摘要
目的探讨因重症化学性眼外伤行人工角膜植入手术复明的患者术前闪光视觉诱发电位(flash visual evoked potentials,FVEP)、闪光视网膜电流图(flash electroretinography,FERG)检查结果与术后视力的相关性。方法收集2016年10月-2019年10月于解放军总医院第一医学中心眼科因重症化学性眼外伤行人工角膜植入手术的患者共32例(32眼)的临床资料,其中男性27例,女性5例,年龄20~60岁。分析其术后最佳矫正视力(best corrected visual acuity,BCVA)与术前FVEP、FERG以及二者联合检查结果的相关性。结果所有患者顺利完成人工角膜植入手术。术前视力为光感或指数,术后BCVA范围为0.05~0.8,其中BCVA≥0.6共14眼(14/32,44%),0.3~0.5共10眼(10/32,31%),0.05~0.25共7眼(7/32,22%),<0.051眼(1/32,3%)。FVEP联合FERG检测正常2眼(2/32,6.2%),异常30眼(30/32,93.8%),包括轻度异常10眼,中度异常11眼,重度异常6眼,不可记录3眼。术前FVEP与术后BCVA呈正相关,相关系数r=0.674,P=0.000;FERG与术后BCVA呈正相关,相关系数r=0.659,P=0.000;FVEP联合FERG检查与术后BCVA呈正相关,相关系数r=0.793,P=0.000。结论FVEP、FERG以及二者联合检查有助于重症化学性眼外伤患者视功能的评估及预测人工角膜植入术后的视力,具有临床实用价值。
Objective To explore the correlation between the results of preoperative flash visual evoked potentials(FVEP),flash electroretinography(FERG)and postoperative visual acuity for patients with severe chemical eye injury requiring artificial corneal implant surgery.Methods Of the 32 patients(32 eyes)who had undergone artificial corneal transplantation due to severe chemical ocular injury in our hospital from October 2016 to October 2019,there were 27 males and 5 females aged 20-60 years.The correlation between the best corrected visual acuity(BCVA)after operation and the results of preoperative FVEP,FERG and their joint examination were analyzed.Results All patients had successfully completed artificial corneal implant surgery.Their preoperative vision was evaluated as light perception or finger count,while the postoperative best corrected visual acuity ranged from 0.05 to 0.8,including 0.6 in 14 eyes(14/32,44%),0.3-0.5 in 10 eyes(10/32,31%),0.05-0.25 in 7 eyes(7/32,22%),and<0.05 in 1 eye(1/32,3%).The preoperative detection result of FVEP combined with FERG was normal in 2 eyes(2/32,6.2%)while abnormal in 30 eyes(30/32,93.8%),including 10 eyes with mild decreasing,11 eyes with moderate decreasing,6 eyes with severe decreasing,and unrecordable in 3 eyes.Preoperative FVEP,FERG and FVEP combined with FERG were all positively correlated with the postoperative best corrected visual acuity(r=0.674,P=0.000;r=0.659,P=0.000;r=0.793,P=0.000).Conclusion FVEP,FERG,especially the combination of FVEP and FERG is helpful for predicting the visual function before artificial corneal inplantation in patients with severe chemical eye injury,and it is worthy of clinical generalization.
作者
张建新
王国艳
李方敏
于鑫悦
张鸿瑫
杨青华
ZHANG Jianxin;WANG Guoyan;LI Fangmin;YU Xinyue;ZHANG Hongtao;YANG Qinghua(Department of Ophthalmology,the First Medical Center,Chinese PLA General Hospital,Beijing 100853,China)
出处
《解放军医学院学报》
CAS
2020年第10期963-966,987,共5页
Academic Journal of Chinese PLA Medical School
基金
国家自然科学基金项目(81670830
81770887)。
关键词
化学伤
眼
视觉诱发电位
人工角膜
视网膜电流图
视功能
chemical burns,eye
visual evoked potentia
artificial corneal
electroretinogram
visual function
