闪光视诱发电位检查对白内障患者术后视力的预测  

Application of flash visual evoked potentials for preoperative estimation of visual acuity in eyes with dense cataract

作　　者：万灵[1] 刘谊[2] 

机构地区：[1]四川省医学科学院四川省人民医院眼科,中国四川省成都市1610072 [2]四川大学华西眼科中心,中国四川省成都市2610041

出　　处：《国际眼科杂志》2007年第4期1013-1015,共3页International Eye Science

摘　　要：目的:评价术前闪光视诱发电位(flash visual evoked potential,FVEP)检查对白内障术后视力的预测价值。方法:试验组白内障患者95例130眼于术前1～3d常规行FVEP检查,术后1wk复查FVEP,1mo复查最佳矫正视力(best corrected visual acuity,BCVA)。对照组38例62眼。分析FVEP-P2波的振幅及潜伏期,并注重波型完整性的分析。结果:术前FVEP正常者78眼,术后视力改善者75眼(96.2%),无改善者3眼(3.8%)。术前FVEP异常者52眼,术后视力改善者40眼(76.9%),无改善者12眼(23.1%)。FVEP对白内障患者术后视力预测的假阳性率28.5%,假阴性率3.9%,预测可靠性66.9%(BCVA=0.3)。各级晶状体混浊者FVEP的潜伏期和振幅差异无显著性,白内障术前与术后FVEP的潜伏期和振幅差异无显著性。FVEP的振幅与术后BCVA相关性较好。结论:白内障术前FVEP正常者高度提示术后视力预后良好,但术前FVEP异常者术后仍有76.9%视力提高。因此,在临床工作中对于术前FVEP异常的白内障患者,不应轻易放弃手术治疗。AIM： To study the preoperative estimation value for visual acuity of flash visual evoked potentials in dense cataract cases. METHODS： A total of 95 patients with cataract （130 eyes） underwent preoperative routine examinations with flash visual evoked potentials （FVEP）. Normal control group presented as 38 cases （62 eyes）. All best corrected visual acuities （BCVA） were obtained at 1 month after operation. And all the patients underwent examinations with FVEP again 1 week after operation. Latency and amplitude, as well as the integrity of the wave P2 were analyzed. RESULTS： In the 78 eyes with normal preoperative FVEP compared with the normal control group; there were three eyes with postoperative BCVA≤0.2 （3.8%）, two eyes 0.2-0.3 （2.6%）, five eyes 0.4-0.8 （6.4%） and 68 eyes 〉0.8 （87.2%）. Yet there were nine eyes with postoperative BCVA≤0.1 （17.3%）, six eyes 0.2-0.3 （11.5%）, 17 eyes 0.4-0.8 （32.7%） and 20 eyes 〉0.8 （38.5%） in the 52 cases with abnormal preoperative FVEP. The FVEP＇s pseudopositive ratio was 28.5% for the preoperative estimation of visual acuity in dense cataract cases and the pseudo-negative ratio was 3.9%. The predictive reliability of FVEP was 66.9%. The differences of latency and amplitude were not significant among different lens opacities, and the same to the pre- and postoperative cases. Amplitude of FVEP keeps more consistency to BCVA compared with latency. CONCLUSION： The normality of preoperative FVEP highly indicates good prognosis of visual acuity. However the prognostic value in preoperative abnormal cases is still to be investigated. Clinical attention must be paid especially to abnormal cases to ensure that the chances should never be lost easily.

关 键 词：视诱发电位 白内障 视力 预测 

分 类 号：R779.66[医药卫生—眼科]