摘要
目的:评估视功能相关生存质量量表-25(NEI VFQ-25)、视功能指数量表(VF-14)和白内障视功能相关生存质量简表(Catquest-9SF)在老视矫正型人工晶状体(PC-IOL)植入术后患者中的适用性。方法:调查研究。2024年6月30日在CNKI数据库和万方数据知识服务平台中检索"人工晶状体"和"问卷"或"量表"相关期刊和学位论文,并排除"ICL"相关条目。经去重和分析确定3份国人常用的白内障术后量表,设计包含量表条目、患者反馈及视觉检测的线上问卷,对2022年5月至2023年9月期间在中山眼科中心白内障科行PC-IOL植入术,术后随访时间≥6个月的178例患者进行调查。采用Pearson和Spearman相关分析评估量表间的关联性,通过响应率和普及率比较量表的患者反馈特性以及Cronbach's α、因子分析检验信效度等,Spearman相关分析评估量表维度得分对视觉的反映,并构建ROC曲线分析量表总分对戴镜率、光干扰及满意度的预测效能。结果:收回有效问卷156份,回收率93.3%,完成率94.0%。3份量表总分高度相关(r=0.80~0.90,均P<0.010)。患者反馈显示,VF-14在反映视觉质量(50.0%)和易理解性(58.3%)方面评分最优,12.8%的患者认为NEI VFQ-25过长。信效度分析中,3份量表总体Cronbach's α系数>0.9,VF-14近/中远视力维度内部一致性最高(α=0.86、0.92),探索性因子分析显示3份量表的结构效度俱佳。视觉检测方面,3份量表对戴镜率(AUC=0.70~0.73,均P<0.001)、光干扰(AUC=0.96~0.98,均P<0.001)及满意度(AUC=0.90~0.92,均P<0.001)均具高预测价值,3组间差异无统计学意义(P>0.05)。VF-14近视力维度与总体戴镜率及近戴镜率相关性最强(r=0.53、0.51,均P<0.001),驾驶困难维度与光干扰相关性最强(r=0.68,P<0.001);VF-14近视维度在非整体视力维度中与满意度相关性最高(r=0.48,P<0.001)。结论:VF-14量表在PC-IOL植入术后视觉质量量表评估中显示出简洁易理解,患者反馈佳,与术后视觉功能关联紧密。
Objective:To evaluate the applicability of three patient-reported outcome measures(PROMs)—the 25-item National Eye Institute Visual Function Questionnaire(NEI VFQ-25),Visual Function Index-14(VF-14),and Catquest-9SF—in patients after presbyopia-correcting intraocular lens(PC-IOL)implantation,and to determine the most suitable tool for postoperative visual quality assessment.Methods:A cross-sectional study was conducted.Literature on"intraocular lenses"and"questionnaires"or"scales"was retrieved from the CNKI and Wanfang databases(as of June 30,2024),excluding entries involving"ICL".After deduplication and analysis,3 commonly used PROMs for postoperative cataract patients in China were identified.An online questionnaire incorporating scale items,patient feedback,and visual assessments was distributed to 178 patients who had undergone PC-IOL implantation at the Cataract Department of Zhongshan Ophthalmic Center between May 2022 and September 2023,with at least 6 months of follow-up.Scale correlations were evaluated using Pearson and Spearman analyses.Patient feedback characteristics,reliability(Cronbach'sα),and validity(factor analysis)were analyzed.ROC curves were used to assess the predictive ability of total scale scores for spectacle dependence,photopic disturbances,and satisfaction.Results:A total of 156 valid questionnaires were collected(response rate:93.3%,completion rate:94.0%).The 3 PROMs showed strong correlations in total scores(r=0.80-0.90,all P<0.010).VF-14 was rated highest in reflecting visual quality(50.0%)and ease of understanding(58.3%),while 12.8%of participants found the NEI VFQ-25 too lengthy.All PROMs demonstrated high internal consistency(Cronbach's α>0.9),with VF-14 showing highest subscale reliability for near and intermediate vision(α=0.86 and 0.92).Factor analysis confirmed structural validity.ROC analysis showed all PROMs had good predictive value for spectacle dependence(AUC=0.70-0.73,all P<0.001),photic disturbances(AUC=0.96-0.98,all P<0.001),and satisfaction(AUC=0.90-0.92,all P<0.001),with no significant differences among the three scales(P>0.05).VF-14's near vision subscale had the strongest correlation with spectacle dependence(r=0.53,0.51,both P<0.001),its driving difficulty subscale was most correlated with photic disturbances(r=0.68,P<0.001),and it showed the highest correlation with satisfaction among non-overall visual function dimensions(r=0.48,P<0.001).Conclusion:Among the three PROMs evaluated,the VF-14 demonstrated the best balance of simplicity,patient acceptance,and clinical relevance.
作者
张彧
张佳晴
林灏文
张一帆
谈旭华
罗莉霞
Yu Zhang;Jiaqing Zhang;Haowen Lin;Yifan Zhang;Xuhua Tan;Lixia Luo(Zhongshan Ophthalmic Center,State Key Laboratory of Ophthalmology,Zhongshan Ophthalmic Center,Sun Yat-sen University,Guangzhou 510060,China)
出处
《中华眼视光学与视觉科学杂志(中英文)》
北大核心
2025年第10期767-777,共11页
Chinese Journal Of Optometry Ophthalmology And Visual Science
基金
国家自然科学基金(82070940)
广州市科学技术局市校(院)企联合资助项目(2024A03J0245)。
