| Objective:Through phacoemulsification and intraocular lens implantation(Phaco+IOL)in patients with high myopia cataract,eyesight at different periods before and after surgery,photopic contrast sensitivity,mesopic contrast sensitivity,glare sensitivity and stereoscopic vision at different periods before and after cataract surgery,and to discuss the influence of different factors on the functional repair of binocular vison.The Life-related Visual Quality Questionnaire(VF-14-CN)which used to assess the postoperative vision-related quality of life changes of these patients,and to explore the impact of Phaco+IOL implantation on cataract patients with high myopia by observing the changes of visual performance and stangards of life in them,in order to provide a basis for achieving relatively comfortable visual effects after surgery.Methods:Establish a study group by collecting a sample of 60 patients(122 eyes)who were diagnosed with binocular cataract with high myopia as the observation group(group A)from September 2021 to December 2022,while 30 patients whose refractive status was at the normal aging level in cataract group were collected as control group(group B).As the observation group(group A),patients with 26.00mm≤axial length≤28.00 mm were included in group A1(high myopia subgroup),a group of 30 patients(60 eyes),and patients with axial length>28.00 mm were included in group A2(ultra-high myopia subgroup),a group of 31patients(62 eyes).Phacoemulsification and intraocular lens implatation were performed in both groups.The whole visual acuity,Contrast sensitivity,Mesopic contrast sensitivity,Glare sensitivity and Stereoscopic vision were examined with Biopter4 P binocular vision instrument before and first month and third month after operation.All subjects filled in the visual function quatity of life questionnaire in the third month after operation,observed and analyzed the results.Results:1.Visual acuity:1 month and 3 months after operation,Best corrected distance visual acuity(BCDVA),Best-corrected intermediate visual acuity(BCIVA),and Best-corrected near visual acuity(BCNVA)of patients in both groups A and B were higher than those before operation(P<0.05).Compared with 1 month after operation,in 3 months after operation,BCDVA and BCNVA in group A1 increased significantly(P=0.047,0.001),while BCIVA did not change significantly(P=0.721);There were no significant changes in BCDVA,BCIVA and BCNVA in group A2(P=0.163,0.670,0.074);The BCDVA of group B was significantly higher(P=0.017),while the BCIVA and BCNVA of group B had no significant changes(P=0.923,0.191).2.Photopic CS:In 1 month and 3 months after surgery,the level of Photopic CS in patients in groups A and B was significantly improved compared with that before surgery,and the difference was significant(P<0.05);Compared with 1 month after operation,Photopic CS in group A1,A2 and B was improved in 3 months after operation(P<0.01).At 1 month and 3months after surgery,Photopic CS in group A2 wasobviously lower than that in group A1 and group B(P<0.05),but no significant difference was showed between the group A1 and group B(P>0.05).Three months after operation,there were 27 patients(90.0%),13 patients(41.9%)and 30 patients(90.9%)respectively in group A1,A2 and B,whose Photopic CS reached the normal reference value(≤ 15%),and the pass rate among the three groups was statistically significant(P<0.001).3.Mesopic CS:The Mesopic CS of patients in group A and group B in 1 month and 3months after operation was significantly higher than that before operation(P<0.05);Compared with 1 month after operation,Mesopic CS in group A1,A2,B was improved in 3months after operation(P<0.05);At 3 months after operation,Mesopic CS in group A1 was better than that in group A2(P<0.05);For Mesopic CS of patients in group A1 and group B,no significant differences were found(P>0.05).4.Glare sensitivity:In 1 month and 3 months after surgery,the GS of patients in both groups A and B was higher than that before surgery(P<0.05);Compared with 1 month after operation,GS in group A1,A2 and B was improved in 3 months after surgery(P<0.05);3months after surgery,Glare sensitivity in group A1 was significantly higher than that in group A2(P<0.05);Glare sensitivity in group A1 was lower than that in group B,with statistically significant difference(P<0.05).5.At 3 months after operation,the number of patients in groups A1,A2 and B who failed1:2.7 under glare condition was higher than that without glare condition(P<0.05).6.Stereoscopic vision:At 1 month and 3 months after operation,the far,middle and near stereoscopic function of patients in group A and B have a further improvement than those before surgery(P<0.05).Three months after surgery,the far-stereoscopic and medium-stereoscopic functions in group A1 were lower than those in group B(P<0.05),but the far-stereoscopic and medium-stereoscopic functions in group A1 were not significantly different from those in group A2(P>0.05);There was no statistically significant difference in near-stereoscopic visual function among groups A1,A2 and B(P > 0.05).7.The Visual unction quatity of Life questionnaire:The preoperative score of group A was lower than that of group B(P<0.05),and there was no striking difference between the scores of preoperative in group A1 and group A2(P>0.05).In 3 months after surgery,the scores of patients in A and B groups were above those in the preoperative period(P<0.05),but the overall scores of group A was below that of group B(P<0.05).The total score of group A1 and the scores of the four items(near-vision function,stereoscopic function,subjective visual perception and visual adaptation)were higher than those in group A2(P<0.05),the total score of group A1 increased significantly compared with that of group A2(P<0.05);The score of stereopsis function in group A1 was below that in group B(P<0.05),and there was no obvious differences in other items and total scores between group A1 and group B(P>0.05);The scores of each item and total scores in group A2 were lower than those in the group B,and the differences were statistically significant(P<0.05).Conclusion: 1.Phacoemulsification and Intraocular Lens Implantation has a clear effect on the treatment of high myopia cataract patients,and can significantly improve the patients’ full range of vision in the early stage after surgery.2.The early Contrast sensitivity,Mesopic contrast sensitivity,Glare sensitivity and Stereoscopic vision of high myopia cataract patients treated by Phacoemulsification and Intraocular Lens Implantation can be significantly improved.3.The degree of myopia can affect the early Contrast sensitivity,Mesopic contrast sensitivity,Glare sensitivity and Stereoscopic vision of high myopia cataract patients after surgery.4.After Phacoemulsification and Intraocular Lens Implantation,the visual-related quality of life of high myopia cataract patients was significantly improved. |
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