoperatively(all P<0.001).The THM,total higher order aberration,spherical aberration,coma,and trefoil at 3 weeks and 2 months postoperatively decreased compared to preoperative levels,while at 2 months postoperatively,they decreased significantly compared to 3 weeks postoperatively(all P<0.05).But there was no significant difference between 2 months and 3 months postoperative(all P>0.05).And there was no correlation between TMH and SR,AR,total higher order corneal aberration,spherical aberration,coma,and trefoil at various time points preoperative and postoperative(all P>0.05).Conclusions:After endoscopic dacryo

关 键 词：鼻泪管阻塞 内镜 泪囊鼻腔吻合术 泪膜 视觉质量 

分 类 号：R779.6[医药卫生—眼科]