Department of Ophthalmology, Jinan Second People's Hospital, Jinan, China.
Medicine (Baltimore). 2024 Aug 23;103(34):e39386. doi: 10.1097/MD.0000000000039386.
In the present study, we aimed to demonstrate the objective guiding role of objective scatter index (OSI) in patients with early stage posterior capsule opacification (PCO), especially in patients with multifocal intraocular lens (IOL) implantation. A prospective randomized case analysis was conducted on elderly patients experiencing PCO, exhibiting best-corrected visual acuity (BCVA) below 0.2 LogMAR. Exclusion criteria comprised patients with diabetes, glaucoma, high myopia, trauma, endothelial dystrophy, maculopathy or prior eye surgery affecting visual acuity. The main observational indicators were patient gender, age, post-cataract surgery duration, BCVA (LogMAR), and OSI values. For patients undergoing laser posterior capsulotomy, meticulous documentation of pre-laser OSI values and post-laser OSI values was undertaken. Subjective visual quality was then compared using the Chinese version visual function index-14 (VF-14-CN). The study comprised 65 eyes from 56 patients. PCO developed, on average, 2.06 ± 0.94 years (ranging from 0.5 to 4 years) after the initial surgery, with the OSI consistently exceeding 3.0. Among these cases, only 40 eyes underwent laser posterior capsulotomy using Nd:YAG laser, including 26 eyes implanted with monofocal IOLs and 14 eyes implanted with multifocal IOLs. Following laser posterior capsulotomy for early-stage secondary cataracts, there was a significant decrease in OSI values compared to the presurgery state, coupled with a notable increase in VF-14-CN scores. Among the 14 cases with multifocal IOL implantation, pre-laser VF-14-CN scores were lower compared to those with monofocal IOLs. Post-laser posterior capsulotomy, patients reported a marked improvement in self-perceived symptoms. The OQAS functioned as an objective assessment metric for the laser treatment of early stage PCO. In cases involving multifocal IOL implantation, the visual disturbance caused by PCO was more pronounced, underscoring the significance of OSI as a valuable guide for laser treatment in these patients.
在本研究中，我们旨在展示客观散射指数（OSI）在早期后囊混浊（PCO）患者中的客观指导作用，特别是在多焦点人工晶状体（IOL）植入的患者中。对患有 PCO、最佳矫正视力（BCVA）低于 0.2 LogMAR 的老年患者进行了前瞻性随机病例分析。排除标准包括患有糖尿病、青光眼、高度近视、外伤、内皮营养不良、黄斑病变或影响视力的先前眼部手术的患者。主要观察指标为患者性别、年龄、白内障手术后时间、BCVA（LogMAR）和 OSI 值。对于接受激光后囊切开术的患者，详细记录激光前 OSI 值和激光后 OSI 值。然后使用中文版视觉功能指数 14（VF-14-CN）比较主观视觉质量。该研究包括 56 名患者的 65 只眼。PCO 在初始手术后平均 2.06±0.94 年（0.5 至 4 年）发展，OSI 始终超过 3.0。在这些病例中，只有 40 只眼接受了 Nd：YAG 激光的激光后囊切开术，其中 26 只眼植入了单焦点 IOL，14 只眼植入了多焦点 IOL。早期继发性白内障行激光后囊切开术后，OSI 值与术前相比显著降低，VF-14-CN 评分显著升高。在 14 例多焦点 IOL 植入病例中，激光前 VF-14-CN 评分低于单焦点 IOL。激光后囊切开术后，患者自述自觉症状明显改善。OQAS 是早期 PCO 激光治疗的客观评估指标。在多焦点 IOL 植入病例中，PCO 引起的视觉障碍更为明显，凸显了 OSI 作为指导此类患者激光治疗的重要价值。
