视力激光测定法

近年来研制了一种利用激光的视力测定装置,方法是用二束激光投影到视网膜上作成干涉条纹,从被检者能分辨出最细的干涉条纹中换算出视力来。用此法测得的视力称激光干涉条纹视力(laser interference fring visual acuity),或简称激光视力(laser visual acuity;LVA)。此法的优点为不受屈光及调节的影响,即使像白内障等屈光间质有混浊,只要稍微有点间隙二束入射光线就能通过,而测知视网膜的视功能情况。因此利用这种方法,即使有复杂的屈光不正,不用眼镜或接触眼镜,也可知道它的视功     

两衍射多焦点人工晶状体的光学性能与视觉质量对比研究

目的 比较白内障手术患者植入Tecnis ZMB00及AcrySof ReSTOR SN6AD1多焦点人工晶状体(multifocal intraocular lens,MIOL)后光学性能与视觉质量.方法 选取2012年3月至2015年7月于我院眼科择期进行白内障手术治疗的患者120例(130眼).所有患者均采用MIOL植入,并根据MIOL类型分为A组(Tecnis ZMB00组)、B组(AcrySof ReSTOR SN6AD1组),测定患者手术前后裸眼远视力(uncorrect distant visual acuity,UCDVA)、裸眼近视力(uncorrect near visual acuity,UCNVA)、裸眼中距离视力(uncorrecta intermediate vision,UCIVA)、最佳矫正远视力(best correct distant visual acuity,BCDVA)、最佳矫正近视力(best correct near visual acuity,BCNVA),均绘制离焦曲线,作对比敏感度分析,并采用术后视功能与生存质量调查表(VF-14)评定患者术后视觉质量.结果 术后1周、1个月、3个月A组UCNVA、UCIVA、BCNVA恢复情况均优于B组(均为P＜0.05),术后1周、3个月A组UCDVA恢复情况均优于B组,术后3个月等效球镜屈光度低于B组(P＜0.05).A组暗视、明视炫光、暗视炫光不同频率下对比敏感度均高于B组(均为P ＜0.05);A组术后3个月VF-14评分低于B组(P＜0.05);A组在0.0D与-2.5D形成2个波峰,-2.0～-2.5 D形成平台期,B组仅在0.0D与-3.0D形成2个波峰.结论 白内障手术患者植入Tecnis ZMB00 MIOL可改善患者术眼裸眼视力,提升对比敏感度,改善患者术后视功能及生活质量.     

双眼植入多焦和单焦人工晶状体后视力及立体视比较研究

目的 比较双眼植入ReSTOR+3D非球面多焦点人工晶状体(MIOL)与传统球面单焦点人工晶状体(SIOL)后全程视力和立体视觉情况.方法 前瞻性临床研究.对2009年5月至2010年6月在上海公利医院眼科治疗的病人18例(36只眼)植入ReSTOR+3DMIOL(SN6ADI),20例(40只眼)植入传统球面SIOL(SNt0AT).以术后第二眼为标准随访3个月.测两组的远、中、近视力及近立体视锐度,进行相应统计学分析.结果 术后裸眼及最佳远、近矫正视力两组无明显差异(t值分别为1.14、1.74、0.99,P＞0.05),在25cm、30cm、33cm、40cm、50cm、60cm、70cm近中距离上,MIOL组远视力矫正下近视力均优于SIOL组(t值分别为14.02、20.28、24.52、32.74、21.91、11.66、9.76,P＜0.01).MIOL组裸眼近立体视锐度优于SIOL组(P＜0.05).双眼矫正近视力后,两组的立体视觉差异无统计学意义(X2=64.97 P＞0.05).结论 ReSTOR+3D多焦点IOL较单焦点IOL可提供更好的近、中视力和裸眼近立体锐度,实现了很高地脱镜率,良好地全程视力使其拥有广泛的应用价值.

Abstract：

Objective To compare visual acuity from far to near and stereoscopic vision in patients who underwent bilateral implantation of aspheric diffractive multifocal intraocular lens (IOLs)with monofocal IOLs. Methods This prospective study comprised patients having implantation of an aspheric diffractive multifocal ReSTOR SN6AD1 IOL with a C3.0 D add (SN6AD1) or a monofocal IOL (SN60AT). Visual acuity from far to near distances and stereoscopic vision were evaluated 3months postoperatively. Results Multifocal IOL group comprised 36 eyes of 18 patients. Monofocal IOL group comprised 40 eyes of 20 patients. The differences between groups of uncorrected and corrected distance visual acuity and corrected near visual acuity had not statistically significant (P＞0.05).The mean distance-corrected visual acuity at 25 cm, 30 cm, 33 cm, 40 cm, 50 cm, 60 cm, 70 cm were better in the multifocal group than in the monofocal group (P＜0.01). The near stereoscopic vision. in the multifocal group were better than in the monofocal group (P＜0.01). When near corrected,there were no significant difference between the stereoscopic vision for the multifocal and monofocal groups (P＞0.05). Conclusions The diffractive multifocal IOL with a low add power provides significantly better intermediate, near visual acuity than the monofocal IOL. When near uncorrected, the multifocal group has better stereoscopic vision. Spectacle independence is higher with the multifocal intraocular lens.     

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。     

VISUAL REHABILITATION IN LOW VISION PATIENTS WITH AGE-RELATED MACULAR DEGENERATION

Using optical visual aids, visual rehabilitation was performed in 14 low vision patients(25 eyes) with age-related macular degeneration. With distance aids, visual acuity improvement appeared in 24 eyes(95%) out of the 25 eyes. Twelve eyes(48%) obtained a visual acuity equal to or better than 0.4. With near visual aids, near acuity of all eyes(100%) was improved. Thirteen eyes(52%) got the near vision equal to or better than 0.5. Ten patients could read No.5 Chinese Reading Card. The reading success rate was 71.4%. The results suggest that application of visual aids is an effective method to improve the distant and near visual acuity of low vision patients with AMD.     

儿童先天性白内障摘除人工晶状体植入术后视功能观察

目的观察儿童先天性白内障摘除联合后房人工晶状体植入术后视功能的变化。方法对27例(46只眼)先天性白内障儿童患者行白内障摘除联合后房人工晶状体植入术,分为双眼组(19例)和单眼组(8例),术后3月观察眼屈光状态、眼轴、最佳矫正远视力(best-corrected distance vision acuity,BCDVA)和最佳矫正近视力(best-corrected near vision acuity,BCNVA)以及远、近立体视锐度。结果27例(46只眼)患者手术年龄(5.8±3.8)岁,眼轴(22.92±2.05)mm,术后等效屈光度(-0.40±1.13)D。两组术后35只眼(76%)BCDVA≥0.3,31只眼(67%)BCNVA≥0.3。27例患者中分别有2例(11%)和12例(44%)患者获得良好远、近立体视功能。结论先天性白内障摘除联合后房人工晶状体植入术后可恢复一定程度的视功能。     

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。     

超高度近视并发白内障患者术后视力与后巩膜葡萄肿相关性分析

目的 探讨后巩膜葡萄肿对超高度近视并发白内障超声乳化术后视力的影响.方法 对129例(153只眼)超高度近视合并白内障患者实施小切口超声乳化吸除联合人工晶状体植入术,术后随访3个月.观测后巩膜葡萄肿与术前测量的眼轴及术后视力的关系.结果 后巩膜葡萄肿组与非后巩膜葡萄肿组相比眼轴长度有所增加,但对术后视力的影响差异无统计学意义(P>0.05).结论 超高度近视并发白内障患者中,术后视力与是否伴发后巩膜葡萄肿无明显相关性.

Abstract：

Objective To evaluate the relationships between the postoperative visual acuity and posterior staphyloma in cataract with extreme myopia.Methods One hundred and twenty-nine cases (153eyes)with extreme myopia received small incision phacoemulsification and followed up for 3 months.The relationship between posterior staphyloma and the postoperative visual acuity as well as axial length were analyzed.Results The axial length in posterior staphyloma group were increased,but there were no statistical difference in postoperative visual acuity when compared with none posterior staphyloma group (P >0.05).Conclusions The postoperative visual acuity of extremely myopic eye with cataract after phacoemulsification has no significant correlation with posterior staphyloma.     

体外循环心脏手术病人的视力及视诱发电位观察

体外循环(CPB)心脏手术后病人的视功能损害,国外已有报道,其主要原因是缺氧、缺血、低温等造成缺血性视神经癍，大脑枕叶病变及视网膜栓塞或梗死所致。我们观察23例患者术前术后的视力及5例患者视诱发电位（visual evoked potential,VEP）的变化。说明CPB心脏手术后可引起或加速缺血性视神经病变的发生和发展；VEP对视功能损害的检查更有价值。 （中华眼底病杂志，1993，9：158-159）     

急性闭角型青光眼自发性前房出血临床分析

目的 探讨急性闭角型青光眼自发性前房出血手术特点、手术时机、手术安全性、可行性及治疗效果.方法 回顾分析13例(13只眼)急性闭角型青光眼自发性前房出血行小梁切除术,对术前后视力、眼压、滤过泡、前房积血、手术并发症和手术成功率进行评估.结果 13例(13只眼)患者手术均取得成功,无明显严重并发症,术前有视功能者术后视力均有提高.结论 急性闭角型青光眼自发性前房出血行行小梁切除术手术治疗,不仅可缩短病程和减少并发症,也是安全有效的,应积极采用手术治疗,以避免视功能的进一步损害.

Abstract：

Objective To investigate the operative characteristics, timing of surgery, surgery safety, feasibility and therapeutic effect in spontaneous acute angle-closure glaucoma hyphema. Methods Retrospective analyzed 13 patients (13 eyes) of acute angle-closure glaucoma with spontaneous hyphema whom received trabeculectomy on visual acuity, intraocular pressure, bleb, hyphema, surgical complications and surgical success rate assessment before and after surgery. Results Thirteen patients (13eyes) had successful surgery, no serious complications occurred, pre-operative visual acuity with visual function were improved in varying degrees. Conclusions Surgical treatment of spontaneous hyphema in acute angle-closure glaucoma not only can shorten the course and reduce complications, but is safe and effective. Trabeculectomy should be actively performed in order to avoid further damage to visual function.     

角膜塑形镜对青少年近视患者视力及角膜形态变化的影响

目的：探讨角膜塑形镜对青少年近视患者视力及角膜形态变化的影响。
　　方法：随机选取97例176眼配戴角膜塑形镜的青少年近视患者,在戴镜前、戴镜后1d,1wk,1、3、6lo检查平均等效球镜度(spherical equivalent,SE)、裸眼视力(uncorrected visual acuity, UCVA )、矫正视力( best corrected visual acuity,BCVA)、角膜曲率及角膜中央厚度,对比分析检查结果。
　　结果：配戴角膜塑形镜后1d,1wk,1、3、6lo 的 SE 下降, UCVA明显改善,与戴镜前比较差异具有统计学意义( P<0.05),戴镜后BCVA与戴镜前比较差异无统计学意义(P>0.05);配戴角膜塑形镜后1d,1wk,1、3、6lo的角膜曲率与戴镜前比较差异具有统计学意义(P<0.05);中央角膜厚度1 wk开始变薄,1、3、6 lo的中央角膜厚度与戴镜前比较差异具有统计学意义(P<0.05)。
　　结论：角膜塑形镜能有效降低近视度,显著提高裸眼视力。     

Acrysoft ReStOr多焦点人工晶状体的临床应用观察

Objective To evaluate the clinical effect of a multifocal IOL (Acrysoft ReSTOR). Methods Thirty-six patients with age-related cataract (46 eyes) were divided into two groups: MIOL group included 19 patients (23 eyes), SIOL group included 17 patients (23 eyes). All patients underwent phacoemulsification. MIOL group implanted ReSTOR SA60D3 and SIOL group implanted NaturalSN60AT. At 1 week, 3 months postoperatively, distant and near visual acuities, pseudoaccomodation, contrast sensitivity and patients's satisfaction with their vision were assessed. Results Uncorrected distance visual acuity (UCDVA), Best-corrected distance visual acuity (BCDVA), Best-corrected near visual (BCNV) in the multifocal were not statistically different from the sonofocal group (P ≥0.05), Uncorrected near visual acuity (UCNVA), Best corrected near visual acuity (BCNVA), pseudoaccomodation and the satisfaction of intermediate and near vision were better statistically in the multifocal group compared to the monofocal group (P ＜0.05). Conclusions Acrysoft ReSTOR can provide excellent outcomes in distance, intermediate and near vision, so as to improve the quality of life after surgery.     

激光视力测定仪及其临床初步应用

视力,为测定眼视功能及诊治眼病的一个重要评判依据。目前,所谓视力,即是分辨二维物体的形状和位置的能力。故,视力不仅与眼球成像特性有关,更进一步,应该说是一种与视网膜适应状态,信息处理系统的特性,眼球运动等物理,生理,心理因素有关的综合功     

双眼多焦点人工晶状体ReSTOR植入术后视功能观察

Objective To evaluate the effectiveness and security after implantation of multifocal intraocular lens in Chinese,by comparing the visual function of bilateral implantation of the new apodized diffractive AcrySof ReSTOR multifocal intraocular lens (MIOL) and Acrysof Natural, Monofocal intraocular lens (MoIOL) Methods Forty-three patients with age-related cataract were divided into two groups with random principia: bilateral Acrysof ResToR multifocal IOLs or the monofocal AcrySof Natural lols. The Acrysof ReSTOR group included 18 patients (36 eyes), and reference group-AcrysofNatural group (MoIOL) included 25 patients (50eyes). Measurements were taken after operation, including uncorrected distant vision acuity (UCDVA), uncorrected near vision acuity (UCNVA), best corrected distant vision acuity (BCDVA), best corrected near vision acuity (BCNVA), distant corrected near vision acuity (DCNVA), Intermediate Vision (40, 60,80 cm), contrast sensitivity (CS) and visual symptoms. Results UCNVA, DCNVA and Intermediate Vision (40, 60, 80cm)were significantly higher in the MIOL group (P＜0.05). No statistical difference was noted between 2 groups with the CS. The adverse symptoms of the MIOL group were slight. The dependence of glasses of the MIOL was 80%. The MIOL group provided better patient satisfaction. Conclusions Bilateral implantation in patients with the new apodized diffractive MIOL multifocal intraocular lens (IOL) appears a better outcome in near and intermediate vision, slight visual symptom, improve the quality of life after surgery.     

玻璃体黄斑牵引综合征的手术疗效观察

目的 探讨玻璃体手术治疗玻璃体黄斑牵引综合征的临床效果及光相干断层扫描、荧光素眼底造影对手术疗效的评价.方法 经裂隙灯前置镜、间接眼底镜检查、B超、光相干断层扫描(OCT)、荧光素眼底血管造影(FFA)等检查确诊为玻璃体黄斑牵引综合征行玻璃体手术的患者30例(30只眼)的临床资料进行回顾性分析.结果 30只眼经手术解除玻璃体对黄斑部的牵引.术后20只眼视力提高.术后黄斑区牵引处OCT测量高度平均减小267μm,有明显改善.术前荧光素眼底血管造影检查存在黄斑囊样水肿伴渗漏,术后明显减轻.术前合并高度近视眼者视力预后不佳.结论 玻璃体手术能够有效解除玻璃体对黄斑部的牵引,阻止患者视力进一步下降,减轻黄斑水肿及渗漏,是治疗玻璃体黄斑牵引综合征的有效方法.光相干断层扫描及荧光素眼底造影检查可以对手术疗效进行评价,有利于术后随访.

Abstract：

Objective To evaluate the efficacy of vitreous surgery for patients with vitreomacular traction syndrome. Methods Of 30 patients (30 eyes) who underwent vitrectomy for vitreomacular traction syndrome were retrospectively analyzed. Results Vitreomacular traction was released successfully, and a better visual acuity was obtained in 20 eyes. Mean macular thickness decreased by 267μ m postoperatively. The eyes showed statistically significant improvement in visual acuity and central macular thickness (P <0.05). Optical coherence tomography (OCT) and fluorescein fundus angiography (FFA) showed macular edema gradually alleviated after vitreous surgery. Preoperative high myopia was associated with prognosis of postoperative visual acuity (P<0.05). Conclusions Vitrectomy can relieve macular traction, and is effective for decreasing macular thickness and improvement of vision in vitreomacular traction syndrome. OCT and FFA are useful for evaluation and follow-up for vitreomacular traction syndrome.     

多焦视皮质诱发电位检查对白内障患者术后视力的预测(英文)

目的:评价术前多焦视皮质诱发电位(multifocal visual evoked potential,mVEP)检查对白内障术后视力的预测价值。方法:随机选取白内障患者共52例60眼,其中老年性白内障27例30眼,合并青光眼的白内障25例30眼(青光眼均为慢性闭角型缓解期或慢性进行期),术前对其行mVEP检查,另取正常对照组30眼。所有患者均行超声乳化联合折叠人工晶状体植入术。患者于术后1wk;1,3mo复查最佳矫正视力(best corrected visual acuity,BCVA)。结果:正常对照组mVEP检测平均主波振幅和潜伏期分别是183±11nV、95±8ms,老年性白内障组平均主波振幅和潜伏期分别是177±10nV、96±8ms,2组在统计学上无显著性差异(P>0.05);合并青光眼的白内障组平均主波振幅和潜伏期分别是138±7nV、99±6ms,与正常对照组及老年性白内障组均存在显著性差异(P<0.05);白内障超声乳化联合人工晶状体植入术后BCVA≥0.8者,无明显眼底视功能改变,其mVEP中心位点主波振幅276±11nV和潜伏期93±8ms与正常对照组无显著性差异(P>0.05);而术后BCVA<0.3者,眼底视功能检查有明显改变(术后检查证实),其mVEP中心位点主波振幅221±6nV,潜伏期105±7ms,与正常对照组差异显著(P<0.05)。结论:白内障术前mVEP振幅和潜伏期的改变可用来客观判断眼底视功能损害及预测术后视力。术前mVEP正常者高度提示术后视力预后良好,而mVEP检查结果变化显著,提示伴有眼底视功能损害,术后BCVA差。因此术前mVEP检查可作为预测白内障术后视力的一种有效、客观的检查方法。     

西藏地区影响老年性白内障术后视力改善因素分析

Objective To analyze impact factors for visual acuity improvement of senile cataract surgery in Tibet prospectively. Methods Of 278 cases were included. To study relations of visual acuity improvement between pre- and post-cataract surgery with patient age, nucleus classification, small incision cataract surgery (SICS) or Phacoemulsification (PHACO) and corneal edema. LogMAR chart was used in visual acuity analysis. Results 1. Univariate analysis: There was no significant difference between PHACO group and SICS group on visual acuity improvement (PHACO 0.92± 0.48, SICS 0.83± 0.46, P ＞0.05). Age group for 70- and 80- years-old had less improvement on visual acuity (P ＜0.05). Diffuse corneal edema had much more influence than central corneal edema on visual acuity improvement (0.52± 0.42, 0.70± 0.44, diffuse vs central, respectively). 2. Multivariate analysis: There were significant differences in age and location of corneal edema on visual acuity improvement (P ＜0.05). Conclusions There is no significant difference on visual acuity improvement between PHACO and SICS. Ophthalmologist can choose either PHACO or SICS for better rehabilitation of visual acuity, depending on area economics, his own experience and so on in Tibet. Visual acuity improvement in cataract surgery is significantly affected by the age of the patients. Since medication is deficient in Tebit, screening of cataract in Tibet is very important for detecting and treating cataract as early as possible. Diffuse corneal edema has much more influence than central edema on visual acuity improvement when corneal edema degrees are not different. It's important to avoid corneal endothelium damage in cataract surgery.     

硅油填充术后OCT检测黄斑中心凹厚度与视力相关分析

目的 分析硅油填充术后OCT榆测黄斑中心凹厚度与术后视力的相关性.方法 对35例(35只眼)行玻璃体切割联合硅油注入术者,分别于术后2周、1、2月行黄斑区OCT检查,观察图像特点,分析黄斑中心凹厚度与最佳矫正视力之间相关性.结果 黄斑中心凹厚度和最佳矫正视力的负对数之间为正相关,即黄斑中心凹厚度与术后最佳矫正视力呈现负相关.结论 随着黄斑中心凹厚度的减少,视力呈现上升的趋势.OCT能评估玻璃体视网膜手术后黄斑区的恢复情况,为临床治疗和预后提供了依据.

Abstract：

Objective To assess the relationships between the macular thickness measured by OCT and postoperative best-corrected visual acuity after vitrectomy with silicone oil eamponade.Methods Thirty-five consecutive cases underwent vitrectomy with silicone oil tamponade were collected.Cross-sectional images of macular with OCT at 2 weeks, 1 month, 2 months after the operation were observed and the relationships between macular foveal thickness and best-corrected visual acuity were analyzed.Results The direct correlation was showed between the macular foveal thickness and the negative logarithm of best-corrected visual acuity.The negative correlation was showed between the macular feveal thickness and postoperative best-corrected visual acuity.Conclusions Along with the increasing of macular foveal thickness, the best-corrected visual acuity is decreasing.We can assess the function of the macular post operative and find the basis of clinic therapy and prognosis.     

二点分辨力在预测白内障术后视力的应用

白内障术前视功能的检查对于术后视力的评估显得至关重要。近10年来,我们除常规视功能(色觉、光觉及光定位)检查外,还采用二点分辨力并辅以视觉电生理及Lotmar检查,均达到术前预测视力,患者满意。材料与方法本文对近10年行白内障联合人工晶体植入3000余例中随机选出50例50只眼,     

准分子激光角膜屈光手术治疗远视性屈光参差性弱视

目的:探讨准分子激光角膜屈光手术治疗成人或大龄青少年远视性屈光参差性弱视的效果.方法:选取2014-03/2016-03在我院治疗的成人或大龄青少年远视性屈光参差性弱视患者26例26眼,均行准分子激光原位角膜磨镶术,观察患者裸眼视力(uncorrected visual acuity,UCVA)、最佳矫正视力(best corrected visual acuity,BCVA)、屈光度及立体视功能情况.结果:患者随访结束时屈光度的等效球镜和双眼间屈光参差分别为1.47±0.51D和1.15±0.22D,均较术前明显降低(P<0.05);患者随访结束时看远和看近UCVA及BCVA分别为0.26±0.13和0.23±0.09、0.42±0.09和0.31±0.16,均较术前明显提高(P<0.05);患者随访结束时立体视功能较术前明显改善(P<0.05),术后立体视功能<100"眼数比例为23%.结论:成人或大龄青少年远视性屈光参差性弱视行准分子激光角膜屈光手术治疗有一定的临床效果.