白内障患者生存质量分析

目的观察白内障患者生存质量下降情况。方法应用视功能损害患者生存质量量表对不同视力损害的82例双眼白内障患者进行测量分析。结果白内障患者生存质量总分以及各指标分数下降。重度视力下降组生存质量分数下降更加明显。结论白内障患者由于视力下降而生存质量受损害。生存质量的研究使医生更加全面了解患者的需求。     

白内障患者视力改变与生存质量的关系

目的:了解白内障病人视力损害及康复与生存质量的关系,探讨影响白内障患者生存质量的因素。方法:应用视功能损害眼病生存质量量表测量142例不同视力损害的白内障患者生存质量及33例白内障摘除 人工晶体植入术前后的生存质量情况。结果:白内障患者视力改变与生存质量的总得分及各方面的得分有相关关系。白内障患者术前后生存质量得分差异有显著性,影响白内障患者生存质量的主要因素为视力损害、年龄和职业。结论:白内障的视力损害将降低患者的生存质量,适当时机进行白内障手术将有助于患者生存质量的提高,生存质量的测量为我们对白内障视力损害的评价提供了新的指标。眼科学报1997;13:85～89。     

西藏林芝地区白内障手术患者生存质量调查

目的:评估高原藏区白内障手术对患者生存质量的影响。方法:采用视功能损害眼病患者生存质量量表(SQOLDVI)对高原地区白内障患者在术前及术后1mo进行问卷调查。结果:白内障术后视功能的提高改善了患者的行为能力,特别是基本生活能力,同时精神生存质量也有明显提高。结论:白内障手术改善患者视功能,显著提高了高原藏区白内障患者生存质量。     

广东省斗门县白内障手术的生存质量评价

目的：评价广东省斗门县年龄≥50岁人群中白内障术后患者的主观视功能（visual function,VF）和生存质量（quality of life,QOL）。方法：整群抽样法确定样本人群,其中白内障术后患者组成手术组,视功能损害者（1只眼视力＜0．1者）和部分正常对照者（双眼视力均＜＞0．3者）组成非手术组,由4位工作人员按照标准化方式完成VF和QOL问卷调查工作。结果：在5342例受检查中,手术组109例白内障术后患者中99例,非手术组626例视功能损害者中535例、3227例正常对照者中119例完成问卷调查工作。随着视力自正常下降至严重盲,非手术组VF和QOL分数的中位数分别自92下降至2和自100下降至19;手术组VF和QOL分数的中位数分别自80下降至8和自90下降至31。手术组视力与VF和QOL分数的关系与非手术组相似。VF和QOL的总分数手术组分别为40和56,非手术组分别为56和72。通过多因素回归分析校正视力、年龄、性别和教育程度后,非手术组和手术组的QOL分数差异有显著意义（P＝0．015）,VF分数差异无显著意义（P＝0．199）。结论：VF和QOL与视力显著相关。在本研究人群中,白内障术后患者的主观VF和QOL无明显提高,临床应进一步重视白内障术后患者的随访工作和社会心理康复。     

白内障患者手术前后视功能相关生存质量分析

目的对行超声乳化吸出联合人工晶体植入术的白内障患者进行视功能相关生存质量评价。方法白内障患者在术前和术后1月分别测量日常生活视力，并进行中文版低视力者生存质量量表的评估。结果白内障患者术后的视力和生存质量各维指标都显著高于术前，术后生存质量评分与术后视力显著相关。结论白内障超声乳化吸出联合人工晶体植入术能够显著提高患者视力及视功能相关生存质量，术后视力情况是决定生存质量的重要因素。     

高度近视并发白内障患者术前及术后生存质量改变的研究

目的：探讨白内障手术疗法对高度近视并发白内障患者生存质量的影响。

方法：选取陕西省子洲县复明工程中46例高度近视并发白内障患者实施白内障摘除术,进行问卷调查、视力检查,分析手术前后视功能、生存质量以及功能性指标变化。

结果：患者46例中44例(96%)为第1眼手术,2例(4%)为第2眼手术。46例患者术后视力均高于术前。术后的视功能、生存质量及视功能损害眼病患者生存质量量表测评均高于术前。手术前后功能性指标变化比较也有显著性改变。

结论：安全且效果极佳的白内障手术疗法可以提高高度近视并发白内障患者的生存质量,是该类患者除了基本康复及视觉康复之外的重要康复手段。     

农村短期集中白内障防盲手术后患者视功能和生存质量的调查

目的评价农村短期集中白内障防盲手术后患者的视力、视功能、生存质量和存在的问题。方法检查接受白内障防盲手术的患者术后6个月时日常生活视力并分级,调查员进行视功能和生存质量现场问卷调查。结果251例接受手术的患者中131例(53.9%)接受调查,术后视功能平均得分为83.21±16.40,生存质量平均得分为86.53±16.33,与视力的等级相关系数分别为-0.48和-0.68。视功能得分与视力状况(t=-7.51,P=0.000)和居住地(t=-2.01,P=0.047)相关,生存质量得分与视力状况(t=-10.27,P=0.000)和性别(t=-2.59,P=0.011)相关。结论白内障术后患者平均视功能和生存质量有明显提高,在农村短期集中开展白内障手术具有重要意义。     

四川省贫困白内障复明手术后患者视功能状况调查分析

目的:评价农村地区开展白内障防盲手术对患者视功能(visual function,VF)与生存质量(quality of life,QOL)的影响以及白内障防盲手术方法学和并发症的研究。方法:采用优化的视功能量表及生存质量量表对接受防盲手术0.5a以上的患者进行问卷调查,并进行视力检查及眼部常规检查,对影响手术后视力的因素进行登记。结果:患者接受白内障手术后视功能及生存质量均有显著地改善,大多恢复了生活自理及部分劳动能力,手术前后平均VF得分百分数分别为30.9%,72.2%,手术前后QOL得分百分比分别为35.3%,84.9%,手术前后相比差异具有统计学意义,手术后存在屈光不正及后发性白内障等是患者视功能不良的主要因素。结论:白内障防盲手术在解决农村白内障发挥重要作用,能明显提高患者的视功能与生存质量。在人工晶状体度数的测算、手术后的随访及对后发性白内障的正确处理等方面应引起重视。     

中国山西334例“百万贫困白内障患者复明工程”手术效果分析

目的：了解中国山西省贫困白内障患者术后视力、视功能和生存质量的变化,分析贫困白内障患者手术成本／效果。方法：采用回顾性方法,对334例334眼接受贫困白内障复明手术的患者进行基本情况、术前及术后1 wk视力、术中并发症、术后并发症的病历采集及现场调查,对其中83例进行视功能和生存质量调查,225例贫困白内障患者和120例非贫困白内障患者进行手术成本／效果的对比分析,使用多重线性回归模型及 Logistic回归模型进行术后视力影响因素分析。结果：患者术后1 wk视力明显高于术前视力（ P＜0．05）,其中术后1 wk视力≥0．5的为235例（70．4％）、视力＜0．05的为16例（4．8％）。多重线性回归分析显示,眼部其他疾病、白内障分类是术后视力的影响因素。 logistic回归分析显示,术前视力低、眼部有其他疾病是术后低视力的危险因素,其OR值及其95％CI依次为6．5（2．8－14．8）和1．3（1．0－1．6）。术后视功能以及生存质量均高于术前。贫困白内障患者手术成本／效果低于非贫困白内障。结论：贫困白内障患者术后视力、视功能明显提高,且手术成本低,显著改善了生活质量。     

青光眼与生存质量的关系

目的:了解青光眼患者视功能损害与生存质量的关系,探讨影响青光眼患者生存质量的主要因素。方法:应用视功能损害眼病生存质量量表测量60例有不同程度视功能损害的慢性闭角型青光眼及开角型青光眼患者的生存质量情况。结果:青光眼患者的视功能改变与生存质量之间存在相关关系(r=0.66,P=0.000),影响青光眼患者生存质量的主要因素是视功能损害,性别及职业。结论:青光眼患者视功能损害降低病人的生存质量,生存质量测量为青光眼筛检及治疗方案选择提供新的指标。眼科学报 1996;12:183～187。     

Relationship between vision impairment and eye disease to vision-specific quality of life and function in rural India: the Aravind Comprehensive Eye Survey

PURPOSE: To determine the impact of vision impairment and eye diseases on vision-specific quality of life and visual function in an older population of rural southern India. METHODS: Presenting and best-corrected visual acuity and burden of eye diseases were determined in a population aged 40 years and older, identified through a random cluster sampling strategy from 50 villages of rural south India. A questionnaire validated previously for use in this population was used to ascertain quality of life and visual function. Visual acuity measurements were obtained with illiterate E Early Treatment Diabetic Retinopathy Study (ETDRS) charts. Cataract was graded and defined based on the Lens Opacities Classification System (LOCS) III. Macular degeneration was defined based on the classification system proposed by the International ARM Epidemiologic Study Group. Glaucoma was defined based on results of clinical examinations including optic disc and visual fields. Analyses were performed to explore the relationship of overall and subscale quality-of-life and visual function scores with presenting acuity in the better-seeing eye, specific eye diseases, and demographic variables. RESULTS: Information on quality of life and visual function were available for 5119 (99.4%) of 5150 study subjects. The mean presenting visual acuity in the better eye was 0.76 +/- 0.53 logMAR (logarithm of the minimum angle of resolution) units. Age, education, occupation, presenting acuity in the better eye, and presence of a cataract, glaucoma, or refractive error were independently associated with overall quality-of-life and vision function scores. After adjustment for demographic variables and ocular disease, persons with vision impairment or bilateral blindness based on presenting visual acuity had lower scores across all domains of quality of life and vision function. Scores for subscales of quality-of-life and vision function domains were significantly lower among those with age-related cataract and glaucoma compared with persons without those eye diseases. CONCLUSIONS: Presenting vision in the better eye was associated with quality of life and vision function in this older population of rural south India. Subjects with glaucoma and age-related cataract had an associated decrease in quality of life and vision function, independent of presenting visual acuity in the better eye.     

Impact of cataract surgery on self-reported visual difficulties: comparison with a no-surgery reference group

PURPOSE: To examine the impact of cataract surgery on older adults' self-reported visual difficulties and compare them with those of patients with cataract who declined surgery over the same period. SETTING: Twelve area practices. METHODS: This was a consecutive chart review over a 6-month period. Primary inclusion criteria were 55 years or older, cataract in 1 or both eyes with 20/40 visual acuity or worse (best corrected, distance), and no previous cataract surgery in either eye. The Activities of Daily Vision Scale (ADVS) and visual acuity, contrast sensitivity, and disability glare tests were administered at baseline and at a 1-year follow-up visit. RESULTS: This study comprised 245 patients, 156 of whom elected to have cataract surgery and 89 of whom declined. Those electing surgery were more likely to be white, female, and have worse visual acuity and no ocular comorbidities. At baseline, ADVS subscale scores ranged from 53 to 76 in the surgery group and from 72 to 89 in the no-surgery group. In the surgery group, subscale scores improved by 15 to 21 points on average at the 1-year follow-up; scores were unchanged or worse in the no-surgery group over this period. This difference between the groups remained statistically significant after adjustment for group baseline differences in demographics, vision, and ADVS score. In the surgery group, visual acuity improvement in the first eye was an independent predictor of increases in the ADVS overall score and night driving and glare disability subscales; contrast sensitivity was an independent predictor of improvement in the night driving subscale. A reduction in disability glare in the second eye was independently linked to increases in the overall ADVS score and the night driving, near vision, and glare disability subscales. CONCLUSIONS: Baseline findings suggest that cataract patients who have surgery have more difficulty in visual tasks than those who decline surgery. After surgery, patients reported less difficulty with visual tasks. In the no-surgery group, no change was reported. Improvements in visual acuity and contrast sensitivity and reductions in disability glare after surgery were independently linked to improvements in ADVS scores.     

Impairment of visual acuity and reading performance and the relationship with cataract type and density

PURPOSE: To evaluate the association between the density of nuclear, cortical, and posterior subcapsular lens opacities and visual impairment in patients with cataract. METHODS: In 80 patients, visual acuity and reading performance were evaluated 1 day before and 4 weeks after cataract surgery. Cataracts were categorized and graded according to the Lens Opacities Classification System (LOCS) III of nuclear color (NC), nuclear opalescence (NO), cortical (C), and posterior subcapsular cataract (P). A multiple linear regression analysis and partial correlation coefficients were calculated. Data were also checked for significant pre- and postoperative differences in visual performance related to cataract grading. RESULTS: In the multiple linear regression analysis, significant associations were found between the improvement in visual acuity and reading performance after cataract surgery and the NC, NO, and P scores (P < 0.001); no significant association was found for the C score (P > 0.05). High partial correlation coefficients were found between the P score and the preoperative visual acuity (r = 0.6; P < 0.001), reading acuity (r = 0.74; P < 0.001), and maximum reading speed (MRS; r = -0.77; P < 0.001). Significant but lower partial correlation coefficients were found for the NO score. No significant partial correlation coefficients were found for the NC and C score. Significant pre- and postoperative differences in MRS were found in patients with P scores > or =3 or NO and NC scores > or =5, representing functionally relevant impairment. CONCLUSIONS: A strong association was found between visual impairment in patients with cataract and the severity of posterior subcapsular cataract (PSC) and nuclear opacity. Particularly in patients with PSC, deficits in reading performance significantly increased. The functionally relevant deficits in patients with P scores > or =3 or NO and NC scores > or =5, should be carefully considered for planning cataract surgery or visual rehabilitation.     

Evaluation of quality of life in patients with cataract in Hong Kong

PURPOSE: To evaluate the quality of life in patients in a public hospital in Hong Kong before and after cataract surgery using a new questionnaire. SETTING: Department of Ophthalmology, Tung Wah Eastern Hospital, Hong Kong, China. METHODS: One hundred ten Chinese patients having cataract extraction were evaluated for surgical outcomes and quality of life using a questionnaire modified to reflect the local culture and environment in Hong Kong. The questionnaire consisted of 20 questions divided into 4 domains: distance vision, near vision, social function, and cataract-related symptoms. The test-retest reliability of the questionnaire was assessed in another 15 patients by weighted kappa and internal consistency tested with the Cronbach alpha. Construct validity was tested by correlating visual acuity with quality of life and subjective visual improvement and satisfaction with quality-of-life improvement. The preoperative and 4-month postoperative quality of life were evaluated, and the association with the patients' characteristics, type of surgery performed, presence of systemic or ocular diseases, and subjective patient satisfaction was analyzed. RESULTS: The preoperative visual acuity in the operated eye had a low correlation (0.11) with the quality-of-life score; visual acuity in the better eye had a higher correlation (0.29). Quality-of-life improvement was moderately correlated with visual acuity improvement and patient satisfaction. Overall, quality-of-life scoring improved in all domains after surgery, with an overall effect size of 0.68. Quality-of-life scores improved postoperatively in 83.6% of patients, did not change in 3.6%, and were worse in 12.7%. Visual acuity improved in 94.5%, remained the same in 2.7%, and was worse in 2.7%. There was no difference in quality-of-life improvement between extracapsular cataract extraction and phacoemulsification at 4 months. Patients with systemic or ocular diseases and those who were phakic in the fellow eye had lower quality-of-life improvement; however, this was statistically significant for systemic diseases only. Age and sex did not affect quality of life or its improvement. CONCLUSIONS: The quality of life and surgical outcomes in cataract patients were assessed by a simple questionnaire. The local culture and environment should be taken into consideration in the questionnaire design.     

手术治疗糖尿病性白内障60眼临床分析

目的:分析小切口白内障囊外摘出人工晶状体植入术和超声乳化白内障吸除人工晶状体植入术治疗糖尿病性白内障的疗效及并发症。方法:选择2006-01/2010-01确诊为糖尿病性白内障患者52例60眼,Ⅱ～Ⅲ级核47眼,采用超声乳化白内障吸除后房型人工晶状体植入术;Ⅳ～Ⅴ级核13眼,采用小切口白内障囊外摘出后房型人工晶状体植入术。结果:糖尿病患者52例60眼白内障术后视力均有不同程度的提高,其中50眼(83%)术后1wk裸眼视力≥0.4。术中术后主要并发症经处理对术后视力无影响。结论:对糖尿病性白内障患者采取恰当的术式,施行小切口白内障囊外摘出人工晶状体植入术或超声乳化白内障吸除人工晶状体植入术疗效肯定。     

高眼压青光眼白内障三联手术的临床观察

目的:探讨高眼压状态下白内障青光眼联合术的临床疗效。方法:对18例18眼白内障青光眼患者在高眼压下行小切口非超声乳化白内障囊外摘出人工晶状体植入联合小梁切除术,术后观察视力,眼压及并发症情况。结果:术后眼压均比术前用降眼压药的情况下明显下降,11～22mmHg者17例,其中眼压26mmHg者1例。术后视力均较术前有不同程度的提高,术后并发症发生率及严重程度并不比小梁切除术或白内障囊外摘除人工晶状体植入术高。结论:在高眼压下行小切口非超声乳化白内障囊外摘出人工晶状体植入联合小梁切除术发生并发症的机会增多,但仍是一种安全、有效的治疗白内障合并青光眼的联合手术。     

白内障超声乳化联合巩膜扣带术治疗白内障合并孔源性视网膜脱离

目的:观察白内障超声乳化、人工晶状体植入联合巩膜扣带术治疗白内障合并有视网膜脱离的疗效。方法:对7例视网膜脱离1wk内合并有白内障患者采用白内障超声乳化、人工晶状体植入联合巩膜扣带术,观察视网膜平复情况及术后3mo矫正视力。结果:7例患者视网膜平复,术后3mo矫正视力均显著提高。结论:对部分白内障合并视网膜脱离患者采用白内障超声乳化、人工晶状体植入联合巩膜扣带术,既解除了白内障对视网膜脱离手术的妨碍,又顺利完成了视网膜脱离复位手术,术后视力显著提高。