瞳孔成形联合人工晶状体植入术后患者视觉生活质量研究

Abstract

目的 评估瞳孔成形联合人工晶状体植入术后患者视力及视觉相关生活质量.方法 临床病例回顾性研究.收集2011年12月至2013年12月在北京大学第三医院眼科,因外伤导致虹膜瞳孔异常的白内障、晶状体脱位或无晶状体眼患者,并行瞳孔成形联合人工晶状体植入术.分别于术前及术后3个月检查裸眼视力及最佳矫正视力,并采用NEI-VFQ-25问卷对患者进行调查,问卷中的各条目分别记为0～100分,评价结果为调查问卷的累积分数.采用配对t检验.结果 共38例38只眼纳入统计.瞳孔成形联合人工晶状体植入术前及术后3个月,裸眼视力分别为31.08±9.28和52.79±15.19;最佳矫正视力分别为38.79±13.13和58.74± 15.69,术后3个月视力均明显提高,差异具有统计学意义(t =-11.50,P＜0.01;t=-7.87,P＜0.01).术后3个月NEI-VFQ-25调查问卷总体评分(45.60±18.37)分,高于术前(57.51±16.73)分,差异具有统计学意义(t=--4.58,P＜0.01).其中有9项与视觉生活质量相关的项目,如一般健康、总体视力、近视力、远视力、社会功能、精神健康、社会活动、依赖性及周边视野等方面的评分均较术前明显提高,差异具有统计学意义(t =-4.58～-2.59,P＜0.05).结论 对于外伤引起伴有瞳孔损伤的白内障、晶状体脱位及无晶状体眼患者,瞳孔成形联合人工晶状体植入手术在提高视力的同时,还可以明显改善患者的视觉生活质量.

Objective To evaluate visual acuity and vision related quality of life in the patients after coreoplasty combined with IOL implantation.Methods In this study,patients accompanying with pupil abnormality and cataract,dislocation of lens or aphakia caused by traumatic reasons,were treated with coreoplasty combined with IOL implantation from December 2011 to December 2011 in our hospital.The uncorrected and best corrected visual acuity acuities (BCVA) as well as the NEI-VFQ-25 questionnaire scores were compared before and 3 months after operation.Each item in the questionnaire table was divided into 0-100 scores,and the accumulated points were used as assessing result.Data were analyzed using paired samples t test.Results Thirty-eight patients (38 eyes) were analyzed.The uncorrected visual acuity,BCVA were 31.08±9.28,38.79±13.13 in pre-operation,52.79±15.19,58.74±15.69 in post-operation,respectively,showing significant enhancements in vision and questionnaires scores after operation (t =-11.50,-7.87,both at P ＜0.01).The overall scores of NEI-VFQ-25 questionnaires were significantly elevated between before and after operation (t =-4.58,P ＜0.01).The scores of each item from NEI-VFQ-25 table,such as general health status,overall vision,near activities,distant activities,social functional,mental health,social roll difficulties,independency and perimetry,were improved 3 months after operation compared to before operation (t =-4.58～-2.59,all at P ＜0.05).Conclusions Besides elevating visual acuity,coreoplasty combined with IOL implantation can also improve the vision related quality of life in patients accompanying with pupil abnormality and cataract,dislocation of lens or aphakia.