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目的:白内障手术是一种复明手术,术前对患者视功能及术后视力预后情况进行预测,对医患双方来说都非常重要,研究和建立能正确预测白内障术后最佳视力的标准方法显得越发重要和迫在眉睫。建立该标准方法正是本课题要解决的问题。方法:经文献检索和查证,我们认为一些文献中报道的单一指标对白内障术后视力预测或单一指标对某种类型白内障患者术后视力预测有其可靠性和值得信赖之处,如:视网膜计对白内障患者潜视力预测、眼电生理检查、B超影像检查、A超眼轴长度测量、近视程度分类、晶状体核硬度分级、多普勒超声、FFA、瞳孔反射及光定位、色觉检查等,但都有局限和片面性,将这些指标和其它相关的检查结果结合起来,分析判断,再依其在整体预测系统中具有的重要性确定其分值,最后根据患者所有在列检查项目中总得分数找出其相对应的术后实测最佳矫正视力,并根据彼此对应关系总结、建立综合判断的标准方法才是客观可靠的。这虽有难度但还是切实可行的。结果:我们对临床经治的600例(眼)白内障患者手术前后的眼部检查情况和手术后的相应视力按上述思路做了前瞻性研究,经比较、分析、归纳、找出了对应关系建立了标准方法,经临床实际应用验证基本符合率为70.2%,达到较高的水平。结论:该方法能基本正确预测白内障患者的手术后最佳视力且具有简单、明确、标准化和可操作性。达到了较满意的结果。并确认了必不可少的检查指标及其可靠性和重要性。
OBJECTIVE: Cataract surgery is a recaptured surgery. Preoperative visual function and prognosis of postoperative visual acuity are predicted. It is very important for both doctors and patients to study and establish a standard method to correctly predict the best visual acuity after cataract surgery It is more and more important and urgent. The establishment of the standard method is the subject to be solved. Methods: After the literature search and verification, we think that the single indexes reported in some literatures have certain reliability and trustworthy for the postoperative visual acuity prediction of a certain type of cataract patients, such as the retina The potential visual acuity, ocular electrophysiological examination, B ultrasound imaging, A length of occipital axis, classification of myopia, classification of lens nuclear hardness, Doppler ultrasound, FFA, pupil reflex and light positioning, color vision examination, But all have limitations and one-sidedness, combine these indicators with other related test results, analyze and judge, and then determine their scores according to their importance in the overall prediction system. Finally, according to all the patients in the column check items total score To find out the corresponding best postoperative corrected visual acuity, and based on the corresponding summary of each other, the establishment of a comprehensive standard judgment method is objective and reliable. Although this is difficult, it is still practicable. Results: We conducted a prospective study on the eye examination and the corresponding visual acuity before and after surgery in 600 cases of (clinically) treated cataract patients. By comparing, analyzing and concluding, we found the corresponding relationship was established The standard method, the clinical application of the basic verification rate of 70.2%, reaching a higher level. Conclusion: This method can basically predict the best visual acuity after cataract surgery and is simple, clear, standardized and operable. Achieved a more satisfactory result. And confirmed the indispensable inspection index and its reliability and importance.