| BackgroundOcular dominance（OD） means that based on the binocular visual, the eye which linein the dominant position of gaze, perception and fusion. The development of oculardominance columns are divided into three phases: pre-critical period, critical period,post-critical period, the critical period is the age period of3years after birth, it is the keyperiod of human neural mature. The traditional view thought that after the critical period,the ocular dominance did not change, but with the development of the brain science,neural development study, neurobiology, electroneurophysiology, and through the methodsof visual evoked potential, extracellular microelectrode measurement and mark immediateearly genes, people found the mature mice which have monocular deprivation suffer thechange of ocular dominance. After Handa measured the ocular dominance through thebinocular balance competing technologies, he found that each people’s ocular dominancehad some kinds of difference, and provided the base for the change of ocular dominance.There were reports about after the laser in situ keratomileusis, some patients suffered thechange of ocular dominance, but there were no report about whether the patients’ oculardominance will change after the cataract surgery.Nowadays, in the ophthalmic clinical areas, the dominant eye mainly used thefollowing aspects: In the corneal refractive surgery and the optometry, when theeyes’diopter correctionwas imbalance, many choices could make the visual quality better inthe dominant eye[1]; In the treatment to Children’s amblyopia, the amblyopic eye woundchange to the dominant eye before6years old, and the treatment wound get better result;Making sure which is the ocular dominance in the strabotomy wound provide basis for thedesign of the operation[2], but the cataract surgery only applied to determine which eye washyperopia in the monocular visual surgery. Yaron studied52improved monocular cataractpatients, the researcher proceed the measure of the ocular dominance before and after thesurgery, and made sure that there are patients of crossed monovision(CMV) after the surgery, And the result show that all the patients with monovision can receive pleased farand near visual acuity after the cataract surgery. Now, the prospective study of theeffectiveness of the cross monovision cataract surgery was still not clearly reported.So, this research observed the situation of the ocular dominance change of the patientsafter binocular cataract surgery, and we proved that the ocular dominance had plasticity inthe adult period. On the base of this, we further assessed the importance and necessity ofthe ocular dominance measurement in the monocular cataract surgery, and observed theclinical effectiveness of cataract surgery of cross monovision.The first part is the research of ocular dominance change and the effect onvisual quality after binocular cataract phacoemulsification and intraocular lensimplantation surgeryObjectiveTo investigate ocular dominance change after binocular cataract surgery and domenstratethat ocular dominance has certain plastically after the key period.Methods:It was a prospective clinical case-series study. According to study standards46cataractpatients were randomly enrolled. All patients were received ocular dominance tests atpreoperative and postoperative1and3months. All patients were received the refractiontests at preoperative and postoperative3months. Each patient was recorded contrastsensitivity and accepted the investigation of visual quality satisfaction at postoperative3months.Results:1. The corrected visual acuity of dominant eyes is better than nondominant eyes beforecataract surgery. The myopia diopter was lower in the dominant eyes than nondominanteyes before surgery(P=0.01).Right eye of priority to make ocular dominance was greaterthan left eye before and after cataract surgery.2. There were13patients（28.3%）ocular dominance changed at1month after surgery,and11patients（23.9%）ocular dominance changed at3months after surgery.3. The contrast sensitivity and visual quality satisfaction had no statistic differencebetween patients with ocular dominance change or not after surgery （P>0.05）. ConclusionsSome patients could change ocular dominance after cataract surgery,whichdomenstrate that ocular dominance has certain plastically after the key period,but there isno impact to patient’s visual quality and satisfaction after ocular dominance change.The second part is to investigate visual function, visual quality and patientsatisfaction after pseudophakic crossed monovisionObjectiveTo investigate visual function, visual quality and patient satisfaction after pseudophakiccrossed monovisionMethods:According to study standards30cataract patients were randomly enrolled.All patientswere received ocular dominance tests at preoperative and postoperative3months. Allpatients were divided two groups,Group A: crossed monovision(the dominant eye iscorrected for near and the undominant eye is corrected for distance); Group B: conventionalmonovision (the dominant eye is corrected for distance and the undominant eye is correctedfor near). Parameters analyzed preoperative and postoperative3months includedbinocular uncorrected distance, near visual acuities, binocular corrected distance, nearvisual acuities; stereo vision； contrast sensitivity； spectacle independence; patientsatisfaction.All atients were administered the VF-14Questionnaire at postoperative3months.Results:1.3month after operation,there was no statistic difference between the crossedmonovision group and the conventional monovision group on BUDVA,BUNVA,BCDVA,BCNVA, refractive diopter (P>0.05).2.3month after operation,there was significant difference between two groups inmean contrast sensitivity（P<0.05）,but there was no statistic difference in difference spatialfrequency （P>0.05）3. there was no statistic difference between the crossed monovision group and theconventional monovision group on near stereopsis acuity with BUNVA after3month ofoperation（P>0.05）. 4. There was significant difference in distance satisfaction score between the twogroups after3month of operation（P <0.05）,but the near satisfaction and visual functionscore was no statistic difference（P>0.05）.5. Ocular dominance could change after pseudophakic crossed monovision（P<0.001）.ConclusionsThis research has verified that patients can obtain good visual function afterpseudophakic crossed monovision; however, some patients are not suitable for crossedmonivision cataract surgery, which further indicates that ocular dominance test is essentialfor pseudophakic crossed monovision.General Conclusions:1.This research has primarily verified that ocular dominance changes after binocularcataract surgery, which makes no impact on visual quality and satisfaction.2.This reseach has verified that cataract patients after crossed monivision cataractsurgery can obtain good near and distant vision; but distant vision satisfaction of somepatients after crossed monivision has decreased, which verifies that ocular dominance test isof important clinic significance for pseudophakic crossed monovision.Innovation and Clinic Significance:It is found that Some patients could change ocular dominance after cataract surgery; Itis the first prospective research to visual quality and visual function after pseudophakiccrossed monovision; and ocular dominance test before pseudophakic monovision isimportant clinic significance. |
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