Chen Mingrui, Li Jianhua, Chen Qinyun, Zhao Yuan
Department of Ophthalmology, People's Hospital Affiliated to Chongqing Three Gorges Medical College, Chongqing, 404100, People's Republic of China.
Department of Ophthalmology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan Province, 637000, People's Republic of China.
Clin Ophthalmol. 2025 Jan 10;19:129-139. doi: 10.2147/OPTH.S494531. eCollection 2025.
To assess the visual quality in patients with primary angle-closure glaucoma (PACG) complicated by cataracts after cataract phacoemulsification with intraocular lens (IOL) implantation and goniosynechialysis, and to explore the relationship between pupil size and visual quality.
A retrospective, non-randomized study was conducted, including 65 PACG patients (75 eyes) who underwent cataract surgery with IOL implantation and goniosynechialysis from July 2021 to June 2023, as well as a control group of cataract-only patients. Visual quality was evaluated using objective and subjective methods at least 3 months postoperatively. PACG patients were divided into large-pupil (≥5 mm) and normal-pupil (<5 mm) groups. Visual quality parameters were compared among groups, and correlations between pupil size and objective visual quality measures were analyzed.
Visual Parameters: The large-pupil PACG group showed significantly higher higher-order aberrations, including coma and spherical aberrations, compared to both the cataract and normal-pupil groups. Contrast sensitivity was also worse in the large-pupil group. Visual Quality Questionnaire: The large-pupil group reported higher scores for night glare and difficulty driving at night. Correlations: Pupil size was positively correlated with higher-order aberrations and negatively correlated with contrast sensitivity.
Pupil dilation is a major factor affecting postoperative visual quality in PACG patients, even after surgery. Larger pupil size significantly increases higher-order aberrations and reduces contrast sensitivity. Techniques like pupil suturing may help improve visual quality in these patients.
评估原发性闭角型青光眼（PACG）合并白内障患者在白内障超声乳化人工晶状体（IOL）植入及房角分离术后的视觉质量，并探讨瞳孔大小与视觉质量之间的关系。
进行一项回顾性、非随机研究，纳入2021年7月至2023年6月期间接受白内障手术联合IOL植入及房角分离术的65例PACG患者（75只眼），以及仅患有白内障的对照组患者。术后至少3个月采用客观和主观方法评估视觉质量。PACG患者分为大瞳孔组（≥5mm）和正常瞳孔组（<5mm）。比较各组视觉质量参数，并分析瞳孔大小与客观视觉质量指标之间的相关性。
视觉参数：与白内障组和正常瞳孔组相比，大瞳孔PACG组的高阶像差，包括彗差和球差，显著更高。大瞳孔组的对比敏感度也更差。视觉质量问卷：大瞳孔组在夜间眩光和夜间驾驶困难方面的得分更高。相关性：瞳孔大小与高阶像差呈正相关，与对比敏感度呈负相关。
瞳孔散大是影响PACG患者术后视觉质量的主要因素，即使在手术后也是如此。较大的瞳孔大小显著增加高阶像差并降低对比敏感度。瞳孔缝合等技术可能有助于改善这些患者的视觉质量。
