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患有威胁视力的糖尿病视网膜病变患者白内障手术的视力相关生活质量和视觉效果:一项前瞻性观察研究。

Vision-related quality of life and visual outcomes from cataract surgery in patients with vision-threatening diabetic retinopathy: a prospective observational study.

作者信息

Zhu Bijun, Ma Yingyan, Lin Senlin, Zou Haidong

机构信息

Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100 Haining Road, Shanghai, 200080, China.

Department of Preventative Opthalmology, Shanghai Eye Disease Prevention and Treatment Center, No. 380 Kangding Road, Shanghai, 200040, China.

出版信息

Health Qual Life Outcomes. 2017 Sep 2;15(1):175. doi: 10.1186/s12955-017-0751-4.

Abstract

BACKGROUND

To examine the benefit of cataract surgery on visual acuity and vision related quality of life in patients with stabilized vision-threatening diabetic retinopathy.

METHODS

A total of 126 patients (153 eyes) who were diagnosed with cataract combined with stabilized vision-threatening diabetic retinopathy underwent phacoemulsification. Measurements included the best-corrected visual acuity (BCVA), which was converted into a weighted logarithm of the minimum angle of resolution (logMAR) and vision related quality of life (VRQoL) using the Chinese-version low vision quality of life questionnaire (CLVQOL).

RESULTS

Three months after phacoemulsification, statistically significant improvements were observed in postoperative weighted logMAR BCVA (Z = -9.390 P < 0.001). In all of the participants, the CLVQOL total scores (Z = -7.995 P <0.001) and four subscale scores including general vision and lighting level (Z = -7.400 P <0.001), mobility level (Z = -6.914 P <0.001), psychological adjustment level (Z = -8.112 P <0.001) and reading, fine work and activities of daily living level (Z = -5.892 P <0.001), all improved significantly after the surgeries. Linear regression analyses indicated that the increase in CLVQOL total scores exhibited a significant correlation with the better postoperative weighted logMAR BCVA, greater gain of weighted logMAR BCVA after surgery, bilateral surgery, and longer duration of diabetic retinopathy.

CONCLUSIONS

Both visual acuity and the vision related quality of life of the patients with diabetic retinopathy improved significantly after cataract surgery. Cataract surgery is an effective intervention for patients with stabilized diabetic retinopathy.

摘要

背景

探讨白内障手术对视力稳定的威胁视力的糖尿病视网膜病变患者视力及与视力相关的生活质量的益处。

方法

共有126例(153只眼)被诊断为白内障合并视力稳定的威胁视力的糖尿病视网膜病变的患者接受了超声乳化白内障吸除术。测量指标包括最佳矫正视力(BCVA),将其转换为最小分辨角加权对数(logMAR),并使用中文版低视力生活质量问卷(CLVQOL)评估与视力相关的生活质量(VRQoL)。

结果

超声乳化白内障吸除术后3个月,术后加权logMAR BCVA有统计学意义的显著改善(Z = -9.390,P < 0.001)。在所有参与者中,CLVQOL总分(Z = -7.995,P < 0.001)以及包括总体视力和照明水平(Z = -7.400,P < 0.001)、活动能力水平(Z = -6.914,P < 0.001)、心理适应水平(Z = -8.112,P < 0.001)和阅读、精细工作及日常生活活动水平(Z = -5.892,P < 0.001)在内的四个子量表得分在手术后均有显著改善。线性回归分析表明,CLVQOL总分的增加与术后更好的加权logMAR BCVA、手术后加权logMAR BCVA的更大改善、双眼手术以及糖尿病视网膜病变的更长病程显著相关。

结论

糖尿病视网膜病变患者的视力和与视力相关的生活质量在白内障手术后均有显著改善。白内障手术是对视力稳定的糖尿病视网膜病变患者的一种有效干预措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/94fc/5581410/67b6914d0fa0/12955_2017_751_Fig1_HTML.jpg

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