摘要
目的基于iTrace系统分析晶状体功能失调指数(DLI)在年龄相关性白内障病情评估及手术指导中的应用价值。方法选取2018年10月至2019年10月于本院眼科收治的160例年龄相关性白内障患者为研究对象,另选取同期160例健康体检者为对照组,均进行眼科常规检查并比较。随后进行晶状体混浊程度分级系统Ⅲ(LOCSⅢ)确诊检查,将患者分为核型组(n=44)、皮质型组(n=62)、后囊下型组(n=54)3组,采用iTrace系统测量DLI。患者均实施白内障超声乳化摘除术,记录超声乳化累积释放能量(CDE),应用Pearson相关检验分析各组指标与DLI值相关性,并绘制受试者工作特征(ROC)曲线分析DLI值诊断价值。观察3个月后各组视觉恢复情况及视觉质量满意度。结果白内障组与对照组眼科常规检查指标均具有统计学意义(P<0.05);核型组患者DLI与最佳矫正视力(BCVA)、核混浊程度(NO)、核颜色(NC)、CDE均呈负相关(r=-0.641、-0.512、-0.559、-0.830,P<0.05),ROC曲线显示DLI最佳截断值为3.12,此时灵敏度、特异度分别为75.00%,70.80%;皮质型组DLI与BCVA、皮质性白内障(CC)均呈负相关(r=-0.639、-0.518,P<0.05),与CDE无明显相关性(r=-0.183,P>0.05),ROC曲线显示DLI最佳截断值为2.49,此时灵敏度、特异度分别为69.20%,86.10%;后囊下型组DLI与BCVA、后囊膜下白内障(PSC)均呈负相关(r=-0.851、-0.618,P<0.05),与CDE无明显相关性(r=-0.235,P>0.05),ROC曲线显示DLI最佳截断值为2.01,此时灵敏度、特异度分别为69.60%,71.00%;各组患者裸眼视力、BCVA均较术前明显提高(P<0.05)。结论对年龄相关性白内障患者应用iTrace分析仪测量DLI能够客观反映晶状体混浊程度,从而为病情评估及手术实施提供重要参考依据。
Objective To analyze the application value of lens dysfunction index(DLI)based on iTrace system in senile cataract assessment and surgical guidance.Methods 160 cases of senile cataract patients admitted to the Ophthalmology Department of our hospital from October 2018 to October 2019 were selected as the study subjects,another 160 healthy examinees in the same period were selected as the control group,routine ophthalmological examinations were performed and compared.Then LOCSⅢwas carried out for confirm,the patients were divided into three groups:karyotype group(n=44),cortical type group(n=62)and posterior subcapsular type group(n=54),DLI was measured by i Trace system.All patients underwent phacoemulsification,accumulated release energy(CDE)of phacoemulsification was recorded,Pearson correlation test was used to analyze the correlation between DLI values with indexes in each group,the diagnostic value of DLI was analyzed by drawing receiver operating characteristic curve(ROC curve).Visual recovery and visual quality satisfaction were observed after 3 months.Results There were statistical significances in routine examination indexes in ophthalmological cataract group and control group(P<0.05);DLI was negatively correlated with best corrected visual acuity(BCVA),nuclear opacity(NO),nuclear color(NC),CDE in karyotype group(r=-0.641,-0.512,-0.559,-0.830,P<0.05),ROC curve showed that the best truncation value of DLI was 3.12,and the sensitivity and specificity were 75.00%and 70.80%respectively;DLI in cortical type group was negatively correlated with BCVA and cortical cataract(CC)(r=-0.639,-0.518,P<0.05),but not with CDE(r=-0.183,P>0.05),ROC curve showed that the best truncation value of DLI was 2.49,and the sensitivity and specificity were 69.20%and 86.10%respectively;DLI in posterior subcapsular cataract group was negatively correlated with BCVA and posterior subcapsular cataract(PSC)(r=-0.851,-0.618,P<0.05),but not with CDE(r=-0.235,P>0.05),ROC curve shows that the best truncation value of DLI is 2.01,the sensitivity and specificity were 69.60%and 71.00%respectively;the naked visual acuity and BCVA of patients in each group were significantly improved compared with those before operation(P<0.05).Conclusion Measuring DLI with iTrace analyzer can objectively reflect the degree of lens opacity in elderly cataract patients,thus providing an important reference for disease assessment and operation implementation.
作者
路露
杨立东
赵俊
刘敏
Lu Lu;Yang Lidong;Zhao Jun;Liu Min(Cangzhou Central Hospital Medical Group Cangzhou Ophthalmological Hospital,Hebei,Cangzhou 061000,China)
出处
《临床眼科杂志》
2020年第1期52-57,共6页
Journal of Clinical Ophthalmology
基金
沧州市科技计划项目(编号:131302034)
