目的：探讨白内障摘除手术单眼视设计中不同的近附加度数对白内障患者预后视觉质量的影响。

方法：选取2016-02/2017-02在我院进行白内障摘除手术的白内障患者84例168眼进行前瞻性研究，根据单眼视设计中近附加度数的不同，将入选患者分为低近附加度数组(1.25～1.75D)和高近附加度数组(2.25～2.75D)每组各42例84眼。比较两组患者的术后6mo双眼裸眼近视力、中距离视力、远视力及立体视，以及治疗前后的视功能生存质量评分。

结果：低近附加度数组患者的双眼裸眼中、远视力分别为0.27±0.20、0.09±0.08，高近附加度数组患者的双眼裸眼中、远视力分别为0.29±0.25、0.10±0.07，两组相比差异均无统计学意义(P>0.05)。高近附加度数组患者的双眼裸眼近视力为0.03±0.06，显著优于低近附加度数组0.07±0.04，差异具有统计学意义(P<0.05)。治疗前两组患者视功能指数量表(VF-14)评分分别为27.93±4.52、28.24±4.91分，治疗后两组患者视功能指数量表(VF-14)评分分别为82.04±14.31、81.22±13.70分，差异均无统计学意义(P>0.05)。与治疗前相比，两组患者治疗后VF-14评分均显著增加，差异具有统计学意义(P<0.05)。低近附加度数组患者正常立体视、周边立体视及黄斑立体视所占百分比分别为47.6%、31.0%、21.4%，高近附加度数组正常立体视、周边立体视及黄斑立体视所占百分比分别为42.9%、23.8%、33.3%，两组相比差异均无统计学意义(P>0.05)。

结论：白内障患者的两种近附加度数对提高单眼视设计白内障摘除手术后患者的裸眼视力、视功能生存质量及立体视均有相似的优越性。

METHODS: Totally 84 cases cataract patients(168 eyes)who receiving cataract surgery were enrolled from February 2016 to February 2017 in our hospital to conduct a prospective study. According to the different near addition in the monovision design, patients were divided into low near addition group(1.25D-1.75D)and high near addition group(2.25D-2.75D), each group was 42 cases. At postoperative 6mo, the binocular uncorrected near visual acuity, uncorrected intermediate visual acuity, uncorrected distance visual acuity and stereoscopic vision were compared between two groups. The visual function survival quality score before and after treatment were compared.

RESULTS: The binocular uncorrected intermediate and distance visual acuity in the low near addition group respectively was 0.27±0.20, 0.09±0.08, and that in the high near addition group respectively was 0.29±0.25, 0.10±0.07, which had no statistically significant difference between two groups(P>0.05). The binocular uncorrected near visual acuity in the high near addition group was 0.03±0.06, which was significantly better than the low near addition group 0.07±0.04, the difference was statistically significant(P<0.05). Before the treatment, the visual function-14(VF-14)score in each two group respectively was 27.93±4.52, 28.24±4.91; after the treatment, VF-14 score in each two group respectively was 82.04±14.31, 81.22±13.70, which had no statistically significant difference between two groups(P>0.05). After treatment, the VF-14 score both significantly increased in the two groups(P<0.05). The proportion of patients with the normal stereoscopic vision, peripheral stereovision and macular stereovision in the low near addition group respectively was 47.6%, 31.0%, 21.4%; and that in the high near addition group respectively was 42.9%, 23.8%, 33.3%, which had no statistically significant difference between two groups(P>0.05).

CONCLUSION: Two kinds of near addition have similar advantages to cataract patients after cataract surgery on uncorrected visual acuity, the quality of visual function and stereopsis.