小孔镜在白内障术前进行视力预测作用的研究

Study on Using Pinhole Glasses to Predict Vision before Cataract Surgery

摘要: 目的：评价术前通过小孔镜检查小孔视力来预测白内障术后最佳矫正视力的有效性。方法：采用随机病例对照研究，选择2022年12月~2023年12月不同类型白内障患者202例354眼，在手术前依照LOCS II晶状体混浊分类标准进行分级，且分为A、B两组。术前小孔镜下检查的小孔视力作为术后预测视力，并将其与术后1 m最佳矫正视力(the best corrected visual acuity, BCVA)对照分析。结果：A、B两组术后视力较术前明显提高(P < 0.01)，A组术前小孔视力与术后BCVA完全一致率87.78%；B组术前小孔视力与术后BCVA完全一致率(14.13%)，假阴性率85.87%。A组术前小孔视力与术后BCVA一致率明显高于B组(P < 0.01)。结论：术前小孔视力检查对白内障术后视力预测的准确性与白内障核硬度有关，术前小孔视力对于白内障核硬度I~IV级患者的术后视力有较好预测效果，对于核硬度V级及以上的白内障患者应综合多项临床检查进行评估。

Abstract: Objective: To investigate the value of Pinhole glasses for predicting postoperative visual acuity in patients with cataracts. Methods: A randomized case-control study was conducted. Total 354 eyes (202 cases) with different types of cataract were enrolled from December 2022 to December 2023, according to LOCS II the lens opacities were classified and the cases were divided into two groups: group A and group B. Pinhole visual was performed with Pinhole glasses, which was compared with the best corrected visual acuity (BCVA) on 1 month after operation. Results: The postoperative visual acuity of all patients was significantly higher than that before operation (P < 0.01). In group A, the rate of complete agreement between the preoperative pinhole visual acuity and postoperative BCVA was 87.78%; in group B, the rate of complete agreement between the preoperative pinhole visual acuity and postoperative BCVA was 14.13%, and the false negative rate was 85.87%. The consistent rate of preoperative pinhole vision and postoperative BCVA in group A was significantly higher than that in group B (P < 0.01). Conclusion: The accuracy of preoperative Pinhole visual in predicting postoperative visual acuity is related to the nuclear hardness of cataract. For cataract patients with nuclear hardness grade I to IV, Pinhole glasses are relatively reliable for predicting postoperative visual acuity before the cataract surgery. For cataract patients with nuclear hardness grade V, it should be combined with relevant clinical examination.