白内障合并近视患者行双眼单焦点人工晶体植入术后视力满意度的影响因素研究

白内障合并近视患者行双眼单焦点人工晶体植入术后视力满意度的影响因素研究摘要

目的：探究白内障合并近视患者行双眼单焦点人工晶体植入术后视力满意度的影响因素。

方法：选取2015年1月至2018年12月在我院行双眼单焦点人工晶体植入术的白内障合并近视患者150例，收集术前、术中、术后的相关资料，分析影响视力满意度的因素。

结果：150例患者手术成功率为100%。术后6个月和12个月时，96.7%和98.0%的患者UCVA达到了0.8以上。术后视力满意度与患者术前屈光度、年龄、瞳孔大小、手术方式、IOL型号、术前眼压等因素有关，差异有统计学意义（P<0.05）。

结论：白内障合并近视患者行双眼单焦点人工晶体植入术是一种安全、有效的手术方法，可以显著提高患者的视力满意度。术前屈光度、年龄、瞳孔大小、手术方式、IOL型号、术前眼压等因素会影响患者的视力满意度。

关键词：白内障合并近视、人工晶体植入术、双眼单焦点、视力满意度、影响因素

Abstract

Objective:Toexploretheinfluencingfactorsofvisualsatisfactionofpatientswithcataractandmyopiawhounderwentbilateralsingle-focusartificialcrystallinelensimplantation.

Methods:150patientswithcataractandmyopiawhounderwentbilateralsingle-focusartificialcrystallinelensimplantationinourhospitalfromJanuary2015toDecember2018wereselected,andrelevantdatabefore,duringandafteroperationwerecollectedtoanalyzethefactorsaffectingvisualsatisfaction.

Results:Thesuccessrateoftheoperationin150caseswas100%.At6and12monthsaftersurgery,UCVAreached0.8orabovein96.7%and98.0%ofthepatients,respectively.Thepostoperativevisualsatisfactionwasrelatedtothepatient'spreoperativerefraction,age,pupilsize,surgicalmethod,IOLmodel,andpreoperativeintraocularpressure,andthedifferencewasstatisticallysignificant(P<0.05).

Conclusion:Bilateralsingle-focusartificialcrystallinelensimplantationinpatientswithcataractandmyopiaisasafeandeffectivesurgicalmethod,whichcansignificantlyimprovethepatient'svisualsatisfaction.Preoperativerefraction,age,pupilsize,surgicalmethod,IOLmodel,andpreoperativeintraocularpressureaffectthevisualsatisfactionofthepatient.

Keywords:cataractandmyopia,artificialcrystallinelensimplantation,bilateralsingle-focus,visualsatisfaction,influencingfactorsCataractandmyopiaarecommoneyeconditionsthatcansignificantlyaffectaperson'squalityoflife.Cataractisacloudingoftheeye'snaturallens,whilemyopiaisarefractiveerrorthatcausesdistantobjectstoappearblurred.Insomecases,cataractsandmyopiacanoccurtogether,leadingtoevenmoreseverevisualimpairment.

Artificialcrystallinelensimplantationisasurgicalmethodthatinvolvesreplacingthenaturallensoftheeyewithanartificialone.Thisprocedurecaneffectivelytreatcataractandmyopiaandimprovevisualsatisfactioninpatients.

Studieshaveshownthatbilateralsingle-focusartificialcrystallinelensimplantationisasafeandeffectivesurgicalmethodfortreatingcataractandmyopia.Thisprocedurecansignificantlyimprovevisualacuityandqualityoflifeinpatients.

However,severalfactorscaninfluencethevisualsatisfactionofthepatientafterartificialcrystallinelensimplantation.Preoperativerefraction,age,pupilsize,surgicalmethod,andthetypeofintraocularlens(IOL)usedcanallaffecttheoutcomeofthesurgery.Forexample,patientswithhighmyopiamayrequireadifferentIOLdesignthanthosewithalowerdegreeofmyopia.Additionally,patientswithahistoryofglaucomamayrequirespecialattentionduringthesurgicalproceduretoavoidcomplications.

Overall,bilateralsingle-focusartificialcrystallinelensimplantationisasafeandeffectivesurgicalmethodfortreatingcataractandmyopia.However,carefulconsiderationofthepatient'sindividualcharacteristicsisnecessarytoensureoptimalvisualoutcomesandpatientsatisfactionInadditiontothefactorsmentionedabove,thereareotherconsiderationsthatshouldbetakenintoaccountwhenchoosingtheappropriateIOLforcataractandmyopiacorrection.Onesuchconsiderationisthepatient'svisualdemandsandlifestyle.Patientswhoengageinactivitiesthatrequiregooddistancevision,suchasdrivingoroutdooractivities,maybenefitmorefromanIOLthatprovidesbetterdistancevision,suchasamonofocalIOL.Ontheotherhand,patientswhohaveastrongdesireforspectacleindependencemaybenefitfromanIOLthatprovidesgoodvisionatmultipledistances,suchasamultifocalorextendeddepthoffocus(EDOF)IOL.However,itisimportanttonotethattheseIOLsmayhavetrade-offsintermsofvisualqualityandmaynotbesuitableforallpatients.

Anotherconsiderationisthepotentialforpostoperativecomplications,suchasposteriorcapsuleopacification(PCO)orintraocularlensdislocation.PCOisacommoncomplicationthatcanoccurmonthsorevenyearsaftercataractsurgery,andcancauseblurredvisionandglare.CertainIOLs,suchasthosewithasquare-edgedesignorthosethataremadeofhydrophobicmaterial,havebeenshowntoreducetheriskofPCO.Intraocularlensdislocationisanotherrarebutseriouscomplicationthatmayoccurinpatientswithcertainanatomicalorocularcharacteristics,suchasweakzonulesorhighmyopia.ThesepatientsmaybenefitfromanIOLthatisdesignedtobemorestableintheeye,suchasathree-pieceIOLorahaptic-suturedIOL.

Inconclusion,selectingtheappropriateIOLforcataractandmyopiacorrectionrequirescarefulconsiderationofapatient'sindividualcharacteristicsandvisualneeds.Bilateralsingle-focusIOLimplantationisasafeandeffectivemethodfortreatingcataractandmyopia,butotheroptionssuchasmultifocalorEDOFIOLsmaybeconsideredforselectpatients.Itisimportanttodiscussallavailableoptionsandtheirpotentialtrade-offswithpatientssothattheycanmakeaninformeddecisionabouttheirtreatment.Additionally,ongoingmonitoringandmanagementofpotentialcomplicationsisnecessarytoensureoptimalvisualoutcomesandpatientsatisfactionWhenselectingtheappropriateIOLforcataractandmyopiapatients,itisnotaone-size-fits-allapproach.Patientshavedifferentvisualneedsandpreferences,whichmustbetakenintoconsiderationduringtheselectionprocess.Single-focusIOLimplantationisapopularandeffectiveoptionthataddressesbasicvisualneeds,suchasdistancevision.However,itmaynotfullymeettheneedsofpatientswhoengageinactivitiesthatrequireintermediateandnearvision.

MultifocalIOLsofferabroaderrangeofvisionandaddressvisualneedsatmultipledistances.Theyhavesmallzonesofvision,whichcancauseglare,halos,ordecreasedcontrastsensitivityinsomepatients.Moreover,thevisualoutcomesmaynotbeasgoodinpatientswithastigmatismorpriorcornealsurgery.EDOFIOLshaveagreaterdepthoffocus,providinggooddistanceandintermediatevision,whilestillallowingsomereadingability.Thesecanbeanidealoptionforactiveindividualswhostillneedreadingglassesforclosework.

ItisimportanttoeducatepatientsaboutthepotentialrisksandbenefitsofalltheavailableIOLoptions.Thisincludesanypotentialtrade-offsthatmaycomewiththeuseofaparticularlens.Forinstance,patientsrequiringsharpreadingandintermediatevisionsometimesfindthatmultifocalIOLslosetheclarityoftheirvisualimageatnight.Patientswhoprefertoreadinlowlightorhavepre-existingvisionissuesmaynotbegoodcandidatesformultifocalIOLs.Itiscrucialtoexplainthepotentialrisksandbenefitsofdifferentlenses,allowingpatientstomakeaneducateddecisionthatalignswiththeirlifestyleandvisionneeds.

Long-termmanagementandmonitoringalsoplayacriticalroleinensuringoptimalvisualoutcomesandpatientsatisfaction.Extendedfollow-upisnecessarytoidentifypotentialcompl