原发性急性闭角型青光眼合并白内障患者双眼联合植入单焦点和多焦点人工晶体的视觉质量  

Visual Quality in Acute Primary Angle Closure Glaucoma with Cataract After Implantation of Single Focus Intraocular Lens and Multifocal Intraocular Lens in Binoculus

作　　者：叶倩 张文强 李颖 谢梅芬 YE Qian;ZHANG Wenqiang;LI Ying;XIE Meifen(Department of Ophthalmology,General Hospital of Central Theater Command,Wuhan Hubei 430070,China)

机构地区：[1]中部战区总医院眼科,湖北武汉430070 [2]湖南省湘潭市中心医院眼科

出　　处：《联勤军事医学》2024年第7期589-593,共5页Military Medicine of Joint Logistics

基　　金：2022年知识创新专项项目(2022020801020520)。

摘　　要：目的观察原发性急性闭角型青光眼(acute primary angle closure glaucoma,APACG)合并白内障患者在行白内障超声乳化后双眼分别植入单焦点人工晶体(single focus intraocular lens,SIOL)和多焦点人工晶体(multifocal intraocular lens,MIOL)后的视觉质量。方法选取28例(56眼)双眼APACG合并白内障患者的临床资料进行回顾性分析。28例(56眼)APACG合并白内障患者,发作眼诊断为APACG急性发作期或慢性期合并白内障,行PEI+GSL,植入SIOL,对侧眼诊断为APACG临床前期合并白内障,行PEI,植入MIOL。记录术后3个月裸眼远视力(uncorrected distant visual acuity,UDVA)、裸眼中视力(uncorrected intermediate visual acuity,UIVA)、裸眼近视力(uncorrected near visual acuity,UNVA)、眼压、离焦曲线、对比敏感度(contrast sensitivity,CS)、国际标准化视觉质量问卷(the quality of vision questionnaire,QoV)评分和脱镜率。结果术后3个月,APACG合并白皮障患者发作眼视力UDVA为(0.48±0.33),对侧眼UDVA为(0.12±0.11),较术前均有明显提高(P均<0.01);术后对侧眼及双眼的UDVA、UIVA、UNVA均优于发作眼(P均<0.05);发作眼术后眼压较术前明显下降(P<0.001)。术后APACG合并白内障患者对侧眼、双眼的离焦曲线呈双峰型,在任意距离,双眼的离焦曲线均在对侧眼之上。明视和暗视条件下,对侧眼及双眼在3 c/d、6 c/d、12 c/d、18 c/d各空间频率处的CS均高于发作眼(P均<0.05);明视条件下12 c/d、18 c/d空间频率处双眼的CS高于对侧眼,暗视条件下6 c/d、12 c/d、18 c/d空间频率处双眼的CS高于对侧眼(P均<0.05)。28.57%(8/28)的患者主诉术后有明显眩光和严重聚焦困难,92.86%(26/28)的患者术后不需要佩戴眼镜。结论APACG合并白内障患者行白内障超声乳化联合眼内分别植入SIOL和MIOL,可以在降低眼压的同时,为患者提供更好的全程视力,提高术后脱镜率。Objective To investigate the visual quality of patients with acute primary angle closure glaucoma(APACG)combined with cataract undergo implantation of single focus intraocular lens(SIOL)and multifocal intraocular lens(MIOL)after cataract ultrasonic emulsification in binoculus respectively.Methods The clinical data of 28 patients(56 eyes)with binocular APACG combined with cataract were retrospectively analyzed.For 28 APACG combined cataract patients(56 eyes),the diagnosis of onset eyes were acute phase or chronic phase of APACG combined cataract,these eyes underwent PEI+GSL and were implanted SIOL,while the diagnosis of the contralateral eyes were preclinical APACG combined cataract,and these eyes underwent PEI and were implanted MIOL.The uncorrected distant visual acuity(UDVA),uncorrected intermediate visual acuity(UIVA),uncorrected near visual acuity(UNVA),intraocular pressure,defocus curve,contrast sensitivity(CS)and the quality of vision questionnair(QoV)score and glass independence rate of the patients were assessed at 3 months after surgery.Results Three months after surgery,the UDVA of onset eyes in APACG combined cataract patients were(0.48±0.33)and contralateral eyes were(0.12±0.11),which were significantly higher than those before(all P<0.01);the UDVA,UIVA and UNVA in contralateral eyes and binocular were all superior to the onset eyes after surgery(all P<0.05),the intraocular pressure of onset eyes were significantly lower than before(P<0.01).After surgery,the contralateral eyes and binocular defocus curve of APACG combined cataract patients showed bimodal shape,at any distance,binocular defocus curve was above the contralateral eyes.Under the photopic and scotopic condition,the CS at spatial frequencies of 3 c/d,6 c/d,12 c/d and 18 c/d in contralateral eyes and binocular were higher than those in onset eyes(all P<0.05);under photopic condition,CS at 12 c/d and 18 c/d were higher in binocular than those in contralateral eyes,under scotopic condition,CS at 6 c/d,12 c/d and 18 c/d were higher in binocul

关 键 词：急性闭角型青光眼 白内障 单焦点人工晶体 多焦点人工晶体 视觉质量 

分 类 号：R775.2[医药卫生—眼科]