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目的评价两种方法联合预测白内障术后视力的可靠性及临床应用价值。方法采用视网膜视力计和闪光视网膜电图(F-ERG)两种检查方法对拟手术的各类型白内障109例(117眼)进行视功能评估,并将视网膜视力即潜视力(Potential visual acuity,PVA)和F-ERGb波振幅值与术后1月的最佳矫正视力(best corrected visual acuity,BCVA)进行分析比较。结果晶体核轻中度混浊,术前PVA与术后BCVA呈显著的正线性相关性(r=0.587,P<0.01)。晶体核严重混浊,术前PVA与术后BCVA无相关性(r=0.037,P>0.05)。F-ERGb波振幅值为正常的50%~100%,术后BCVA≥0.5占68.47%,F-ERGb波振幅值低于正常的50%,术后BCVA全部<0.5。结论视网膜计可以准确的量化预测轻中度晶体混浊的术后视力,但对晶体核或后囊严重混浊者预测偏差较大。而F-ERG的检查结果不受晶体混浊程度的影响,可以定性判断视网膜的功能状态,因此将两者检查结果结合起来可以更加准确地预测白内障术后视功能的改善情况。
Objective To evaluate the reliability and clinical value of the two methods in predicting visual acuity after cataract surgery. Methods The retinal visual acuity and flash electroretinography (F-ERG) were used to assess the visual function of 109 cases (117 eyes) of all types of cataract. The retinal visual acuity (potential visual acuity, PVA ) And F-ERGb wave amplitude were compared with best corrected visual acuity (BCVA) at 1 month after operation. Results The nucleus of the crystal was moderately cloudy. There was a significant positive linear correlation between preoperative PVA and postoperative BCVA (r = 0.587, P <0.01). There was no correlation between preoperative PVA and postoperative BCVA (r = 0.037, P> 0.05). The amplitude of F-ERGb was 50% ~ 100%, the postoperative BCVA≥0.5 was 68.47%, the amplitude of F-ERGb was lower than 50%, and the postoperative BCVA was all <0.5. Conclusion The retinometer can accurately quantify the postoperative visual acuity of mild to moderate lens opacities, but the prediction of severe opacification of the lens nucleus or posterior capsule is large. The F-ERG test results are not affected by the degree of crystal opacity, retinal function can be qualitatively judged state, so the results of the two combined can be more accurately predict the improvement of visual function after cataract surgery.