双通道视觉质量系统评估不同方位白内障透明角膜切口手术疗效

发布时间：2018-05-20 07:21

本文选题：双通道视觉质量分析系统 + 角膜切口　；参考：《眼科新进展》2017年03期

【摘要】：目的探讨不同方位白内障透明角膜切口手术疗效以及双通道视觉质量分析系统在白内障手术前后视觉质量评估中的应用。方法收集白内障超声乳化联合囊内人工晶状体植入术患者共64例64眼,根据术中透明角膜切口的位置分为A组(透明角膜切口位于双眼颞侧)和B组(采用正上方透明角膜切口)。所有入选病例均行标准对数视力评估,双通道视觉质量分析系统检测。比较两组视力、MTF截止空间频率(MTF cut-off)、斯特列尔比值(strehl ratio,SR)、客观散射指数(objective scattering index,OSI)值及对比度为100%、20%、9%时的OQAS值(OQAS value,OV100%、OV20%和OV9%)。结果所有患者术后1d、1周裸眼视力及最佳矫正视力均逐渐上升,较术前差异均有统计学意义(P0.05),1周后视力逐渐趋于稳定;其中A组术后1d、1周裸眼视力及最佳矫正视力均高于同时间点B组患者,差异均有统计学意义(均为P0.05)。术后1个月及3个月两组间裸眼视力及最佳矫正视力无明显差异(P0.05)。术后1d及1周两组患者OSI值均较术前逐渐下降,各时间点比较差异均有统计学意义(均为P0.05),其中A组术后1d(2.81±0.89)及1周(1.98±0.73)OSI值明显低于B组术后1d(3.46±1.17)及1周(2.61±1.20)(均为P0.05)。两组患者术后1个月及3个月与术后1周比较OSI值均无明显差异(均为P0.05)。术后1d、1周、1个月及3个月两组患者OV9%值均较术前逐渐上升,各时间点比较差异均有统计学意义(均为P0.05),其中A组术后1d(0.29±0.09)、1周(0.33±0.12)、1个月(0.37±0.14)及3个月(0.42±0.17)均明显高于B组术后1d(0.24±0.10)、1周(0.27±0.09)、1个月(0.31±0.09)及3个月(0.34±0.14)(均为P0.05);所有患者术后各时间点MTF值、SR值、OV100%值、OV20%值与术前比较差异均无统计学意义(均为P0.05)。结论白内障术中采用颞侧角膜切口,术后眼内散射小,视力恢复快,视觉质量高,远期效果有待进一步研究。双通道视觉质量分析系统能进一步量化视觉质量参数,在视觉质量评估方面具有一定优势。
[Abstract]:Objective to investigate the effect of transparent corneal incision for cataract in different directions and the application of dual channel visual quality analysis system in the evaluation of visual quality before and after cataract surgery. Methods 64 cases (64 eyes) of cataract phacoemulsification combined with intraocular lens implantation were collected. According to the location of transparent corneal incision during operation, group A (transparent corneal incision was located on the temporal side of the eyes) and group B (using a clear corneal incision directly above the cornea) was divided into two groups. All patients were evaluated with standard logarithmic visual acuity and two-channel visual quality analysis system. The visual acuity cut-off frequency, Strehl ratioSRI, objective scattering index, and contrast value of MTF cut-off, Strehl ratio and objective scattering index were compared between the two groups. The OQAS values at 9 were 20% and 20%, respectively, and the value of OQAS valueof OV100 was 20% and OV9B was higher than that of OV9. Results the uncorrected visual acuity and the best corrected visual acuity of all the patients increased gradually at 1 week after operation, and the visual acuity tended to be stable after 1 week compared with the preoperative visual acuity. The uncorrected visual acuity and best corrected visual acuity in group A were significantly higher than those in group B at 1 day after operation (P 0.05). There was no significant difference in uncorrected visual acuity and best corrected visual acuity between the two groups at 1 month and 3 months after operation (P 0.05). The values of OSI in group A and group A were significantly lower than those in group B at 1 day and 1 week after operation (P0.05 卤0.89) and 1.98 卤1.17 in group A and 2.61 卤1.20 in group B respectively. There was no significant difference in OSI between the two groups at 1 month and 3 months after operation (P 0.05). The value of OV9% in the first week, one month and three months after operation was gradually higher than that before operation. There were significant differences at each time point (P0.05, 1d(0.29 卤0.09) and 3 months after operation (1d(0.29 卤0.09) and 3 months (0.42 卤0.17) in group A and 1d(0.24 卤0.10 卤0.09, 0.31 卤0.09 in group B and 0.34 卤0.14 in 3 months after operation, respectively, and MTF was 0.34 卤0.14 (all P0.05A) after operation in all the patients after operation, and MTF was significantly higher in group A than that in group B (P < 0.01), and in group A was 0.34 卤0.14 (all P0.05A, P < 0.01), and that in group A was significantly higher than that in group B (1d(0.24 卤0.10 卤0.09, 0.31 卤0.09) and in group A (all P0.05). There was no significant difference between the values of SR and OV 100% and OV 20% (P 0.05). Conclusion the temporal corneal incision is used in cataract surgery, the intraocular scattering is small, the visual acuity recovers quickly, the visual quality is high, and the long-term effect needs further study. Dual-channel visual quality analysis system can further quantify visual quality parameters and has some advantages in visual quality evaluation.
【作者单位】：湖南师范大学第一附属医院暨湖南省人民医院眼科;
【基金】：湖南省2017年卫生计生委科研计划课题(编号:C2017038)~~
【分类号】：R779.66

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