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。

The comparison of two methods to predict the post-operative visual acuity of cataractous patients

OBJECTIVE: To study the accurate methods to predict the post-operative visual acuity of cataractous patients with different degrees of opaque lenses. METHODS: Visual electrophysiological methods and retinometer were used to evaluate the visual function after phacoemulsification and intraocular lens implantation in 152 cases (152 eyes). The regressive analyses between the post-operative best corrected visual acuity (BCVA) and each of the following results: the pre-operative flash electroretinogram (F-ERG), flash visual evoked potentials (F-VEP) and potential visual acuity (PVA) were performed, respectively. RESULTS: More obvious linear-relationship was shown between PVA and BCVA (r = 0.654) than that between the combination of b wave's amplitude of F-ERG with wave's amplitude of F-VEP and BCVA (r = 0.528) in the patients with partial opaque lenses. Obvious linear-relationship between the combination of the F-ERG with F-VEP values and BCVA (r = 0.487) and no obvious relationship between the potential visual acuity and BCVA (r = 0.049) were shown in the patients with near complete/complete opaque lenses. CONCLUSION: Both visual electrophysiological and retinometric detection, especially the latter one, can predict the post-operative visual acuity of the patients with partial opaque lenses accurately. Visual electrophysiological detection can predict the post-operative visual acuity of cataractous patients with near complete/complete opaque lenses accurately but retinometric detection can not.