摘要
目的借助OPD-SCANⅢ视觉分析仪评估糖化血红蛋白(HbA1c)浓度对白内障患者行白内障超声乳化联合人工晶体植入术后视觉质量的影响。方法选取2019年4月~2019年6月眼科中心收治的老年性白内障患者共计120例(120眼),所有患者顺利完成了白内障超声乳化联合人工晶体植入手术。实验分为高HbA1c组(HbA1c>6.5%,40例40眼)、低HbA1c组(HbA1c≤6.5%,40例40眼)和对照组(40例40眼)。利用OPD-SCANⅢ视觉分析仪检查患者手术前后波前像差(球差、慧差、三叶草、高阶像差)并进行统计学分析。结果最佳矫正视力(BCVA)结果表明,3组患者术后1d、1周和1个月的BCVA均明显提高。术后1d和1周,3组患者BCVA比较,差异无显著性(P>0.05)。术后1个月,高HbA1c组的患者BCVA明显低于对照组和低HbA1c组,差异有显著性(P<0.05)。球差结果表明,术前、术后1d、术后1周,3组患者球差比较,差异无显著性(P>0.05)。术后1个月,高HbA1c组球差明显高于对照组与低HbA1c组,差异有显著性(P<0.05)。慧差结果表明,对照组和低HbA1c组患者术后慧差均降低,而高HbA1c组患者在术后1d、1周慧差提高,差异有显著性(P<0.05)。术后1个月,3组慧差比较,差异无显著性(P>0.05)。三叶草像差结果表明,对照组患者术后三叶草像差降低,低HbA1c组和高HbA1c组三叶草像差在术后均升高。术后1d、1周,高HbAlc组明显高于对照组和低HbAlc组,差异有显著性(P<0.05)。术后1个月,低HbA1c组和高HbA1c组患者三叶草像差均高于对照组患者,差异有显著性(P<0.05)。高阶像差结果表明,对照组和低HbA1c组高阶像差在术后都降低,而高HbA1c组高阶像差在术后升高。术后1周和1个月,低HbA1c组和高HbA1c组高阶像差比对照组高,差异有显著性(P<0.05)。结论 HbA1c可以对糖尿病性白内障患者的术后早期视觉质量产生影响,低HbA1c糖尿病患者和正常患者术后早期视觉质量好于高HbA1c糖尿病患者。OPD-SCANⅢ屈光分析仪可以全面、精确检查患者的视觉质量,指导患者的术后康复。
Objective To analyze the effect of HbAlc level on visual quality after phacoemulsification and intraocular lens implantation with OPD-SCANⅢ.Methods The clinical data of 120 patients(120 eyes) with senile cataract admitted to the Eye Center from April 2019 to June 2019 were analyzed.All patients underwent phacoemulsification and intraocular lens implantation smoothly.The patients were divided into high HbA1 c group(HbA1 c>6.5%,40 eyes),low HbA1 c group(HbA1 c≤6.5%,40 eyes) and control group(40 eyes).BCVA was detected and wavefront aberration(spherical aberration,coma,trefoil aberration and high order aberration) was analyze perioperatively with OPD-SCANⅢafter surgery,and statistical analysis was performed.Results BCVA showed that BCVA in the three groups all improved 1 d,1 wk and 1 mon after surgery.No significant difference was found amid the 3 groups after surgery(P>0.05).BCVA in the high HbA1 c group was significantly lower than that in the control group and low HbA1 c group 1 mon after surgery(P<0.05).The results of spherical aberration(SA) showed there was no significant SA difference among the three groups pre-operation,1 d and 1 wk after surgery(P>0.05).SA in the high HbA1 c group was significantly higher than the control group and the low HbA1 c group,1 mon after the surgery(P<0.05).The results of coma showed that the coma in the control group and the low HbA1 c group decreased after surgery,while the coma significantly increased in the high HbA1 c group 1 d and 1 wk after surgery(P<0.05).There was no significant coma difference among the three groups 1 mon after surgery(P>0.05).The results of trefoil aberration(TA) showed that TA in the control group decreased after surgery,while it increased in the low HbA1 c group and high HbA1 c group after surgery.TA in the high HbAlc group was higher than TA in the control group and low HbAlc level group 1 d and 1 wk after surgery(P<0.05).TA in the low HbA1 c group and high HbA1 c group was higher than TA in the control group 1 mon after surgery(P<0.05).The results of the high order aberration(HOA) showed that HOA in the control group and low HbA1 c group decreased after surgery,while it increased in the high HbA1 c group.HOA in the low HbA1 c group and high HbA1 c group was higher than the control group 1 wk and 1 mon after surgery(P<0.05).Conclusion The level of HbA1 c affects the early visual quality of the patients with diabetic cataract.The early postoperative visual quality of the normal patients and low HbA1 c patients is better than that of the high HbA1 c patients.OPD-SCAⅢ Refractive Analyzer can comprehensively and accurately measure the visual quality of patients and provide effective basis for the recovery.
作者
刘宪金
孙海霞
杨伟舟
孙乙
王惠
朱玉广
LIU Xianjin;SUN Haixia;YANG Weizhou;SUN Yi;WANG Hui;ZHU Yuguang(Department of Ophthalmology,Weifang Medical University,Weifang 261053,China;Ophthalmic Center,the Affiliated Hospital of Weifang Medical University)
出处
《潍坊医学院学报》
2019年第5期341-344,共4页
Acta Academiae Medicinae Weifang
基金
山东省卫生厅科技计划资助项目(项目编号:2018WS056)
