预测白内障患者术后视力的两种方法比较

目的 探讨准确评估晶状体不同混浊程度白内障患者术后视功能的方法。方法 采用视觉电生理和视网膜计两种检查方法,评估152例（152只眼）白内障患者术后的视功能情况,分别将闪光视网膜电图（flash electroretinogram,F-ERG)、闪光视觉诱发电位（flash visual evoked potentials,F-VEP)及潜视力（potential visual acuity,PVA)结果与患眼术后最佳矫正视力(best corrected visual acuity,BCVA)进行相关性分析。结果 对于晶状体不完全混浊者,术前F－ERG b波和F－VEP波振幅的综合值及PVA与术后BCVA呈显著正线性相关性（r=0.528,0．654;P＜0．05）;对于晶状体近完全及完全混浊者,术前F－ERG b波和F－VEP振幅的综合值与术后BCVA呈显著正线性相关性（r＝0．487,P＜0．05）,术前PVA与术后BCVA无显著相关性（r=0．049,P＞0．05）。结论 视觉电生理和视网膜计两种检查方法均可较准确评估晶状体不完全混浊患者术后的视功能,其中视网膜计的检查结果更具预测性;F－ERG和F－VEP检查结果可综合评估晶状体近完全及完全混浊患者术后的视功能,视网膜计检查方法以此类患者术后视力进行评估的准确性欠佳。     

白内障患者F-ERG表现及其临床意义的研究

目的：探讨晶状体混浊对闪光视网膜电流图（flash electroretinogram,F-ERG)的影响。以及白内障术前F－ERG评估视网膜功能的价值。方法：对一组白内障患者手术前后暗适应ERG、闪烁ERG检查。分析FERG的检查结果及其与术后视力、眼底情况的关系。结果：眼底正常组术前暗适应ERGb波振幅、峰时与正常对照组无显著差异，而眼底异常组与正常对照组有显著差异。术前暗适应ERGb波振幅与术后视力有关。结论：白内障手术前行FERG检查有助于视功能的评估及预测术后视力。     

视觉电生理与视网膜计对成熟期白内障患者术后视功能预测的评价

目的探讨术前视觉电生理和视网膜计检查评估成熟期白内障患者术后视功能的可靠性。方法对75例(75眼)成熟期白内障患者在术前分别行视觉电生理和视网膜计检查,即分别行闪光视网膜电图(flash electroretinogram,F-ERG)、闪光视觉诱发电位(flash visual evoked potentials,F-VEP)及潜视力(potential visual acuity,PVA)检查,并将结果与患者术后1个月最佳矫正视力(best corrected visual acuity,BCVA)进行相关性分析。结果术前F-ERG b波振幅平均为(405.75±38.40)μV,F-VEPP2波潜伏期平均为(112.59±26.67)ms,PVA平均为0.27±0.19,术后1个月BCVA为0.42±0.22。术前F-ERG与术后BCVA一致者51眼,可靠性为68.0%,经统计学处理,2者存在显著正线性相关(r=0.3391,t=3.0799,P<0.05)。术前F-VEP与术后BCVA一致者55眼,可靠性为73.3%,经统计学处理,2者存在显著正线性相关(r=0.4754,t=4.6168,P<0.05)。术前PVA与术后BCVA基本一致者16眼,一致率为21.3%,经统计学处理,2者不相关(r=0.0447,P>0.05)。结论 F-ERG和F-VEP检查可综合评估成熟期白内障患者术后的视功能,而视网膜计检查对此类患者术后视力进行评估的准确性欠佳。     

F—ERG及F—VEP检查对外伤性白内障术后视力的预测

对92例眼外伤性白内障术前行闪光视网膜电图及闪光视诱发电位检测.92眼中,F—ERG预测正确的有65眼,可靠性为70.7%,F—VEP预测正确的有80眼,可靠性为87.0%.二者正常与异常之间术后矫正视力0.3以上者有显著性差异(P<0.01).结果说明二者对预测外伤性白内障术后视力有一定价值.     

VEP、F—ERG在眼挫伤中应用研究

目的 视觉诱发电位（VEP）和闪光视网膜电图（F-ERG）联合应用评价钝挫伤眼的视功能。方法 86例（86眼）钝挫伤眼及健康对侧眼为对照组,按照国际标准分别行VEP和F-ERG检查。比较分析两组间VEP P100波潜时值、F-ERG的a、b波幅值的平均值。结果 眼挫伤组VEP P100波潜时明显延迟,波幅值明显降低;F-ERG a、b波幅明显降低,其异常率随视功能损伤程度的加重而增加。结论 VEP和F-ERG联合应用是评价眼挫伤视功能及早期确定诊断的客观检测手段。     

白内障患者术后F-VEP、F-ERG检查预测中心视力的评价

目的：评估F－VEP和F－ERG在白内障患者超声乳化人工晶状体植入术后中心视力预测中的价值。方法：对1062眼白内障患者术前使用国产泰克公司TGS－150型眼电生理仪分别行F－VEP和F－ERG检查，比较分析单纯F－VEP异常，F－ERG异常，F－VEP和F－ERG均异常或正常的白内障术后中心视力情况，结果：二项指标结果均正常者976眼，其中术后中心视力≥0．8者920眼（94．42％），≤0．3者78眼（7．99％），F－VEP异常者45眼，术后中心视力≤0．3者6眼（13．3％），F－ERG异常者33眼，术后中心视力≤0．3者16眼（48．5％），二项指标均异常者8眼，术后中心视力≤0．3者5眼（62．5％）。结论：F－VEP和F－ERG对白内障术后的视功能预测有客观性和有效性，在本研究中F－ERG对预测白内障术后中心视力有一定价值。     

白内障手术前视觉电生理测定的意义

目的：探讨白内障手术前视觉电生理检查,评估视功能的价值。方法：回顾性白内障患手术前闪光视网膜电流图(flash electrotinogram,F-ERG)暗适应、闪烁反应,闪光视诱发电位F-VEP及多焦视网膜电图m-ERG (First orderkernel,FOK一阶反应)检查与正常对照组结果分析,及其与术后视力、眼底情况的关系。结果：白内障手术前闪光视网膜电图F-ERG暗适应、闪烁反应检查呈降低型,多焦视网膜电图m-ERG中心反应密度低平,高度近视、眼底病白内障下降更明显,伴有闪光视诱发电位F-VEP异常术后视力差。结论：白内障手术前视觉电生理检查有助于视功能的评估,提高预测术后视力的准确性。     

眼外伤玻璃体切除术前ERG及VEP检查对术后视力预测价值

目的 观察闪光视网膜电图（flicker electroretinogram,F-ERG）及闪光视诱发电位（flicker visual evoked potential,F-VEP）测定对眼后段外伤玻璃体切除术后视力预测价值。方法 对42例（42只眼）眼后段外伤伴玻璃体混浊或积血的患者在玻璃体切除术前两周内行F-VEP及F-ERG检查,并分析其与术后1个月最佳矫正视力的关系。结果 F-ERG检查正常或轻度异常25只眼,术后视力提高23只眼（92．0％）,中度异常或重度异常和记录不到波形17只眼,术后视力提高7只眼（41．2％）。F-VEP检查正常或轻度异常27只眼,术后视力提高24只眼（88．9％）,中度异常或重度异常和记录不到波形15只眼,术后视力提高5只眼（33．3％）。F-VEP及F-ERG均正常或轻度异常的18只眼,术后视力均提高,且术后视力均恢复至0．1以上。F-VEP及F-ERG均重度异常或记录不到波形的2只眼,术后视力1只眼下降,1只眼不变。结论 眼外伤玻璃体切除术前联合检测F-VEP及F-ERG对术后视力预测有重要意义。     

早期糖尿病视网膜病变的视网膜电图分析

目的 分析早期糖尿病视网膜病变(DR)的闪光视网膜电图(F—ERG)和视网膜电图震荡电位(OPs)各参数的变化特点，寻找反映早期DR的敏感指标。方法 对16例(32只眼)正常人进行OPs和F-ERG检测。对27例(53只眼)糖尿病病人进行眼底荧光血管造影(FFA)、OPs和F—ERG检测。结果 OPs中Os波幅、O4波幅、OPs总波幅及F-ERG中b波峰潜时较其他指标敏感，其中O4波幅和b波峰潜时为最敏感指标，但均不能反映早期DR的严重程度。结论 OPs的O4波幅和F—ERG的b波峰潜时可作为早期糖尿病视网膜病变诊断的敏感指标。     

干涉条纹视力计预测白内障术后视力的准确性分析

目的 研究干涉条纹视力计预测白内障患者术后视力的准确性及各种影响因素。方法 69只白内障眼在手术前用Heine视网膜视力计进行干涉条纹视力的检查。干涉条纹视力与术后最佳矫正视力进行比较,得出预测准确率、假阳性率和假阴性率。分析了白内障浑浊程度、自内障合并其他病变、术前最佳矫正视力、预测视力大小等因素对Heine视网膜视力计预测准确性的影响。结果 Heine视网膜视力计对白内障患者预测准确率为45．3％,假阳性率3．1％,假阴性率51．6％。预测视力比术后最佳矫正视力平均低3．75行对数视力表视力,预测视力与术后最佳矫正视力相关性较差（相关系数r=0．411）。白内障术前最佳矫正视力≥4．0组预测准确率为60．7％,最佳矫正视力〈4．0组为33．3％,差异有显著性意义（P=0．029）。预测视力≥4．7组预测准确率89．5％,而预测视力〈4．7组预测准确率为26．7％,差异有显著性意义（P〈0．001）。结论 Heine视网膜视力计不能准确预测白内障患者的术后视力,它往往较大程度地低估术后视力。Heine视网膜视力计预测准确性受白内障浑浊程度和术前最佳矫正视力的影响。     

视觉电生理检查对白内障患者术后视力的评估

目的:评价闪光视觉诱发电位(flash visual evoked potentials,FVEP)和闪光视网膜电图(flash electroretinogram,FERG)或图形视网膜电图(pattern electroretinogram,PERG)对白内障患者术后视力预测的可靠性。方法:对412例白内障患者术前应用GT-2000NV型眼电生理自动测试仪,根据FVEP和FERG(或PERG)结果对白内障术后最佳矫正视力(best-corrected visual acuity,BCVA)进行相关性分析。结果:术前FERGb波和FVEP振幅的综合值与术后BCVA呈显著正线性相关性(r=0.492,0.487;P<0.05)。结论:视觉电生理检查结果可综合评估白内障患者术后的视功能状况。     

老年性白内障电生理分析

目的:分析老年性白内障患者视觉电生理的改变。方法:对100例老年性白内障患者进行F-VEP、F-ERF检查。结果:F-VEP大多数正常,F-ERG表现为b波潜时延长,振幅降低。结论:视觉电生理检查对老年性白内障患者的视功能及预后判断有一定指导意义。     

老年性白内障患者闪光视觉诱发电位测定与术后视力对比研究

目的：探讨闪光视觉诱发电位（ｆｌａｓｈ ｖｉｓｕａｌ ｅｖｏｋｅｄ ｐｏｔｅｎｔｉａｌｓ,ＦＶＥＰ）在预测老年性白内障患者术后视力中的应用价值。方法：对４３眼老年白内障患者进行了白内障囊外摘除及后房型人工晶体植入术,将术前ＦＶＥＰ、光定位、辨色力等检查结果与术后视力进行了对比研究。结果：患者术后视力与ＦＶＥＰ的振幅（Ｘ１）、Ｐ１波潜伏期（Ｘ２）及辨色力之间存在有显著相关性（Ｐ〈０．０１）,相关系数     

白内障术前行相关检查对视功能评估及视网膜疾病检出的有效性探索

目的:评价闪光视觉诱发电位(FVEP)、闪光视网膜电图(FERG)或图形视网膜电图(PERG)、眼底照相、眼部B超和光学相干断层扫描(OCT)应用于白内障术前对视功能的评估及对视网膜疾病检出的有效性观察。方法:对148例196眼白内障患者术前应用眼科电生理仪、眼底照相、眼部B超和OCT,根据FVEP和FERG(或PERG)、眼底照相、OCT、眼部B超检查结果的阳性率进行分析。结果:患者148例196眼中,B超检查显示玻璃体混浊165眼(84.2%),无法获取B超图像31眼(15.8%);成功获取眼底照相图像161眼(80.6%),无法获取图像35眼(19.4%);获得有价值VEP、ERG 58眼(29.6%),VEP、ERG未见明显异常138眼(70.4%);成功获取OCT图像167眼(85.2%),无法获取OCT图像29眼(14.8%)。结论:视觉电生理检查、眼底照相、眼部B超和光学相干断层图像结果可对白内障患者术前的视功能状况进行综合评估,多种检查方法相互配合,可进一步提高白内障手术前对视网膜疾病以及其他眼科疾病的检出率。     

干涉条纹视力测定在高度近视者白内障术前检查的应用

目的评价激光干涉条纹视力(IVA)检测在预测高度近视者白内障术后潜在视力的可靠性及应用价值。设计前瞻性病例系列。研究对象49例(71眼)高度近视白内障患者(眼轴长度≥26.00 mm)。方法所有患者术前进行IVA检测,按LOCSII标准依晶状体核硬度将患者分为,甲组(60眼):晶状体核I～III级,乙组(10眼):晶状体核IV级,丙组(1眼):晶状体核V级;根据术前IVA值分为,A组(51眼):IVA≥0.4,B组(20眼):IVA<0.4。检测结果与患者术后1个月最佳矫正视力(BCVA)进行相关分析及检验,评价IVA检测在预测高度近视者白内障术后潜在视力的应用价值。主要指标IVA值、晶状体混浊程度及术后最佳矫正视力。结果 IVA预测高度近视者白内障术后视力相符率达71.8%;晶状体核硬度IV级及以下者(n=70)术前IVA值与术后BCVA呈显著相关性(r=0.677,P=0.000);IVA≥0.4者与术后BCVA的差异显著低于IVA<0.4者与术后BCVA的差异(χ2=9.906,P=0.002)。结论 IVA能比较准确地反映高度近视白内障患者潜在视功能,特别是对于晶状体核硬度IV级及以下、术前IVA≥0.4者。     

The need for cataract surgery: projections based on lens opacity, visual acuity, and personal concern

AIM: To assess the projected needs for cataract surgery by lens opacity, visual acuity, and patient concern. METHODS: Data were collected as part of the Melbourne Visual Impairment Project, a population based study of age related eye disease in a representative sample of Melbourne residents aged 40 and over. Participants were recruited by a household census and invited to attend a local screening centre. At the study sites, the following data were collected: presenting and best corrected visual acuity, visual fields, intraocular pressure, satisfaction with current vision, personal health history and habits, and a standardised eye examination and photography of the lens and fundus. Lens photographs were graded twice and adjudicated to document lens opacities. Cataract was defined as nuclear greater than or equal to standard 2, 4/16 or greater cortical opacity, or any posterior subcapsular opacities. RESULTS: 3271 (83% response) people living in their own homes were examined. The participants ranged in age from 40 to 98 years and 1511 (46.2%) were men. Previous cataract surgery had been performed in 107 (3.4%) of the participants. The overall prevalence of any type of cataract that had not been surgically corrected was 18%. If the presence of cataract as defined was considered the sole criterion for cataract surgery with no reference to visual acuity, there would be 309 cataract operations per 1000 people aged 40 and over (96 eyes of people who were not satisfied with their vision, 210 eyes of people who were satisfied with their vision, and three previous cataract operations). At a visual acuity criterion of less than 6/12 (the vision required to legally drive a car), 48 cataract operations per 1000 would occur and people would be twice as likely to report dissatisfaction with their vision. CONCLUSIONS: Estimates of the need for cataract surgery vary dramatically by level of lens opacity, visual acuity, and patient concern. These data should be useful for the planning of health services.     

高龄老年人白内障摘除人工晶状体植入术后视力分析

目的：评价高龄老年人白内障摘除人工晶状体植入术后视力状况及影响因素。方法：对387例(425只眼)80岁以上老年人实施白内障摘除人工晶状体植入手术，观察其术后视力及影响因素并予以分析。结果：术后矫正视力1．0以上为221只眼(52．O％)，在0．5-0．9之间为98只眼(23．1％)，低于0．5者为106只眼(24．9％)。影响视力的主要原因依次是老年性黄斑变性、青光眼、视网膜静脉栓塞、视神经萎缩。结论：高龄老年人在白内障摘除人工品状体植入术后视力有明显提高，眼底病是影响视力的主要疾病。眼科学报2003；19：95-97     

Relative afferent pupillary defect in patients with asymmetric cataracts

PURPOSE: To prospectively investigate the incidence, associated factors, and prognostic significance of relative afferent pupillary defects (RAPDs) in eyes with less severe cataract than in contralateral eyes. SETTING: Department of Ophthalmology, Seoul Municipal Boramae Hospital, College of Medicine, Seoul National University, Seoul, Korea. METHODS: Forty patients with asymmetric cataract and a differences of 3 or more lines of Snellen visual acuity between eyes had detailed ophthalmic examinations including visual acuity, slitlamp evaluation, a swinging flashlight test before and after cataract surgery, and color vision assessment. RESULTS: Twenty-three of 40 patients (58%) had an RAPD (mean extent 0.39 log unit +/- 0.17 [SD]) in the eye with less severe cataract. The RAPD resolved or switched to the other eye after cataract extraction. All 5 patients with a unilateral totally opaque lens had a contralateral RAPD, confirming the relationship between totally opaque cataracts and RAPDs. The difference in visual acuity between the 2 eyes did not differ between patients with RAPD and those without RAPD. There was no association between the presence of RAPD and postoperative visual acuity. CONCLUSIONS: More than half the patients with asymmetric cataract had an RAPD that resolved in the eye with less severe cataract after cataract extraction. All patients with a unilateral totally opaque lens had an RAPD. The presence of a preoperative RAPD was not related to postoperative visual acuity.     

YZ53白内障视力检查仪预测白内障术后视力的临床研究

目的 :评估YZ5 3白内障视力检查仪对白内障术后视力预测的可靠性。方法 :连续选择行白内障超声乳化联合人工晶状体植入术 16 2眼 ,术前散瞳后使用YZ5 3白内障视力检查仪检查 ,比较YZ5 3术前预测视力 (PPVA)与术后 1个月最佳矫正视力 (BCVA)。结果 :14 6眼能配合检查 ,占 90 .12 %。术后BCVA与PPVA符合率为 80 .14 %、术后BCVA好于PPVA者占 16 .4 4 %、低于PPVA者占 3.4 2 %。结论 :YZ5 3白内障视力检查仪能较准确预测出白内障患者术后的视力提高程度 ,临床应用价值高