晶状体功能失调指数在混合型白内障术前评判中的应用  

Application of lens dysfunction index in the diagnosis and operation of mixed cataract

作　　者：牛梦琪 刘梦可 温跃春 Niu Mengqi;Liu Mengke;Wen Yuechun(Bengbu Medical College,Bengbu 233030,China;The First Affiliated Hospital of University of Science and Technology of China(Anhui Provincial Hospital)Department of Ophthalmology,Hefei 230000,China)

机构地区：[1]蚌埠医学院,233030 [2]中国科学技术大学附属第一医院

出　　处：《临床眼科杂志》2023年第3期193-197,共5页Journal of Clinical Ophthalmology

摘　　要：目的探究晶状体功能失调指数(DLI)在混合型白内障中作为术前评判及手术指导中的应用价值。方法选取2021年4月至2022年6月于我院住院的混合型白内障患者为研究对象,共46例(79只眼),所有患者均行白内障超声乳化摘除联合一期人工晶状体植入术,术前记录裸眼视力、晶状体混浊程度,晶状体混浊程度采用LOCSⅡ分级系统对白内障皮质性(C)、核性(N)和后囊性(P)分数评分,分数总和相加作为最终的LOCSⅡ评分指数;采用iTrace系统测量DLI和调制传递函数(MTF)。术中记录超声乳化累积耗散能量(CDE),术后记录1个月裸眼视力、最佳矫正视力(BCVA)和术中角膜内皮细胞丢失数,应用相关性检验分析DLI值与各项指标的相关性。结果DLI与术前裸眼视力、LOCSⅡ分级总和呈负相关(r=-0.481,r=-0.465,P<0.001),与MTF值呈正相关(r=0.916,P<0.001),与术中CDE值呈负相关(r=-0.411,P<0.001),与术中角膜内皮细胞丢失数、术后1个月BCVA无明显相关性(r=-0.043,P=0.702;r=0.120,P=0.290);术前logMAR视力与LOCSⅡ分级总和呈正相关(r=0.274,P=0.014)。CDE值与术中角膜内皮细胞丢失数呈正相关(r=0.356,P=0.001)。结论术前测量DLI值能够客观反映混合型白内障的晶状体混浊程度,可以指导混合型白内障病情评估及手术实施。Objective To appraise the diagnostic evaluation of dysfunctional lens index(DLI)in the mixed cataract.Methods Forty six cases(seventy nine eyes)with mixed cataract were recruited from April 2021 to June 2022 in Anhui provincial hospital as the study subjects.Phacoemulsification and intraocular lens implantation were used to all patients.The preoperative visual acuity(logMAR visual)was recorded.and the degree of lens opacity was scored by LOCSⅡ grading system for cortical type,karyo type,and posterior subcapsular type,DLI and MTF was measured by iTrace system.The cumulative released energy(CDE)of phacoemulsification was recorded during operation,operative corneal endothelial cells loss and uncorrected visual acuity,corrected visual acuity one month after surgery were recorded.We used dependency check to appraise the relevance of DLI and various indexes.Results Negatively correlation was found between DLI and preoperative logMAR visual acuity,LOCSⅡ grade summation(r=-0.481,r=-0.465,all P<0.001),and positively correlation was found between DLI and MTF(r=0.916,P<0.001),negatively correlation was found between DLI and CDE(r=-0.411,P<0.001),and DLI had no correlation with operative corneal endothelial loss and postoperativeBCVA(r=-0.043,P=0.702;r=0.120;P=0.290).There was positively correlation was found between Preoperative logMAR visual acuity and the sum of LOCSⅡ grades(r=0.274,P=0.014).CDE was positively correlated with the operative corneal endothelial loss(r=0.356,P=0.001).Conclusions DLI can objectively reflect the degree of lens opacity in patients with mixed cataract.The DLI can provide an important reference for the evaluation and surgical implementation of mixed cataract.

关 键 词：晶状体功能失调指数 LOCSⅡ分级系统 混合型白内障 术前评判 

分 类 号：R779.66[医药卫生—眼科]