Cataract surgery is not associated with post-operative binocular vision anomalies in age-related cataract patients.
Cataract surgery is not associated with post-operative binocular vision anomalies in age-related cataract patients.
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DOI：
10.1111/opo.13012
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发表时间：
2022-09
影响因子：
2.9
通讯作者：
Scheiman, Mitchell M.
中科院分区：
文献类型：
--
作者：
Tan, Qing-Qing;Lewis, James S.;Lan, Chang-Jun;Liao, Xuan;Tang, Xiao-Li;Wang, Jingyun;Aljohani, Saeed;Scheiman, Mitchell M.
比较白内障手术前后患者的双眼视力状态，并探讨患者术后出现双眼视力异常的危险因素。对选择接受双侧白内障手术的患者（≥50 岁）进行了一项前瞻性研究。在第一次手术前和第二只眼手术后的第三次就诊时，进行了全面的双眼视力测试，包括立体视觉、眼球对准、融合聚散、聚散设施、近会聚点和会聚不足症状调查 (CISS)。应用详细的诊断分类方案来识别手术前和手术后是否存在双眼视觉异常。基线时纳入了 73 名参与者，其中 24 名（33%）被诊断患有非斜视双眼视觉异常（NSBVA），主要是会聚不足（18/73，25%）。 51 名参与者完成了术后评估，其中 17 名（33%）人在手术前接受了 NSBVA，13 名（26%）人在手术后接受了 NSBVA（P=0.48）。有许多人从 NSBVA 转变为正常双眼视力，反之亦然。 Logistic回归显示，预先存在的NSBVA诊断预测术后NSBVA风险的调整优势比为6.37（P<0.01）。术后大多数双眼视力指标没有显着变化，除了 CISS 评分显着改善（P<0.01，Cohen’s d=0.83）。双眼视力异常，尤其是会聚不足，在年龄相关性白内障人群中普遍存在。白内障手术似乎并不是出现新的双眼视力异常的重要危险因素。预先存在的双眼视力异常是预测该人群术后双眼视力异常的主要危险因素。
To compare the binocular vision status of patients pre- and post-cataract surgery, and to investigate the risk factors for patients who develop binocular vision anomalies post-surgery. A prospective study of patients (≥50 years) who elected to undergo bilateral cataract surgery was implemented. A comprehensive binocular vision test battery including stereopsis, ocular alignment, fusional vergence, vergence facility, near point of convergence and the Convergence Insufficiency Symptom Survey (CISS) were administered before the first surgery and at the third visit after surgery on the second eye. A detailed diagnostic classification protocol was applied to identify the presence of binocular vision anomalies pre- and post-surgery. Seventy-three participants were included at baseline, 24 (33%) of whom were diagnosed with non-strabismic binocular vision anomalies (NSBVA), mainly convergence insufficiency (18/73, 25%). Fifty-one participants completed the postoperative evaluation, 17 (33%) of whom had NSBVA pre-surgery and 13 (26%) post-surgery (P=0.48). There were a number of conversions from NSBVA to normal binocular vision and vice-versa. Logistic regression showed that the adjusted odds ratio of pre-existing NSBVA diagnosis for predicting the risk of postoperative NSBVA was 6.37 (P<0.01). There were no significant changes in most binocular vision measures post-surgery, except for a significant improvement in the CISS score (P<0.01, Cohen’s d=0.83). Binocular vision anomalies, especially convergence insufficiency, are prevalent in the age-related cataract population. Cataract surgery does not appear to be a significant risk factor for the development of new binocular vision anomalies. A pre-existing binocular vision anomaly is the main risk factor for predicting a postoperative binocular vision anomaly in this population.
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