On Research Of Accommodation, Fusion And Stereoscopic Vision Among The Patients With Cataract Extraction And Intraocular Lens Implantation

Objective With the development of the cataract operation techniques, intraocular lens technology and life condition, the acquired good visual function desire seems more urgent to cataract patients after operation. That means not only ideal visual acuity, but also satisfied functional vision, fusion and stereoscopic vision are needed. Being important visual function, fusion and stereoscopic vision play a key part in three-dimension image sensation, which tells the bulk, direction and distance of surrounding objects. In this research, comprehensive optometry unit and synoptophore stereoscopic vision pictures are used to inspect the visual accommodation, fusion and stereoscopic. And through the study of binocular visual function recovery, there shows patients acquire satisfied visual acuity and visual function after cataract operation.Method After the inspections of visual acuity, slit lamp, fundus oculi, intraocular pressure, 36 eyes of unilateral cataract of 36 patients (group 1) and 64 eyes of bilateral cataract of 32 patients (group 2) are choused from the department cataract inpatients in Tianjin Eye Hospital. All patients are excluded diabetes mellitus, keratopathy, glaucoma and other fundus diseases, whose postoperative eyes are with 2 mm diameter round pupils and clear posterior capsular. The recovery of visual accommodation, fusion and stereoscopic vision are observed through inspections of comprehensive optometry unit, synoptophore, Titmus stereoscopic vision pictures and Yan's Randomized Dot Stereoptic vision pictures. The 30 healthy persons are used as control(group 3). For three groups, the investigation are carried on near point of visual accommodation, positive relatedaccommodation, negative related accommodation, fusion crossed cylinder, amplitude of accommodation, AC/A, fusion range, synoptophore, Titmus stereoscopic vision pictures and randomized dots stereoptic(RDS) vision pictures. The results are analyzed with SPSS 12.0. The student's t-test, x2 test and single factor square analysis of variance (F test) are used to tell the difference between the groups, if there were different significantly, the q-test was used to compare the difference between the groups. The value of p<0.05 is taken as significant difference level.Result Among three groups, there is no difference in age and sex, and there is significantly difference in near point of visual accommodation, positive related accommodation, negative related accommodation, fusion crossed cylinder lens, amplitude of accommodation statistically.For near point of visual accommodation, F=5.85, p=0.004;groupl verse group 2, q=4.77, p<0.01;group 1 verse group 3, q=3.14, p<0.05;group 2 verse group 3, q=1.46, p>0.05. There are significant difference between the bilateral cataract group and unilateral cataract group, bilateral cataract group and control group. And there is not difference between unilateral cataract group and control group.For positive related accommodation, negative related accommodation and amplitude of accommodation, F= 11.18, p=0.000;group 1 verse group 2, q= 1.32, p>0.05;group 1 verse group 3, q=4.97, p<0.01;group 2 verse group 3, q=6.40, p<0.01, there is significantly difference between bilateral cataract group and control group, unilateral cataract group and control group. And there is not difference between unilateral cataract group and bilateral group.For negative related accommodation, F=50.61, p=0.000;group 1 verse group 2,q= 1.04, p>0.05;group 1 verse group 3, q=l 1.73, p<0.01;group 2 verse group 3, q=13.09,p<0.01.For amplitude of accommodation, F=13.20, p=0.000;group 1 verse group 2, q=1.27, p>0.05;group 1 verse group 3, q=5.53, p<0.01;group 2 verse group 3, q= 6.93, p<0.01.For fusion crossed cylinder, F=4.30, p=0.016;group 1 verse group 2, q=1.97, p>0.05;group 1 verse group 3, q=2.15, p>0.05;group 2 verse group 3, q=4.15, p<0.05. There is not difference between bilateral cataract group and unilateral cataract group, bilateral cataract group and control group. The difference is significant between the unilateral cataract group and control group.For fusion factor AC/A, F=2.80, p=0.066, no difference are showed among the three groups.For amplitude of accommodation, F=9.86, p=0.000;group 1 verse group 2, q=3.85, p<0.01;group 1 verse group 3, q=2.33, p>0.05;group 2 verse group 3, q=6.19, p<0.01, there was significantly difference between unilateral cataract group and bilateral group, unilateral cataract group and control group.For stereoscopic vision factor of the three groups, F=0.87, p=0.421, no difference is found in synoptophore inspection. But Titmus stereoscopic vision showed the F=6.56, p=0.002;group 1 verse group 2, q=4.33, p<0.01;group 1 verse group 3, q=0.17, p>0.05;group 2 verse group 3, q=4.43, p<0.01.RDS: showed significant difference, F=5.71, p=0.005;group 1 verse group 2, q=4.65, p<0.01;group 1 verse group 3, q=1.38, p>0.05;group 2 verse group 3, q=3.!5, p<0.05, There was significantly difference between bilateral cataract group and control group, bilateral cataract group and unilateral cataract group, unilateral cataract groupand control group.Conclusion The visual acuity and visual function of postoperative cataract patients is improved obviously. After the opaque crystalline lens extraction and the intraocular lens implantation, the visual acuity of cataract patients is improved, moreover, the postoperative eye (bilateral cataract group and unilateral cataract group) partly retain accommodation, fusion and stereoscopic vision function. On accommodation, fusion and stereoscopic vision function, the postoperative patients in bilateral cataract group were superior to unilateral group, but was inferior to control group. Above all, the postoperative binocular vision of bilateral group is superior to that of unilateral group. Theoretically, this research provides guidance on postoperative visual acuity correction and binocular vision quality improvement.