摘要
目的研究超声乳化白内障吸除联合人工晶状体（IOL）植入术后年龄相关性白内障患者运动视标分辨力的变化。方法病例对照研究。将2011年7月至12月拟于北京大学第三医院眼科行超声乳化白内障吸除联合IOL植入术的年龄相关性白内障患者24例（48只眼）作为患者组，晶状体无明显混浊并排除老视以外的其他眼部疾病的老年人23例（46只眼）作为正常对照组，同期就诊的超声乳化白内障吸除联合单焦点、球面、非蓝光滤过型IOL植入术后3个月的年龄相关性白内障术后患者23例（5例单眼手术，18例双眼手术，41只IOL眼，5只自然晶状体眼）作为术后组。以logMAR视力表测定单眼及双眼静态最佳矫正远视力，在双眼最佳矫正状态下测定对水平运动速度分别为15、30、60及90°／s（dps）的运动视标的分辨能力。采用两均数t检验对数据进行统计学分析，并以Bonferroni法进行校正。结果视标运动速度为15、30、60及90dps时，患者组视力分别为0．29±0．16，0．34±0．17，0．47±O．19及0．52±0．17；正常组视力分别为0．04±0．06，0．06±0．06，0．12±O．09及0．15±0．11，患者组对各速度水平动态视标的分辨能力均低于正常组（t=-6．952，-7．558，-8．235，-8．737；P值均〈0．01）。对视力随视标运动速度增大而下降的幅度进行比较，在0～15dps及30～60dps的变化中，患者组视力的下降幅度分别为0．14±0．13及0．13±0．09，均大于正常组的0．03±0．05及0．06±0．07（t0-15dps=-3．874，P：0．001；t30-60dps=-3．113，P=0．003）。术后组对运动速度为15、30、60及90dps动态视标的分辨力分别为0．03±0．05，0．05±0．07，0．11±O．10及0．16±0．11，均高于患者组（t=-7．336，-7．673，-8．328，-8．583；P值均〈0．01）并恢复至与正常组一致的水平（t=0．669，0．400，0．372，-0．504；P值均〉0．05）；随视标运动速度增大，术后组视力变化幅度与正常组一致（t=0．586，-0．326，0．133，-1．600；P值均〉0．05），且在0～15dps及30～60dps的变化中，视力改变幅度分别为0．03±0．04及0．05±0．06，均小于患者组（t0-15dps=-4．182，P〈0．01；t30-60dps=-3．334，P值均〈0．01）。结论年龄相关性白内障患者在观察动态视标时将表现出更加明显的视力下降，超声乳化白内障吸除联合IOL植入术可有效恢复老年人的运动视标分辩力。
Objective To compare the spatial resolutions of dynamic optotypes at different speed levels among age-related cataract patients, older people with clear crystalline lenses and senile individuals implanted with intraoeular lenses （IOL）. Methods The control study recruited 24 patients （48 eyes） with age-related cataract scheduled for phacoemulsification surgery in our hospital between Jul. 2011 and Dec. 2011 in the cataract group. Twenty-three older volunteers （46 eyes ） with clear crystalline lenses were enrolled in the normal group. The postoperative group consisted of 23 contemporary cases implanted with spherical monofocal non-yellow-tinted IOL and followed up for 3 months postoperatively, of which 5 cases undertook unilateral surgery for normal visual acuity of the contralateral eye. Monocular and binocular best corrected visual acuity at static condition and binocular spatial resolution of optotypes at speeds of 15, 30, 60 and 90 degrees per second （dps） were measured by a logarithmic visual acuity chart. Statistical analysis was performed with student＇s t test （with Bonfen＇oni correction）. Results Binocular spatial resolutions at speeds of 15, 30, 60 and 90 dps were （0.29±0.16）, （0.34 ±0.17）, （0.47 ±0.19） and （0.52± 0. 17）, respectively, in the cataract group, and （0.04 ±0.06）, （0.06 ±0.06）, （0.12±0.09） and （0. 15 ± 0. 11 ）, respectively, in the normal group. Resolution of dynamic optotypes at the four speed levels were statistically lower in the cataract group than in the normal group （ t = - 6. 952, - 7. 558, - 8. 235, - 8. 737 ; P 〈 0. 01 ）. Velocity dependent spatial resolution changes manifested statistically higher values in the cataract group than in the normal group, with （0. 14 ±0. 13） versus （0. 03 ±0. 05） at the interval between sLatic and 15 dps （t0-15dps = -3. 874, P=0. 001 ） and （0. 13 ±0. 09） versus （0. 06 ±0. 07） at the interval between 30 dps and 60 dps （t30-60dps= - 3. 113, P = 0.003 ） . In the postoperative group, resolutions of dynamic optotypes at speeds of 15, 30, 60 and 90 dps were （0.03 ± 0.05 ） , （0.05±0.07） , （0. 11 ±0. 10） and （0. 16 ＋0. 11 ）, respectively. Dynamic visual acuities at all the four speed levels were statistically higher in the postoperative group than in the cataract group （t = - 7. 336, - 7. 673, - 8. 328, - 8. 583 ; P 〈0. 01 ） and compatible to that in the normal group （t =0. 669, 0. 400, 0. 372, -0. 504; P 〉O. 05）. Visual acuity differences between consecutive speed levels were comparable between the postoperative group and the normal group （t =0. 586, -0. 326, O. 133, - 1. 600; P 〉0. 05） , while at the interval between static and 15 dps and the interval between 30 dps and 60 dps, the postoperative group exhibited lower visual acuity changes than the cataract group, with （0. 03 ± O. 04） versus （0. 14 ± O. 13） （t0-15dps = - 4. 182, P 〈 0. O1 ） and （0. 05 ±0. 06） versus （0. 13 ± O. 09） （ t30-60ps = - 3. 334, P =0. 002） , respectively. Conclusions As the optotype＇s moving speed increased, spatial resolutions declined more rapidly in patients with age-related cataract. Phacoemulsification combined with IOL implantation could effectively restore the spatial resolution of dynamic optotypes.
出处
《中华眼科杂志》
CAS
CSCD
北大核心
2013年第5期405-409,共5页
Chinese Journal of Ophthalmology
