两种附加度数在白内障摘除手术单眼视设计中应用的临床观察  

Clinical observation on monovision of cataract surgery with different near addition

作　　者：穆晶[1] 李一壮[2] 吴强[1] 严良[1] 陈晖[2] Mu Jing Li Yizhuang Wu Qiang Yan Liang Chen Hui(Department of Ophthalmology, Shanghai JiaoTong University Affiliated Sixth People＇s Hospital, Shanghai 200233, Chin)

机构地区：[1]上海交通大学附属第六人民医院,200233 [2]南京大学附属鼓楼医院眼科中心

出　　处：《中华眼科杂志》2017年第6期451-454,共4页Chinese Journal of Ophthalmology

摘　　要：目的观察白内障摘除手术单眼视设计中不同的近附加度数对白内障患者术后视功能、满意度以及脱镜率的影响。方法前瞻性临床研究。选择2013年10月至2015年3月于上海交通大学附属第六人民医院眼科诊断为双眼白内障并行双眼超声乳化白内障吸除联合IOL植入手术的患者64例，年龄51．0—70．0岁，平均（65．4±6．0）岁；男性28例，女性36例。根据患者对脱镜的不同要求及生活习惯，分为单眼视1组（MV1组），单眼视2组（MV2组），MV1组患者设计近附加度数1．25～1．75D，MV2组近附加度数2．25±2．75D，所有患者均植入单焦点非球面AcrySof IQ IOL，比较两组患者双眼术后6个月的远、中、近距离视力（双眼裸眼）、屈光状态、立体视。根据视功能调查问卷了解患者脱镜率以及满意度。对术后裸眼视力的比较采用￡检验；术后远、近未矫正立体视行WhitneyU检验；两组间性别分布比较，视功能调查等计数资料行Х^2检验。结果术后两组患者数据比较，双眼裸眼远视力MV1组0．09±0．09，MV2组0．11±0．08（t=1．62，P=0．264，LogMAR），中距离视力MV1组0．27±0．25，MV2组0．30±0．22（t=0．23，P=0．876，LogMAR），差异无统计学意义，双眼裸眼近视力MV1组0．06±0．06，MV2组0．02±0．07（t=2．38，P=0．021，LogMAR）差异有统计学意义，近立体视锐度检查MV1组优于MV2组（Z=1．29，P=0．031），满意度调查显示两组患者日常生活的不适感差异无统计学意义（x。=0．10，P=0．756），MV2组中有2例述光线昏暗时行走楼梯有一定障碍，MV1组中有3例视近时依赖低度数老光镜，脱镜率低于90％，MV2组1例患者在中距离电脑使用及桌牌游戏时戴低度数近视镜。结论对于不同患者，两种近附加度数范围对提高白内障摘除术后患者脱镜率、满意度以及全程视力改善有相似的优越性。Objective To observe the influence on spectacle independence, satisfaction and visual function after cataract surgery monovision with different ADD. Methods Prospective clinical study. All patients were collected from the department of ophthalmology, Shanghai JiaoTong University Affiliated Sixth People＇s Hospital who were diagnosed as bilateral cataract from Oct. 2013 to Mar. 2015. This study comprised 64 cases （128 eyes）. All consecutive patients scheduled to undergo bilateral cataract phacoemulsification and implantation of a monofocal AcrySof IQ IOL. The average age of patients was （65.4± 6.0）years old, ranged from 51 to 70 years. 28 males and 36 females. According to the different demands of spectacle independence and living habits of patients, all cases were divided into two groups： MV 1 group （32 patients）, whose near addition being 1.25-1.75 D and MV2 group （32 patients）, whose near addition being 2.25-2.75 D. Parameters 6 months postoperatively included binocular uncorrected distance, intermediate, and near visual acuities, stereo vision and refractive states were analyzed. Parameters of spectacle independence, subjective visual symptoms and patient satisfaction according to visual function questionnaire were analyzed at the same time. T test was used to compare uncorrected visual acuity. Whitney U test was operated in stereo vision comparison. Chi-square test was applied in sex-distribution comparison and visual function questionnaire between two groups. Results The uncorrected distance vision in MV1 group was （0.09±0.09）, while it was （0.11 ±0.08） in MV2 group. The uncorrected intermediate vision in MV 1 group was （0.27±0.25）, and it was （0.30±0.22） in MV2 group. There were no significant difference between two groups in bilateral uncorrected distance vision （t=1.62, P=0.264, LogMAR）, intermediate （t=-0.23, P=0.876, LogMAR）. However, there was significant difference between two groups in uncorrected near vision （t=2.38, P=0.021, LogMAR）. It was （0.0

关 键 词：超声乳化白内障吸除术 晶体植入 眼内 视觉 单眼 深度知觉 

分 类 号：R779.66[医药卫生—眼科]