暗室瞳孔直径下Nd:YAG激光后囊膜切开术后屈光状态及视觉质量的变化  

Changes in refractive status and visual quality after Nd:YAG laser capsulotomy in the scotopic pupil diameter

作　　者：吴丹萍 华焱军[1] 吴强[1] WU Dan-Ping;HUA Yan-Jun;WU Qiang(the Department of Ophthalmology,Shanghai Jiaotong University Affiliated Sixth People’s Hospital,Shanghai 200233,China)

机构地区：[1]上海交通大学附属第六人民医院眼科

出　　处：《眼科新进展》2019年第6期579-582,共4页Recent Advances in Ophthalmology

摘　　要：目的探讨暗室瞳孔直径下Nd:YAG激光后囊膜切开术后的屈光状态、高阶像差(higher order aberration,HOA)、视觉相关生活质量变化特点。方法收集2017年9月至11月在我院就诊的后发性白内障患者57例73眼。所有患者均行Nd:YAG激光后囊膜切开术治疗,切开直径为暗室下瞳孔直径(3~4 mm),观察激光术前后最佳矫正视力(best corrected visual acuity,BCVA)、屈光状态及Catquest-9SF量表总分和各问题得分的变化,应用KR-1W视觉质量分析仪分别测量分析4 mm和6 mm瞳孔直径下激光术前后HOA的变化。结果 Nd:YAG激光后囊膜切开术后BCVA(0.095±0.020)较术前(0.550±0.039)显著提高,差异有统计学意义(P<0.05);术前球镜度数、等效球镜度数分别为(-0.938±0.209)D、(-1.581±0.207)D,术后分别为(-0.658±0.218)D、(-1.204±0.213)D,手术前后差异均有统计学意义(均为P<0.05);术后Catquest-9SF量表总分及各问题得分均较术前显著提高,差异均有统计学意义(均为P<0.05);4 mm、6 mm瞳孔直径下的全眼及眼内总HOA、三阶像差、四阶像差、三叶草像差、彗差、二阶像差术后较术前显著降低,差异均有统计学意义(均为P<0.05)。结论暗室瞳孔直径下Nd:YAG激光后囊膜切开术后,屈光状态呈远视漂移,高阶像差明显降低,视力及视觉相关生活质量问卷评分显著提高,患者视觉质量明显改善。Objective To evaluate the changes in refractive status,higher order aberration(HOA) and visual quality of life after Nd:YAG laser capsulotomy with scotopic pupil diameter.Methods Fifty-seven patients(73 eyes) with posterior capsule opacification were recruited from September,2017 to November,2017 in our hospital.The patients received Nd:YAG laser capsulotomy with scotopic pupil diameter(3-4 mm).The changes in the best corrected visual acuity(BCVA) and refractive status and scores of Catquest-9 SF questionnaire were collected,as well as the HOA under the 4 mm and 6 mm pupil diameter were assessed by KR-1 W respectively before and after laser surgery.Results The postoperative BCVA(0.095±0.020) was obviously improved compared with the preoperative data(0.550±0.039),and the difference was significant(P<0.05).The preoperative spherical power and spherical equivalences were(-0.938±0.209)D,(-1.581±0.207)D,respectively,while the postoperative data were(-0.658±0.218)D,(-1.204±0.213)D,respectively,and there were significant differences between preoperative data and postoperative data(both P<0.05).The postoperative total scores and scores of each problem of Catquest-9 SF questionnaire were obviously improved compared with the preoperative data,and the differences were significant(all P<0.05).Ocular and intraocular total HOA,3 rd order aberration,4 th order aberration,trefoil,coma,and 2 nd order astigmatism at 4 mm and 6 mm pupil diameter were significantly lower than those before surgery,and the differences were statistically significant(all P<0.05).Conclusion After Nd:YAG laser capsulotomy under scotopic pupil diameter,the refractive status shows hyperopic shift,higher order aberration is significantly reduced,BCVA and visual related quality of life questionnaire scores are significantly improved,and visual quality of patients is also significantly improved.

关 键 词：后囊膜混浊 ND:YAG激光后囊膜切开术 屈光 高阶像差 

分 类 号：R776[医药卫生—眼科]